Kronik Obstruktif Akciğer Hastalığının Amfizem Fenotipinde Egzersiz Kapasitesini Etkileyen Faktörler

Amaç: Çalışmamızın amacı Kronik Obstruktif Akciğer Hastalığının (KOAH) amfizem fenotipindeki olgularında egzersiz kapasitesini etkileyen faktörlerin ve egzersiz programlarının hastaların klinik durumları üzerine etkisinin belirlenmesidir. Gereç ve Yöntemler: Amfizem tanısı almış olup egzersiz programına alınan hastalar çalışmaya dahil edildi. Hastalara 2 ay süresince aerobik ve rezistif egzersiz programı uygulandı. Hastaların egzersiz kapasitesi 6 dakikalık yürüme testi mesafesi (6DYM) ile, dispne algısı modifiye Medical Research Concile (mMRC) dispne skoru ile, ve semptom şiddetleri KOAH değerlendirme anketi ile (CAT) değerlendirildi. Ayrıca 1. saniyedeki Force Ekspiratuar Volümleri (FEV1), Force Vital Kapasiteleri (FVC) ve beden kitle indeksleri (BKİ)’de kaydedildi. Program sonu klinik durumdaki değişimler ve yürüyüş testinden elde edilen yürüme mesafesi ile diğer klinik özellikler arasında ilişki analizi yapıldı. Bulgular: Çalışmaya toplam 66 hasta dahil edildi. Yaş ortalaması 64, %91’i erkekti. Program sonu değerlendirmede 6DYM’de (p=.000), mMRC’de (p=.000) ve CAT değerlerinde (p=.000) istatistiksel olarak anlamlı fark elde edildi. Başlangıç 6DYM ile BKİ (r=.355), mMRC (r=.553), FEV1% (r=.323) ve FVC% (r=.277) ile korelasyon saptandı. Program sonu 6DYM’de meydana gelen gelişim ile mMRC (r=.279) ve FEV1% (r=.262)’de meydana gelen değişimler arasında ilişki bulundu. Sonuç: Bu çalışma, amfizem hastalarında egzersiz kapasitesinin vücut kompozisyonu, solunum fonksiyonları ve semptomlarla ilişkili olduğunu, egzersiz programlarının egzersiz kapasitesi, dispne ve hastalık semptomları üzerine olumlu etkileri olduğunu göstermiştir.

Factors Affecting Exercise Capacity of Emphysema Phenotype of Chronic Obstructive Pulmonary Disease

Objective: The aim of our study is to determine the effect of exercise factors and exercise programs on the clinical status of patients with Chronic Obstructive Pulmonary Disease (COPD) in the emphysema phenotype. Materials and Methods: Patients diagnosed with emphysema and included in the exercise program were included in the study. Aerobic and resistive exercise program was applied to the patients for 2 months. The exercise capacity of the patients was assessed with a 6-minute walking test distance (6MWM), dyspnea perception was modified with a modified Medical Research Concile (mMRC) dyspnea score, and symptom severity was assessed by the COPD assessment questionnaire (CAT). In addition, Force Expiratory Volumes in one seconds (FEV1), Force Vital Capacities (FVC), and body mass indices (BMI) were recorded. Relationship between changes in clinical status and walking distance obtained from walking test and other clinical features were made at the end of the program. Results: A total of 66 patients were included in the study. The average age was 64 and 91% were male. A statistically significant difference was obtained in 6MWD (p = .000), mMRC (p = .000) and CAT values (p = .000). Initial 6MWD was correlated with body mass index(r=.355), mMRC (r = .553), FEV1% (r = .323) and FVC% (r = .277). At the end of the program, there was a relationship between the development in 6MWD and changes in mMRC (r = .279) and FEV1% (r = .262). Conclusions: This study showed that exercise capacity is associated with body composition, pulmonary functions and symptoms in emphysema patients, and exercise programs have positive effects on exercise capacity, dyspnea and disease symptoms.

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