Pervin DEMİR, Pınar ERGÜN, Ezgi UTKU, Dicle KAYMAZ, Neşe DEMİR, Nurcan EGESEL, Fatma ŞENGÜL, İpek CANDEMİR

Pulmonary rehabilitation in interstitial lung diseases

Giriş: İnterstisyel akciğer hastalıkları, egzersiz dispnesi, egzersiz intoleransı, kuru öksürük ve yaşam kalitesinde bozulma ile karakterizedir. Bu çalışmada amaç, pulmoner rehabilitasyonun interstisyel akciğer hastalıkları üzerine olan etkisini değerlendirmektir.Materyal ve Metod: İnterstisyel akciğer hastalıkları tanısı olan ve merkezimize yönlendirilen ayaktan takip edilen 10 hasta, 8 hafta yoğun pulmoner rehabilitasyon programına alındı. Olguların; dispne algısı Medical Research Council ile, yaşam kaliteleri St. George Solunum Anketi (SGRQ) ile, vücut kompozisyonları biyoelektriksel impedans yöntemiyle, egzersiz kapasiteleri artan hızda mekik yürüme testi (AHMYT) ve endurans mekik yürüme testi (EMYT) ile, anksiyete ve depresyonları ise hastane anksiyete depresyon skalası (HADS) ile değerlendirildi. Çalışmaya alınan hastaların pulmoner rehabilitasyon programı öncesi ve sonrası parametreleri kaydedildi.Bulgular: Pulmoner rehabilitasyon programı sonrası olguların dispne algılarında (p: 0.023), anksiyete ve depresyon skorlarında iyileşme mevcuttu. (p: 0.026, p: 0.039). SGRQ'nun alt başlıIğı olan etki skorunda da istatistiksel anlamlı iyileşme saptandı (Z= 1.988; p= 0.047). Pulmoner rehabilitasyon sonrası AHMYT ortancasında 60 metre artış saptanmasına rağmen bu artış istatistiksel anlamlılığa ulaşmadı (Z= 1.863; p= 0.063). Fakat bu artış AHMYT için hesaplanan minimal klinik anlamlılık düzeyinden daha fazlaydı.Sonuç: Çalışmamızdaki sonuçlar da kuvvetle gösteriyor ki pulmoner rehabilitasyonun interstisyel akciğer hastalıklarının tedavisinde standart tedavi yaklaşımı olmalıdır ve olguların yönetiminde pulmoner rehabilitasyonun tanı aşamasından itibaren mutlaka yer almalıdır.

İnterstisyel akciğer hastalıklarında pulmoner rehabilitasyon

Introduction: Interstitial lung diseases are characterised by dyspnea on exertion, low quality of life, cough and exercise intolerance. The aim of this study was to evaluate the effects of comprehensive pulmonary rehabilitation in patients with interstitial lung disease.Materials and Methods: Data from patients who were referred to pulmonary rehabilitation with the diagnosis of interstitial lung diseases were included to this study. Ten patients with interstitial lung disease participated to our outpatient, 8 weeks, comprehensive pulmonary rehabilitation programme. Dyspnea was assessed with the Medical Research Council (MRC) scale; health related quality of life was assessed with the St.George's Respiratory Questionnaire (SGRQ). Exercise capacity was measured using the incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT); anxiety and depression were assessed with the hospital anxiety depression scale (HADS). All parameters were recorded before and after pulmonary rehabilitation programme.Results: Dyspnea sensation, anxiety and depression scores decreased after pulmonary rehabilitation (p: 0.023, p: 0.026, p: 0.039 respectively). Also impact domains of SGRQ significantly reduced (Z= 1.988; p= 0.047).The difference between median values of ISWT results before and after pulmonary rehabilitation was 60 meters. Although it was not statistically significant (Z= 1.863; p= 0.063), the level of increment was higher than the minimaly important clinical differance for ISWT.Conclusion: Our results showed that comprehensive pulmonary rehabilitation programmes were benefical for patients with interstitial lung diseases and it should be regarded as a standard care in this population from the early stages

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