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Duchenne musküler distrofi'de üst ekstremite dinamik egzersizinin solunum fonksiyonu ve yaşam kalitesi üzerine etkisi

Amaç: Çalışmamızın amacı; Duchenne Musküler Distrofi’li (DMD) çocuklarda üst ekstremite dinamik egzersizinin solunum fonksiyonu ile yaşam kalitesi üzerindeki etkilerini incelemek idi.Yöntemler: Bu çalışmada DMD tanısı almış, Brooke Üst Ekstremite Fonksiyonel Sınıflandırması (BÜEFS)’na göre Devre 1 veya 2’de yer alan çocuklar yazı-tura yöntemi ile randomize olarak çalışma ve kontrol gruplarına ayrıldı. Demografik bilgileri kaydedildi. Süreli performans testleri (sırtüstü yatıştan ayağa kalkma, T-shirt giyme/çıkarma), elektronik bir solunum kas kuvveti ölçüm aleti, PedsQL-3.0 Nöromusküler Modül çocuk/ebeveyn anketi sırasıyla üst ekstremite performansları, tepe ekspiratuar akım (TEA) ve sağlıkla ilişkili yaşam kalitelerini değerlendirmek için kullanıldı. Çalışma grubu elektronik kol ergometresinde 8 hafta, haftada 3 gün, ortalama 40 dakika çalıştırıldı. Kontrol grubuna ev programı olarak normal eklem hareketlerini içeren üst ekstremite egzersizleri uygulandı. 8 hafta sonunda değerlendirmeler tekrarlandı.Sonuçlar: Çalışmaya yaş ortalamaları sırasıyla 9.33±1.37 ve 9.50±1.38 olan 12’si kontrol ve 12’si çalışma grubuna toplam 24 DMD’li çocuk dahil edildi. Egzersiz programı sonrası sırtüstü yatıştan ayağa kalkma ve T-shirt giyme süresinde çalışma grubu lehine istatistiksel olarak anlamlı fark bulundu (p<0.05). Çalışma grubunda egzersiz sonrası TEA litre değerinde anlamlı artış bulundu (p<0.01). PedsQL-çocuk skorları ile TEA arasında, pozitif yönde, orta kuvvette (r=0.590; p<0.05); TEA ile T-Shirt giyme süresi arasında negatif yönde, kuvvetli (r=-0.629; p<0.05) ilişki bulundu. Tartışma: Çalışmamızda, DMD’li çocuklarda kol ergometresi ile gerçekleştirilen üst ekstremite dinamik egzersizinin, çocukların solunum performansını arttırdığı ve yaşam kaliteleri üzerinde olumlu etkiye sahip olduğu belirlenmiştir
Anahtar Kelimeler:

Duchenne kas distrofisi; ekshalasyon; aerobik egzersiz; üst ekstremite

Effects of upper extremity dynamic exercise on respiratory function and quality of life in duchenne muscular dystrophy

Purpose: The aim of this study was to investigate the effects of upper extremity dynamic exercise on respiratory function and quality of life in children with Duchenne Muscular Dystrophy (DMD). Methods: In this study, children who diagnosed DMD scored as Level 1 or 2 according to the Brooke Upper Extremity Functional Classification (BUEFC) were divided into study and control groups with coin toss method randomly. Demographic datas were recorded. Timed performance tests (standing from supine, T-Shirt wearing/removing), electronic respiratory muscle strength device and Pediatric Quality of Life-3.0 (PedsQL-3.0) Neuromuscular Module child/parent questionnaire were used for evaluation of upper extremity performances, peak expiratory flow (PEF) and health-related quality of life, respectively. Study group had trained in arm ergometer, 8 weeks, 3 days per week, mean 40 minutes. Control group was applied normal range of motion upper extremity exercises as home programme. Assessments were repeated after 8 weeks. Results: 24 DMD children, 12 control and 12 study subjects, respectively with mean age 9.33±1.37 and 9.50±1.38 were evaluated. Statistically significant differences were found in favor of study group in standing from supine position and T-shirt wearing time after exercise program (p<0.05). Significant increase was found in PEF liter value in study group (p<0.01). There were positive, moderate correlation between PedsQL-child scores and PEF (r=0.590; p<0.05); negative, strong correlation between PEF and T-Shirt wearing time (r=-0.629; p<0.05).Discussion: It was found that upper extremity dynamic exercise with arm ergometer increased respiratory function and showed positive effect on quality of life of children with DMD
Keywords:

Duchenne muscular dystrophy; exhalation; aerobic exercise; upper extremity,

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Türk Fizyoterapi ve Rehabilitasyon Dergisi-Cover
  • ISSN: 2651-4451
  • Başlangıç: 1974
  • Yayıncı: Türkiye Fizyoterapistler Derneği
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Duchenne musküler distrofi'de üst ekstremite dinamik egzersizinin solunum fonksiyonu ve yaşam kalitesi üzerine etkisi