Publication: Kistik fibrozisli hastalarda solunum fizyoterapisine eklenen postüral egzersizlerin, sadece solunum fizyoterapisine göre postüre, solunum fonksiyonlarına, ağrıya, yaşam kalitesine etkilerinin araştırılması
Abstract
Amaç: Kistik Fibrozisli (KF) çocuklarda pulmoner rehabilitasyona eklenen postür egzersizlerinin, ağrı, egzersiz toleransı, solunum fonksiyonu, yaşam kalitesi, denge ve omurga deformitelerine etkisi araştırılmasıdır. Gereç- Yöntem: Çalışmaya 6-14 yaşları arası KF tanılı hastalar dahil edildi. Hastalar kapalı zarf sistemine göre iki gruba randomize edildi. İlk gruba altı hafta boyunca haftada bir kez pulmoner rehabilitasyon ve postür egzersizleri, ikinci gruba ise yalnızca pulmoner rehabilitasyon uygulandı. Her iki grup altı aylık rehabilitasyon süreci boyunca haftalık olarak telefonla takip edildi. Hastaların solunum fonksiyonu FEV1 ile, ağrı düzeyi VAS ile, egzersiz toleransı Modifiye Shuttle Testi (MST) ile, postüral stabilitesi Stabilite Limiti Testi (SLT) ile, yaşam kalitesi Yeniden Düzenlenmiş Kistik Fibrozis Anketi (CFQR) ile değerlendirildi. Omurga deformiteleri için Cobb ve Modifiye Cobb açıları ölçüldü. Değerlendirmeler tedavi öncesinde, tedavi sonrası altıncı hafta, üçüncü ay ve altıncı aylarda yapıldı. Torakal vertebra değerlendirmesi birbirinden bağımsız iki araştırmacı tarafından tedavi öncesi ve tedavi sonrası altıncı ayda yapıldı. Bulgular: Çalışmaya yaş ortalaması 9,37±2,17, vücut kitle indeksleri (VKİ) ortalaması 16,16±2,36 olan, 19 (%36,8 kız ve %63,2 erkek) hasta katıldı. Hastaların 10’u pulmoner rehabilitasyon ve egzersiz grubuna, 9’u ise pulmoner rehabilitasyon grubuna alındı. Gruplar yaş, VKİ, cinsiyet ve tedavi öncesi değerlendirme parametreleri açısından benzerdi (p>0,05). Tedavi sonrası her iki grup FEV1 ve MST değerlerinde artış saptanırken; postüral egzersizlerin eklendiği grupta CFQR emosyonel durum (p=0,012) ve tedaviye uyum (p=0,041) alt gruplarında artış tespit edildi. VAS, SLT, Cobb ve modifiye Cobb değerlerinde gruplar arası ve grup içi anlamlı farklılık bulunmadı (p>0,05). Sonuç: Henüz postürde belirgin değişikliğin oluşmadığı çocuk yaş grubu KF hastalarında göğüs fizyoterapisine eklenen postüral egzersiz programının solunum fonksiyonu, ağrı, egzersiz toleransı, postür ve dengede anlamlı değişiklikler meydana getirmezken, emosyonel durumu iyi yönde etkilediği ve tedaviye uyumu artırdığı gözlemlendi.
INVESTIGATION THE EFFECTS OF POSTURAL EXERCISES ADDED TO CHEST PHSIOTHERAPHY PROGRAM ON POSTURE, RESPIRATORY FUNCTIONS, PAIN AND QUALITY OF LIFE IN PATIENS WITH CYSTIC FIBROSISSabiha Güngör Karaca Supervisor: Prof Evrim Karadağ Saygı MD Department of Physical Medicine and RehabilitationİNGİLİZCE ÖZET (ABSTRACT) Objective: To investigate the effect of postural exercises addition to pulmonary rehabilitation in children with cystic fibrosis (CF) on pain, exercise tolerance, respiratory function, quality of life, balance and spinal deformities.Materials and Methods: Patients diagnosed with CF between the ages of 6 and 14 were included in the study. They were randomized into two groups according to the closed envelope system. The first group received pulmonary rehabilitation and posture exercises once a week for six weeks while the second group received only pulmonary rehabilitation. Both groups were followed by phone calls weekly for six months. Patients were evaluated for respiratory function with FEV1, pain level with VAS, exercise tolerance with Modified Shuttle Test (MST), postural stability with Limits of Stability Test (SLT), and Cystic Fibrosis Questionnaire- Revised Application (CFQR). Cobb and Modified Cobb angles were measured for spinal deformities. The assessments were made before the treatment, at the sixth week, the third month and the sixth month after the treatment. The thoracic vertebral measurement was performed by two independent researchers before treatment and at six months after treatment.Results: Nineteen patients (%36,8 female, %63,3 male) with the mean age 9,37±2,17 and mean body mass index (VKI) 16,16±2,36 included into the study. 10 of them were involved to pulmonary rehabilitation and exercise group and 9 to pulmonary rehabilitation group. Age, VKI, gender and baseline assessment parameters were similar in both groups (p>0,05). FEV1 and MST were increased in both groups after treatment; while emotional state (p=0,012) and treatment burden (p=0,041) subgroups of CFQR were increased only in the group with postural exercises. VAS, SLT, Cobb and modified Cobb inter-group and intra-group values were not shown any difference by treatment (p>0,05).Conclusion: It has been observed that the postural exercise program in addition to pulmonary rehabilitation in pediatric CF patients whose postural changes have not yet taken place does not cause significant changes in pain, exercise tolerance, posture and balance; however, it affected the emotional state well and improved the compliance with the treatment.
INVESTIGATION THE EFFECTS OF POSTURAL EXERCISES ADDED TO CHEST PHSIOTHERAPHY PROGRAM ON POSTURE, RESPIRATORY FUNCTIONS, PAIN AND QUALITY OF LIFE IN PATIENS WITH CYSTIC FIBROSISSabiha Güngör Karaca Supervisor: Prof Evrim Karadağ Saygı MD Department of Physical Medicine and RehabilitationİNGİLİZCE ÖZET (ABSTRACT) Objective: To investigate the effect of postural exercises addition to pulmonary rehabilitation in children with cystic fibrosis (CF) on pain, exercise tolerance, respiratory function, quality of life, balance and spinal deformities.Materials and Methods: Patients diagnosed with CF between the ages of 6 and 14 were included in the study. They were randomized into two groups according to the closed envelope system. The first group received pulmonary rehabilitation and posture exercises once a week for six weeks while the second group received only pulmonary rehabilitation. Both groups were followed by phone calls weekly for six months. Patients were evaluated for respiratory function with FEV1, pain level with VAS, exercise tolerance with Modified Shuttle Test (MST), postural stability with Limits of Stability Test (SLT), and Cystic Fibrosis Questionnaire- Revised Application (CFQR). Cobb and Modified Cobb angles were measured for spinal deformities. The assessments were made before the treatment, at the sixth week, the third month and the sixth month after the treatment. The thoracic vertebral measurement was performed by two independent researchers before treatment and at six months after treatment.Results: Nineteen patients (%36,8 female, %63,3 male) with the mean age 9,37±2,17 and mean body mass index (VKI) 16,16±2,36 included into the study. 10 of them were involved to pulmonary rehabilitation and exercise group and 9 to pulmonary rehabilitation group. Age, VKI, gender and baseline assessment parameters were similar in both groups (p>0,05). FEV1 and MST were increased in both groups after treatment; while emotional state (p=0,012) and treatment burden (p=0,041) subgroups of CFQR were increased only in the group with postural exercises. VAS, SLT, Cobb and modified Cobb inter-group and intra-group values were not shown any difference by treatment (p>0,05).Conclusion: It has been observed that the postural exercise program in addition to pulmonary rehabilitation in pediatric CF patients whose postural changes have not yet taken place does not cause significant changes in pain, exercise tolerance, posture and balance; however, it affected the emotional state well and improved the compliance with the treatment.