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ORIJINAL ARAŞTIRMA

Postakut COVID-19 Semptomlarında Kardiyopulmoner Rehabilitasyon ve Ev Temelli Egzersiz Programının Karşılaştırılması
Cardiopulmonary Rehabilitation Versus Home-Based Exercise Program for Post-Acute COVID-19 Symptoms
Received Date : 01 Sep 2023
Accepted Date : 18 Mar 2024
Available Online : 21 Mar 2024
Doi: 10.31609/jpmrs.2023-99394 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2024;27(2):105-13
ÖZET
Amaç: Dispne ve nefes darlığı gibi post-akut koronavirüs hastalığı- 2019 [coronavirus disease-2019 (COVID-19)] semptomlarında, kardiyopulmoner rehabilitasyon (KPR) ihtiyacı bilinmektedir. Ancak rehabilitasyon ünitelerinin kapasiteleri tüm post-akut COVID-19 hastalarını üstlenmeye yetmemektedir ayrıca bu da ekonomi üzerinde büyük bir yüktür. Bu çalışmanın amacı, KPR ve ev egzersiz programının, post-akut COVID-19 hastalarında egzersiz dayanıklılığı ve yaşam kalitesi üzerine etkileri kıyaslamaktır. Gereç ve Yöntemler: Bu retrospektif çalışma, hastanede (n=45) KPR uygulanan ve ev egzersiz programı verilen (n=43) toplam 88 post-akut COVID-19 hastanın dosya kayıtları ile yürütülmüştür. Her iki program da aerobik, solunum ve fleksibilite egzersizlerini içeriyordu (KPR: haftada 3 veya 4 gün, toplam 20 seans, ev egzersiz programı: haftada 3 veya 4 gün, 6 hafta boyunca). Egzersiz dayanıklılığı ölçümü için primer veri olarak 6 dakika yürüme testi (6DYT) kullanıldı. Sekonder veri olarak Borg-dispne/yorgunluk, ağrı için görsel analog skala [visual analogue scale (VAS)] ve Kısa Form-36 (KF-36) kullanıldı. Tüm tedavi öncesi ve sonrası primer ve sekonder veriler kayıt altına alındı. Bulgular: KPR grubunda, ev egzersiz programı grubuna göre Borg-dispne (p=0,004), yorgunluk (p=0,001), VAS-ağrı (p=0,034), KF-36: fiziksel fonksiyon (p=0,023), fiziksel rol (p=0,049), emosyonel rol (p=0,038), beden ağrısı (p=0,021), enerji (p=0,001) değerlerindeki gelişmeler daha fazla idi. Ancak 6DYT değerindeki gelişmeler her iki grupta benzerdi (p=0,266). Sonuç: KPR ve ev egzersiz programlarının egzersiz enduransı üzerine benzer etkileri göz önüne alındığında, hem güvenli hem de uygun maliyetli olan ev egzersiz programlarının, hastane temelli KPR programlarına alternatif olabileceği kanısındayız.
ABSTRACT
Objective: The need for cardiopulmonary rehabilitation (CPR) for post-acute coronavirus disease-2019 (COVID-19) symptoms such as dyspnea and fatigue is known. However, rehabilitation units cannot handle all post-acute COVID-19 patients also this would be a huge economic burden. This study aimed to compare the effect of CPR and home-based exercise programs on exercise endurance and quality of life in post-acute COVID-19 patients. Material and Methods: This retrospective study was conducted with the records of 88 post-acute COVID-19 patients who received CPR (n=45) or home exercise programs (n=43). Both programs included aerobic, breathing, and flexibility exercises (CPR: three or four days per week for a total of 20 sessions, home exercise program: three or four days per week over a period of six weeks). The results of the six-minute walk test (6MWT) were used for exercise endurance as a primary outcome measure. Borg-dyspnea/fatigue, the visual analog scale (VAS) for pain, and the Short Form-36 (SF-36) were used as secondary outcome measures. All before and after primary and secondary outcome measurements were recorded. Results: Borg-dyspnea (p=0.004), fatigue (p=0.001), VAS-pain (p=0.034), SF-36: physical function (p=0.023), physical role (p=0.049), emotional role (p=0.038), bodily pain (p=0.021) energy (p=0.001) showed more improvement in CPR group than home exercise program group. However, improvements in the 6MWT were similar in both groups(p=0.266). Conclusion: Considering that both CPR and home-based exercise programs showed similar effects on exercise endurance, we believe home exercise programs which are also safe and cost-effective could be an alternative to CPR programs.
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