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Pulmonary rehabilitation in chronic obstructive pulmonary disease

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Chest Diseases and Tuberculosis

Advisors

El-Hadidi, Ahmad A. , Masaoud, Husam H. , Muhammad, Amani R. , Ahmad, Naglaa B.

Authors

Shaaban, Marwa Muawwadh

Accessioned

2017-07-12 06:42:14

Available

2017-07-12 06:42:14

type

M.D. Thesis

Abstract

COPD affects various structural and functional domains in the lungs, leading to airflow limitation. It also has significant extrapulmonary effects. Weight loss, nutritional abnormalities, and skeletal muscle dysfunction are well-recognized systemic effects. Pulmonary rehabilitation (PR) programs are beneficial to COPD in order to improve exercise capacity, muscle force, symptoms, and health-related quality of life.The aim of study is to evaluate the efficacy of PR program as a non-pharmacological treatment method to:Improve functional capacity, improve dyspnea level as assessed by Modified Medical Research Council (MMRC) , improve Pulmonary function and improve Arterial blood gas.It was performed on forty five COPD patients presenting to chest outpatient clinic of Kasr El-Aini. They divided into: 15 patients subjected to Outpatient Hospital-Based supervised aerobic training program (Aerobic Training Group), 15 patients subjected to Inspiratory musclt training using incentive spirometry & respiratory exercises (Respiratory Training Group)and15 patients were included in Non-rehabilitation group (Control Group). All cases submitted to: Full history taking, clinical examination , routine laboratory parameters, plain Chest x- ray (P-A view), pre & post study Body weight and Body mass index (BMI) assessment, Pulmonary function tests (PFTS) and Arterial blood gas(ABG) analysis to estimate PaCO2, PaO2, SO2. .Both training groups showed no statistically significant improvement in BMI .There was an improvement in baseline dyspnea score grade (MMRC grade 2/3) , However didn’t reach a statistically significant. .As regards aerobic training group : There was a statistically significant improvement in 6 min walk test (P-value 0.001), BODE score(P-value 0.001) and both FEV1 (P-value 0.006) & FVC (P-value 0.002).Also there was a highly significant improvement of FVC% (P-value 0.006) than respiratory training group.Although there was no statistically significant difference in ABG variables between control and aerobic training groups, there was a statistically significant improvement of both PO2 (P-value 0.001) & Sat O2 (P-value 0.002) within aerobic training group. As regards respiratory training group: There was a higher % of improvement (66.7%) of dyspnea score grade within respiratory training group than aerobic training and control groups. Although there was no statistically significant difference of both physiological parameters and ABG variables between control and respiratory training groups, there was a significant improvement of both FVC (P-value 0.001) & FEV1 (P-value 0.047) and PO2(P-value 0.001) & Sat O2 (P-value 0.001) within respiratory training group. Short- term PR program (6-8 weeks) especially aerobic training program has the capacity to: Break the vicious circle of dyspnea, increasing inactivity and exercise intolerance- the hallmark features of COPD patients, improve physiological parameters (FVC&FEV1) and improve some components of BODE index.This findings suggested that even if the program duration does not exceed 8 weeks, it can still benefit patients with COPD.

Issued

1 Jan 2011

DOI

http://dx.doi.org/10.21473/iknito-space/37688

Details

Type

Thesis

Created At

28 Jan 2023