Kardiyak ve Pulmoner Rehabilitasyon
Özet
Kardiyovasküler hastalıklar günümüzde halen en sık ölüm nedenleri arasındadır. Kardiyak rehabilitasyon (KR), kardiyovasküler hastalığın (KVH) ilerlemesini önlemeye çalışan, risk faktörlerini azaltan bireyin fiziksel, psikolojik, sosyal, mesleki ve ekonomik iyilik hallerini iyileştiren ikincil tedavi programıdır. KR,maliyet- etkin tedavilerin ön plana çıktığı günümüz dünyasında kardiyovasküler hastalıklarla mücadelede önemli bir kaynaktır. Kardiyovasküler dayanıklılığı arttırma amacıyla yoğun aerobik egzersizlerin yapıldığı egzersiz eğitim dönemi, maksimal nitelikte egzersiz tolerans testi ile başlar. Genellikle hastanede, hastanın egzersiz kapasitesi belirlendikten sonra koşu bandı veya ergometrik bisiklette egzersiz yaptırılır. Egzersiz şiddetinin, hastanın kısıtlanmış olan kardiyak kapasitesinin üzerine çıkarak tehlike oluşturmasına engel olmak, aritmi ve iskemi gibi kardiyovasküler yanıtlarını önlemek için monitörizasyon uygulanır. Egzersize dayalı KR; kardiyovasküler mortaliteyi, tekrarlayan kardiyak olayları ve hastaneye yatışları azalttığı doğrulanmış ve sağlıkla ilişkili yaşam kalitesinde iyileşmeler sağlamıştır. Kronik solunum hastalıkları, küresel olarak hastalar ve sağlık sistemleri üzerinde yüksek bir morbidite ve mortalite yükü oluşturmaktadır. Pulmoner rehabilitasyon (PR), kronik solunum hastalığı olan bireyin fiziksel ve psikolojik durumlarını iyileştirmeye yönelik; egzersiz eğitimi ve davranış değişikliğini içeren hasta değerlendirmesi ile başlayan multidisipliner uygulamalardır. Pulmoner rehabilitasyona katılım, kronik obstrüktif akciğer hastalığı (KOAH) ve diğer solunum hastalıklarında; nefes darlığını azaltır, egzersiz kapasitesini arttırır ve sağlıkla ilişkili yaşam kalitesini iyileştirir, hastaneye başvuruları ve hastaneye yatış sonrası ölüm riskini azaltır.
Cardiovascular diseases(CVD) are still among the most common causes of death today.
Cardiac rehabilitation(CR) is a secondary treatment program that reduces risk factors that try to prevent the progression of CVD and improves the physical, psychological ,social, occupational and economic well-being of the individual.CR is an important resource in the fight against CVD in today’s world where cost- effective treatments are at the forefront.The exercise training period in which intensive aerobic exercise are performed to increase cardiovascular endurance begins with a maximal exercise tolerance test.Usually,after determining the patient’s exercise capacity in the hospital,they are made to exercise on a treadmill or ergometric bike.Monitoring is applied to prevent the intensity of the exercise from exceeding the patient’s limited cardiac capacity and creating a danger and to prevent cardiovascular responses such as arrhythmia and ischemia.Exercise – based CR has been proven to reduce cardiovascular mortality,recurrent cardiac events and hospitalizations and has provided improvements in health- related quality of life. Chronic respiratory diseases(CRD) impose a high morbidity and mortality burden on patients and healthcare systems globally.Pulmonary rehabilitation (PR) is a multidisciplinary practice that begins with patient assessment,including exercise training and behavioral changes to improve the physical and psychological conditions of individuals with CRD.Participation in PR reduces dyspnea in chronic obstructive pulmonary disease and other respiratory diseases.İncreases exercise capacity and improves health-related quality of life.Reduces hospital admissions and the risk of death following hospitalization.
Referanslar
Geler, D., & Gürsel, Y. (2003). Kardiyak rehabilitasyon. Turkiye Klinikleri Journal of Physical Medicine Rehabilitation, 3(1), 26-36.
İnkaya, B. V., & Oğuz, S. (2010). Kardiyak rehabilitasyon. Yoğun Bakım Hemşireliği Dergisi, 14(1), 14-19.
Piepoli, M. F., et al. (2010). Secondary prevention through cardiac rehabilitation: From knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil, 17(1), 1-17.
World Health Organization, et al. (2007). Prevention of Cardiovascular Disease. Pocket guidelines for assessment and management of cardiovascular risk. Africa: Who/Ish Cardiovascular Risk Prediction Charts for the African Region. World Health Organization.
Demirsoy, N. (2010). Epidemiology of cardiovascular diseases/Kardiyovaskuler hastaliklarin epidemiyolojisi. Turkish Journal of Physical Medicine and Rehabilitation, 4-10.
Jones, J., et al. (2012). The BACPR standards and core components for cardiovascular prevention and rehabilitation 2012. Retrieved from https://www.bacpr.com/resources/46C_BACPR_Standards_and_Core_Components_2012.pdf
World Health Organization, et al. (1993). Rehabilitation after cardiovascular diseases, with special emphasis on developing countries: Report of a WHO expert committee [meeting held in Geneva from 21 to 18 October 1991]. World Health Organization.
Akman, M., & Civek, S. (2022). Dünyada ve Türkiye’de kardiyovasküler hastalıkların sıklığı ve riskin değerlendirilmesi. The Journal of Turkish Family Physician, 13(1), 21-28.
Kaplan, Ş. (2014). Kardiyak Rehabilitasyon. Spor Hekimliği Dergisi, 49(2), 053-061.
Oğuz, H., Dursun, E., & Dursun, N. (2004). Tıbbi rehabilitasyon. Nobel Tıp Kitabevleri.
Giannuzzi, P., et al. (2003). Secondary prevention through cardiac rehabilitation: Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. European Heart Journal, 24(13), 1273-1278.
Dibben, G. O., Faulkner, J., Oldridge, N., et al. (2023). Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis. European Heart Journal, 44(6), 452-469. https://doi.org/10.1093/eurheartj/ehac747
Squires, R. W., et al. (1990). Cardiovascular rehabilitation: Status, 1990. In R. W. Squires, J. K. Vetrovec, & S. A. Greenberg (Eds.), Mayo Clinic Proceedings (pp. 731-755). Elsevier.
American College of Sports Medicine, et al. (2007). Exercise and acute cardiovascular events: Placing the risks into perspective: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation, 115(17), 2358-2368.
Karapolat, H., & Durmaz, B. (2008). Kardiyak rehabilitasyonda egzersiz. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi, 8(1).
Boydak, B. (2017). Yaşlı hastalarda kardiyak rehabilitasyon. Turk Kardiyol Dern Ars, 45(5), 117-119.
Martin, S. S., et al. (2024). 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation, 149(8), e347-e913.
Kaminsky, L. A., et al. (2016). Assessment of physical as an essential component in cardiac rehabilitation: Position statement of the America Cardiovascular and Pulmonary Rehabilitation Association. Journal of Cardiopulmonary Rehabilitation and Prevention, 36(4), 217-229.
Aktürk, S. (2016). Akut Koroner Sendromlu Hastalarda Kardiyak Rehabilitasyon. Medicine Science, 5(1), 244-252.
Mezzani, A., et al. (2013). Aerobic exercise intensity in cardiac rehabilitation evaluation and prescription: Joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Cardiovascular and Pulmonary Rehabilitation Association, and the Canadian Cardiac Rehabilitation Association. European Journal of Preventive Cardiology, 20(3), 442-446.
Uysal, H., et al. (2012). Kardiyak rehabilitasyon ve hemşirenin sorumlulukları. Kardiyovasküler Hemşirelik Dergisi, 3(3), 49-59.
Sazak, Y., Kanadlı, K. A., & Olgun, N. (2021). KARDİYAK REHABİLİTASYON EKİP ÇALIŞMASINDA HEMŞİRENİN ROL VE SORUMLULUKLARI. Yoğun Bakım Hemşireliği Dergisi, 24(3), 217-226.
Öncü, G. T., et al. (2016). Kardiyak Rehabilitasyonun Tanımı, Ekip Çalışmasının Önemi ve Ekip Üyelerinin Rolleri. Journal of Cardiovascular Nursing, 7(Suppl 2), 35-40.
Fernandez, R. S., et al. (2011). Improving cardiac rehabilitation services—Challenges for cardiac rehabilitation coordinators. European Journal of Cardiovascular Nursing, 10(1), 37-43.
Gürses, H. N. (2012). Dünyada ve Türkiye'de kardiyak rehabilitasyon konusunda yaşanan güçlükler. Turkiye Klinikleri Cardiology-Special Topics, 5(2), 9-13.
Levine, G. N., & Balady, G. J. (1993). The benefits and risks of exercise training: The exercise prescription. In G. N. Levine & G. J. Balady (Eds.), Advances in Internal Medicine (Vol. 38, pp. 57-79).
Rochester, C. L., et al. (2023). Pulmonary rehabilitation for adults with chronic respiratory disease: An official American Thoracic Society clinical practice guideline. American Journal of Respiratory and Critical Care Medicine, 208(4), e7-e26.
McCarthy, B., et al. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2.
Spruit, M. A., et al. (2013). An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188(8), e13-e64.
Holland, A. E., et al. (2024). European Respiratory Society Clinical Practice Guideline on symptom management for adults with serious respiratory illness. European Respiratory Journal, 44(6), 1428-1446.
Holland, A. E., et al. (2014). An official European Respiratory Society/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease. European Respiratory Journal, 44(6), 1428-1446.
Dowman, L. M., et al. (2017). The evidence of benefits of exercise training in interstitial lung disease: A randomised controlled trial. Thorax, 72(7), 610-619.
Wapenaar, M., et al. (2020). The effect of the walk-bike on quality of life and exercise capacity in patients with idiopathic pulmonary fibrosis: A feasibility study. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 37(2), 192.
Agustí, A., et al. (2023). Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine, 207(7), 819-837.
Moore, E., et al. (2016). Pulmonary rehabilitation as a mechanism to reduce hospitalizations for acute exacerbations of COPD: A systematic review and meta-analysis. Chest, 150(4), 837-859.
Ries, A. L., et al. (1995). Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 122(11), 823-832.
Çilingir, B. M., Pulmoner Rehabilitasyonda Yapay Zeka; Giyilebilir Takip Cihazları.
Akdemir, N. (Ed.). (2021). İç hastalıkları ve hemşirelik bakımı. Akademisyen Kitabevi.
Arslan, Y. (2022). Pulmoner Rehabilitasyon. Turkiye Klinikleri Thoracic Surgery-Special Topics, 13(2), 126-131.
Referanslar
Geler, D., & Gürsel, Y. (2003). Kardiyak rehabilitasyon. Turkiye Klinikleri Journal of Physical Medicine Rehabilitation, 3(1), 26-36.
İnkaya, B. V., & Oğuz, S. (2010). Kardiyak rehabilitasyon. Yoğun Bakım Hemşireliği Dergisi, 14(1), 14-19.
Piepoli, M. F., et al. (2010). Secondary prevention through cardiac rehabilitation: From knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil, 17(1), 1-17.
World Health Organization, et al. (2007). Prevention of Cardiovascular Disease. Pocket guidelines for assessment and management of cardiovascular risk. Africa: Who/Ish Cardiovascular Risk Prediction Charts for the African Region. World Health Organization.
Demirsoy, N. (2010). Epidemiology of cardiovascular diseases/Kardiyovaskuler hastaliklarin epidemiyolojisi. Turkish Journal of Physical Medicine and Rehabilitation, 4-10.
Jones, J., et al. (2012). The BACPR standards and core components for cardiovascular prevention and rehabilitation 2012. Retrieved from https://www.bacpr.com/resources/46C_BACPR_Standards_and_Core_Components_2012.pdf
World Health Organization, et al. (1993). Rehabilitation after cardiovascular diseases, with special emphasis on developing countries: Report of a WHO expert committee [meeting held in Geneva from 21 to 18 October 1991]. World Health Organization.
Akman, M., & Civek, S. (2022). Dünyada ve Türkiye’de kardiyovasküler hastalıkların sıklığı ve riskin değerlendirilmesi. The Journal of Turkish Family Physician, 13(1), 21-28.
Kaplan, Ş. (2014). Kardiyak Rehabilitasyon. Spor Hekimliği Dergisi, 49(2), 053-061.
Oğuz, H., Dursun, E., & Dursun, N. (2004). Tıbbi rehabilitasyon. Nobel Tıp Kitabevleri.
Giannuzzi, P., et al. (2003). Secondary prevention through cardiac rehabilitation: Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. European Heart Journal, 24(13), 1273-1278.
Dibben, G. O., Faulkner, J., Oldridge, N., et al. (2023). Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis. European Heart Journal, 44(6), 452-469. https://doi.org/10.1093/eurheartj/ehac747
Squires, R. W., et al. (1990). Cardiovascular rehabilitation: Status, 1990. In R. W. Squires, J. K. Vetrovec, & S. A. Greenberg (Eds.), Mayo Clinic Proceedings (pp. 731-755). Elsevier.
American College of Sports Medicine, et al. (2007). Exercise and acute cardiovascular events: Placing the risks into perspective: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation, 115(17), 2358-2368.
Karapolat, H., & Durmaz, B. (2008). Kardiyak rehabilitasyonda egzersiz. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi, 8(1).
Boydak, B. (2017). Yaşlı hastalarda kardiyak rehabilitasyon. Turk Kardiyol Dern Ars, 45(5), 117-119.
Martin, S. S., et al. (2024). 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation, 149(8), e347-e913.
Kaminsky, L. A., et al. (2016). Assessment of physical as an essential component in cardiac rehabilitation: Position statement of the America Cardiovascular and Pulmonary Rehabilitation Association. Journal of Cardiopulmonary Rehabilitation and Prevention, 36(4), 217-229.
Aktürk, S. (2016). Akut Koroner Sendromlu Hastalarda Kardiyak Rehabilitasyon. Medicine Science, 5(1), 244-252.
Mezzani, A., et al. (2013). Aerobic exercise intensity in cardiac rehabilitation evaluation and prescription: Joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Cardiovascular and Pulmonary Rehabilitation Association, and the Canadian Cardiac Rehabilitation Association. European Journal of Preventive Cardiology, 20(3), 442-446.
Uysal, H., et al. (2012). Kardiyak rehabilitasyon ve hemşirenin sorumlulukları. Kardiyovasküler Hemşirelik Dergisi, 3(3), 49-59.
Sazak, Y., Kanadlı, K. A., & Olgun, N. (2021). KARDİYAK REHABİLİTASYON EKİP ÇALIŞMASINDA HEMŞİRENİN ROL VE SORUMLULUKLARI. Yoğun Bakım Hemşireliği Dergisi, 24(3), 217-226.
Öncü, G. T., et al. (2016). Kardiyak Rehabilitasyonun Tanımı, Ekip Çalışmasının Önemi ve Ekip Üyelerinin Rolleri. Journal of Cardiovascular Nursing, 7(Suppl 2), 35-40.
Fernandez, R. S., et al. (2011). Improving cardiac rehabilitation services—Challenges for cardiac rehabilitation coordinators. European Journal of Cardiovascular Nursing, 10(1), 37-43.
Gürses, H. N. (2012). Dünyada ve Türkiye'de kardiyak rehabilitasyon konusunda yaşanan güçlükler. Turkiye Klinikleri Cardiology-Special Topics, 5(2), 9-13.
Levine, G. N., & Balady, G. J. (1993). The benefits and risks of exercise training: The exercise prescription. In G. N. Levine & G. J. Balady (Eds.), Advances in Internal Medicine (Vol. 38, pp. 57-79).
Rochester, C. L., et al. (2023). Pulmonary rehabilitation for adults with chronic respiratory disease: An official American Thoracic Society clinical practice guideline. American Journal of Respiratory and Critical Care Medicine, 208(4), e7-e26.
McCarthy, B., et al. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2.
Spruit, M. A., et al. (2013). An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188(8), e13-e64.
Holland, A. E., et al. (2024). European Respiratory Society Clinical Practice Guideline on symptom management for adults with serious respiratory illness. European Respiratory Journal, 44(6), 1428-1446.
Holland, A. E., et al. (2014). An official European Respiratory Society/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease. European Respiratory Journal, 44(6), 1428-1446.
Dowman, L. M., et al. (2017). The evidence of benefits of exercise training in interstitial lung disease: A randomised controlled trial. Thorax, 72(7), 610-619.
Wapenaar, M., et al. (2020). The effect of the walk-bike on quality of life and exercise capacity in patients with idiopathic pulmonary fibrosis: A feasibility study. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 37(2), 192.
Agustí, A., et al. (2023). Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine, 207(7), 819-837.
Moore, E., et al. (2016). Pulmonary rehabilitation as a mechanism to reduce hospitalizations for acute exacerbations of COPD: A systematic review and meta-analysis. Chest, 150(4), 837-859.
Ries, A. L., et al. (1995). Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 122(11), 823-832.
Çilingir, B. M., Pulmoner Rehabilitasyonda Yapay Zeka; Giyilebilir Takip Cihazları.
Akdemir, N. (Ed.). (2021). İç hastalıkları ve hemşirelik bakımı. Akademisyen Kitabevi.
Arslan, Y. (2022). Pulmoner Rehabilitasyon. Turkiye Klinikleri Thoracic Surgery-Special Topics, 13(2), 126-131.
