Araya AK

Language: Spanish
References: 27
Page: 12-25
PDF size: 294.15 Kb.

ABSTRACT

The main objective of the study is to describe the response of the elderly patient with pulmonary osbtructive or interstitital lung disease to pulmonary rehabilitation program. Pulmonary rehabilitation is defined as a training exercise program and at least one of the following components: education, psychosocial and nutritional support, as defined in other studies.
Methods: Observational, descriptive and retrospective study.
Results: Of the 12 patients, only 9 completed the program. Dyspnea, according to the MMRC scale, improved by 42% and remained unchanged at 58%. There was a significant improvement in the six-minute walk (p = 0.009), in the PIMax in 83%, with an average of 16.6 kPa (16.9 cmH2O); the BODE index in 100% of patients (p = 0.015). In this index, the greatest improvement occurred in dyspnea components (p = 0.007) and W6M (p = 0.009). In the Saint George questionnaire, 75% received a positive response, with a greater response in symptoms. There was no improvement in FEV1 or FEV1 / FVC. Muscle endurance of upper and lower extremities increased. No variable had significant correlation with age, sex and FEV1.
Conclusions: Pulmonary rehabilitation in older adults with pulmonary osbtructive or interstitital lung disease shows a statistically significant response in the C6M walk, BODE index, respiratory muscle muscle strength and muscular endurance in upper and lower extremities. With improvement, but not statistically significant in the mMRC dyspnea scale, and Saint George questionnaire. There were no changes in the spirometric parameters

REFERENCES

1. Fernández X. Primer Informe de la Persona Adulta Mayor en Costa Rica. Universidad de Costa Rica, Octubre 2007.

2. Divo M, y Pinto-Plata V. Role of Exercise in Testing and in Therapy of COPD. Medicine Clinic of North America 2012; 96: 753 – 766.

3. Halter J, Ouslander J, Tinetti M et al. Hazzard ´s Geriatric Medicine and Gerontology. Six Edition. McGraw Hill Medical 2009; pags 983 – 1007.

4. Regiane V, Gorostiza A, Gáldiz JB, López E et al. Beneficios de un programa de rehabilitación respiratoria domiciliaria en pacientes con EPOC grave. Archivos de Bronconeumología 2007; 43: 599 – 604.

5. De Lucas P. ¿Cuánto debe durar la rehabilitación respiratoria?. Archivos de Bronconeumología 2001; 37: 459 – 460.

6. Rikli, R. y Jones, C. Functional fitness nor ma ti ve sco res for com mun nity-re si ding adults, ages 60-94. Journal of Aging and Physical Activity, 7 1999; 160-179.

7. Rikli, R. y Jones, C. Senior fitness test manual. Estados Unidos de América. Human Kinetics 2001.

8. Bestall J C, Paul E A, Garrod R, Garnham R, Jones P W, Wedzicha J A. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54: 581-6

9. Cote C G, Celli B R. Pulmonary rehabilitation and the BODE index in COPD. Eur Respir J 2005; 26: 630- 6.

10. Pathy J, Sinclair A, Morley J. Principles and Practice of Geriatric Medicine. Fourth Edition. Wiley Editorial, 2006; pags 665-730.

11. Connolly M, Shaw L. Respiratory Disease in Old Age. Research into Ageing Workshop. London, 1998. Age and Ageing 2000; 29: 281-285.

12. Matthews B. Alzheimer Disease Update. Continuum Lifelong Learning Neurol 2010;16(2):15–30.

13. Ries AL, Kaplan RM, Limberg TM, Prewitt LM. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine 1995; 122: 823.

14. Ries AL, Baldoff GS, Carlin BW, et al. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence – Based Clinical Practice Guidelines. Chest 2007; 131: 4S.

15. Di Meo F, Pedone C, Lubich S et al. Age does not hamper the response tp pulmonary rehabilitation of COPD patients. Age and Ageing 2008: 37 (5): 530 – 535.

16. Salhi B, Troosters T, Behaegel M et al. Effects of Pulmonary Rehabilitation in Patients with Restrictive Lung Diseases. Chest 2010; 137 (2): 273 – 279.

17. Nonna S. Factors Associated with Outcome among COPD Patients Undergoing Pulmonar Rehabilitation. Chest 2013; 144: 829A.

18. Tout R, Tavara L, Hamili M. The effects of respiratory nuscle training on improment of the internal and external thoraco – pulmonary respiratory mechanism in COPD paatients. Annals of Physical and Rehabilitation Medicine; 56 (3): 193 – 211.

19. Serón P, Riedemann P, Muñoz S, et al. Efecto del entrenamiento muscular inspiratorio sobre la fuerza muscular y la calidad de vida en pacientes con limitación crónica del flujo aéreo. Ensayo Clínico aleatorizado. Archivos de Bronconeumología 2005; 41 (11): 601- 606.

20. Crisafulli E, Gorgone P, Vagaggini B, et al. Efficacy of standard rehabilitation in COPD outoatients with comorbidities. European Respiratory Journal 2010; 26: 1042.

21. Miranda G, Gómez A, Pleguezuelos E, Capellas L. Rehabilitación respiratoria en España. Estudio SORECAR. Rehabilitación 2011; 45 (3): 247 – 255.

22. Pan L, Guo YZ, Yan JH, et al. Does upper extremity exercise improve disnea in patients with COPD? A meta-analysis. Respiratory Medicine 2012; 106: 151

23. Costi S, Crisafulli E, Antoni FD, et al. Effects of unsupported upper extremity exercise training in patients with COPD: a randomized clinical trial. Chest 2009; 136: 387.

24. Kavoura P, Harikiopoulou M, Dumitru S, et al. Does pulmonary rehabilitation – induced improvement in BODE index correlate with improvements in anxiety and depression and quality of life?. CHEST 2009; 136: 52S.

25. Nasis OG, Vogiatzis I, Stratakos G et al. Effects of interval – load versus constant – load training on the BODE index in COPD patients. Respiratory Medicine 2009; 103: 1392.

26. American College of Chest Physicians (ACCP). ACCP Pulmonary Medicine Board Review. 25th Edition. American College of Chest Physicians. 2009; Pags: 113 – 118.

27. Rosenberg S, Kalhan R. An Integrated Approach to the Medical Treatment of Chronic Obstructive Pulmonary Disease. Medical Clinic of North America 2012; 96: 811-826.