Bronşektazili hastalarda solunum kas eğitiminin egzersiz kapasitesine etkisinin araştırılması
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Özalp, Ö., Investigation the effect of respiratory muscle training on exercise capacity in patients with bronchiectasis. Hacettepe University, Health Sciences Institute PhD Thesis in Cardiopulmonary Rehabilitation, Ankara, 2017. There are few studies investigating respiratory muscle training in bronchiectasis patients. For this reason, further studies are needed to examine the effect of respiratory muscle training on important physiological and clinical outcomes in bronchiectasis patients. In this study, it was aimed to assess the impact of high-intensity inspiratory muscle training on exercise capacity in bronchiectasis patients. In this study, 45 individuals diagnosed with bronchiectasis were randomly assigned into two groups using the computer program. High-intensity inspiratory muscle training was given one group (H-IMT) three days per week for eight weeks, while the same training protocol with low-intensity inspiratory muscle training was given the other group (Control). Subjects’ demographic and physical characteristics were recorded. Before and after treatment, pulmonary functions by a spirometer, respiratory muscle strength using mouth pressure device, respiratory muscle endurance with a constant load test, dyspnea perception by MMRC scale, fatigue perception by Fatigue Severity Scale, exercise capacity using incremental shuttle walking test and the quality of life with Leicester Cough Questionnaire were measured. The physical and demographic characteristics, number of exacerbations in the last year, symptoms and findings, pulmonary function test results, fatigue perception levels, respiratory muscle strength and endurance values, exercise capacity parameters were similar before treatment between H-IMT and control groups (p>0,05). In the H-IMT group, the number of hospitalizations in the last year and hemoptysis were significantly higher than the control group (p<0,05). The pre-treatment MMRC dyspnea score and the Leicester Cough Questionnaire social dimension score of the H-IMT group were significantly lower than the control group (p<0,05). The results showed that there was statistically significant increase in the maximal inspiratory and expiratory muscle strength, duration of respiratory muscle endurance test, the distance of incremental shuttle walking test and Leicester Cough Questionnaire social dimension score in the H-IMT group when compared to the control group (p<0,05). In conclusion, respiratory muscle training improves exercise capacity, inspiratory and expiratory muscle strength and endurance and the quality of life in patients with bronchiectasis. Further studies are needed to understand the effects of respiratory muscle training on respiratory functions, dyspnea, and fatigue perception. These results should be taken into consideration regarding the studies that investigate the efficacy of pulmonary rehabilitation programs and clinical applications for bronchiectasis patients.