تأثیر تمرینات توانبخشی ریوی بر عملکرد ریوی، اکسیژن شریانی، استرس، افسردگی و کیفیت زندگی بیماران پساکرونا

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشکده علوم ورزشی، گروه فیزیولوژی ورزشی، دانشگاه حکیم سبزواری، سبزوار، ایران.

2 دانشکده علوم ورزشی، گروه فیزیولوژی ورزشی، دانشگاه حکیم سبزواری، سبزوار، ایران. مرکز تحقیقات بیماریهای غیر واگیر، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران

3 بخش فوق تخصصی ریه، گروه داخلی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران

چکیده

زمینه و هدف: کووید-19 یک بیماری عفونی با قدرت واگیری بسیار زیاد می­باشد که مدیریت و کنترل آن همچنان یک چالش برای دستگاه‌های بهداشتی جامعه به‌شمار می‌رود. عفونت‌های شدید تنفسی با پیامدهای بسیار گسترده از جمله هایپوکسی، لنفوپنی، تنگی نفس و آسیب حاد قلبی از جمله تظاهرات این بیماری است. خستگی، کاهش عملکرد ریوی و مشکلات روان‌شناختی از جمله افسردگی، استرس، کاهش کیفیت زندگی و اختلال حرکتی از مشکلات ماندگار پساحاد بهبودیافتگان ویروس کروناست. به‌دلیل جدید بودن ویروس کرونا یافته‌های یکپارچة فراوانی بر پایة تأثیرگذاری تمرینات توانبخشی بر بهبود وضعیت بدنی، عملکرد ریوی و ذهنی بیماران پساکرونایی در دست نیست. بنابراین پژوهش حاضر با هدف تعیین تأثیر یک دوره تمرینات توانبخشی ریوی بر عملکرد ریوی، اکسیژن شریانی، استرس، افسردگی و کیفیت زندگی بیماران پساکرونایی انجام گرفت.
مواد و روش‌ها: در تحقیق حاضر، 42 بیمار (22 مرد و 20 زن) با شدت‌های متوسط تا شدید پیامدهای بیماری کووید 19 در ردة سنی 45-70 سال، به دو گروه تمرین و کنترل تقسیم شدند. برنامة گروه مداخله شامل گروه تمرین به مدت هشت هفته تمرینات هوازی، ذهنی و تنفسی (سه روز در هفته هر جلسه 80 دقیقه) تحت نظارت و مانیتورینگ (پایش) اکسیژن شریانی EKG صورت گرفت. سنجش عملکرد ریوی (PFT) شدت استرس از راه پرسشنامة استاندارد استرس کرونا (CSS-18)، شدت افسردگی از راه پرسشنامة افسردگی بک نسخة دوم و کیفیت زندگی از طریق پرسشنامةSF-36 در آغاز و پایان تمرینات توانبخشی ریوی مورد سنجش قرار گرفت. برای مقایسة دو گروه کنترل و تمرین از آزمون تی مستقل استفاده شد.
نتایج: حمایت اکسیژن بیماران در گروه توانبخشی به شکل شایان توجه و معناداری کاهش یافت (001/0P<). تراز اشباع اکسیژن خون شریانی  SaO2(%)در گروه تمرینات توانبخشی ریوی نسبت به کنترل به شکل معناداری در شرایط استراحت، تمرین و فعالیت بدنی بهبود یافت (001/0P<). همچنین شاخص‌های عملکرد ریوی (001/0P<)، اکسیژن شریانی (001/0P<) و کیفیت زندگی (001/0P<) به‌طور معناداری بهبود یافت و میزان استرس (05/0P<) و افسردگی (01/0P<) کاهش معناداری را در مقایسه با گروه کنترل نشان داد.
نتیجه‌گیری: با توجه به درگیری چندجانبة بیماری کرونا و پیامدهای بی‌شمار آن و تأثیرات متنوع و فراگیر برنامة بازتوانی ریوی، به‌نظر می‌رسد تمرینات توانبخشی ریوی بتواند در روند بهبودی عملکرد و اکسیژن‌رسانی دستگاه ریوی، همچنین کاهش شدت استرس، افسردگی و کیفیت زندگی و به‌طور کلی بر توانایی عملکردی و روان‌شناختی بیماران پس از ابتلا به کرونا مؤثر و سودمند باشد.
 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of pulmonary rehabilitation training on pulmonary function, arterial oxygen, stress, depression and quality of life in post-coronavirus patients

نویسندگان [English]

  • zahra jalili 1
  • hamid marefati 2
  • asghar kazemzadeh 3
  • amir hossein haghighi 1
1 Faculty of Sports Sciences, Department of Sports Physiology, Hakim Sabzevari University, Sabzevar, Iran.
2 Faculty of Sports Sciences, Department of Sports Physiology, Hakim Sabzevari University, Sabzevar, Iran. Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
3 Pulmonary Subspecialty Department, Department of Internal Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
چکیده [English]

Background and Purpose: Covid-19 is an infectious disease with a very high contagion in the society that its management and control is still considered a challenge for the health systems. Severe respiratory infections with corona various (COVID 19) complications such as hypoxia, lymphopenia, shortness of breath and heart disorders are among the manifestations of this disease. Fatigue, reduced lung function, reduced cardio-respiratory capacity, psychological problems such as depression and stress, reduced quality of life, and movement disorder are some of the permanent post-acute problems of people who have recovered from the corona virus. Due to the novelty of the corona virus, there is not much consistent evidence that rehabilitation training are effective in improving the physical condition, pulmonary and mental function in post-coronavirus patients. Therefore, the purpose of this study was to investigate the efficacy of pulmonary rehabilitation training on pulmonary function, arterial oxygen, stress, depression and quality of life in post-covid patients.
Materials and Methods: Forty two patients (22 men and 20 women) with moderate to severe consequences of the covid-19 disease in the age range of 45-70 years were admitted to comprehensive 8-week outpatient pulmonary rehabilitation programme and divided into two groups of training and control. The trining protocol included eight weeks of aerobic, mental and breathing exercises (three days a week, 80 minutes per session) under the supervision and monitoring of arterial oxygen EKG. Pulmonary function measurement (PFT), Corona Stress Standard Questionnaire (CSS-18), depression intensity (Beck Depression Questionnaire), and quality of life (SF-36 questionnaire) were assessed befor and after the pulmonary rehabilitation program. Independent t-test was used to compare the data between control and training groups.
Results: The oxygen support in patients with pulmonary rehabilitation was significantly reduced (p<0.001). In addition, the level of oxygen saturation in arterial blood (SaO2%) was significantly improved in the pulmonary rehabilitation group compared to the control both at rest, during exercise and physical activity (p<0.001). The pulmonary function indices (FVC, FEV1), and quality of life significantly (p<0.001) improved in rehabilitation group, whereas the level of stress (p<0.05) and depression (p<0.01) showed significant decreases compared to the control group.
Conclusion: Considering the multifaceted involvement of corona disease and its numerous complications, it seems that compehensive pulmonary rehabilitation training could be effective in post-covid patients through improving the performance, oxygenation of the pulmonary system, and quality of life, as well as reducing the stress and depression which total improve the functional and cognitive abilities.
 

کلیدواژه‌ها [English]

  • Covid-19
  • Rehabilitation Training
  • Depression
  • Stress
  • Spirometry Index

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  • تاریخ دریافت: 21 خرداد 1402
  • تاریخ بازنگری: 15 مهر 1402
  • تاریخ پذیرش: 23 مهر 1402
  • تاریخ اولین انتشار: 08 آذر 1402
  • تاریخ انتشار: 01 بهمن 1402

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