Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation

TOKTAŞ, HASAN; ULAŞLI, Alper Murat; SOLAK, Özlem; EROĞLU, SELMA; ÖZKEÇECİ, Gülay; DÜNDAR, Ümit; AKÇİ, Önder; YAMAN, Fatima

Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation

Özlem SOLAK, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Fatima YAMAN, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Alper Murat ULAŞLI, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Selma EROĞLU, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Önder AKÇİ, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Kardiyoloji Kliniği, Afyon, Türkiye)

Gülay ÖZKEÇECİ, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Kardiyoloji Kliniği, Afyon, Türkiye)

Hasan TOKTAŞ, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Ümit DÜNDAR (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Afyon, Türkiye)

Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi

0 0

Yıl: 2015 Cilt: 61 Sayı: 2 Sayfa Aralığı: 130 - 135 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation

Öz:

Amaç: Kardiyak rehabilitasyon programında (KRP), hastalar kardiyak bir olay veya işlem sonrasında optimal fiziksel ve psikososyal sağlık durumlarına ulaşabilmeleri ve koruyabilmeleri için desteklenir. Biz bu çalışmada kardiyopulmoner rehabilitasyon ünitemizde uyguladığımız KRPnın etkilerini retrospektif olarak değerlendirmeyi amaçladık. Gereç ve Yöntemler: Otuz seansı tamamlamış koroner arter hastalığı (KAH) olan 40, koroner arter baypas graft (KABG) operasyonu geçirmiş 10 hastanın kayıtları değerlendirildi. KRP, sabit kalp hızı yöntemi ile bisiklet ergometresiyle uygulanan aerobik ve üst ve alt ekstremiteleri güçlendirme egzersizlerini içeriyordu. Hastaların vital bulguları bisiklet ergometresi kullanılarak yapılan aerobik egzersiz süresince monitörize edildi. Hastaların yaşam kaliteleri Short Form-36 (SF-36), aerobik egzersiz kapasiteleri ve metabolik eşlenik (MET) düzeyleri Bruce protokolünde yapılan efor testi, fonksiyonel kapasiteleri 6 dakika yürüme testi (6DYT), depresyon düzeyleri ise Beck Depresyon Envanteri (BDE) uygulanarak belirlendi. Bulgular: KRPnin sonunda KAHda SF-36 anketinin sosyal fonksiyon, emosyonel rol ve mental komponent hariç tüm alt birimlerinde, KABG hastalarında ise fiziksel fonksiyon, fiziksel rol, sosyal fonksiyon ve mental sağlık alt birimlerinde istatistiksel anlamlı artış gözlendi (p<0,05). Hastaların ortalama MET değeri her iki grup hastada anlamlı artış gösterdi (p<0,05). 6 DYT ortalaması ise KAHda 455,3±66,4den KRP sonunda 522,7±68,5 mye, KABG hastalarında da 389,1±88,5den 495,0±99,1e istatistiksel anlamlı olarak arttı (p<0,05). BDE skoru KAHda 4,3±7,1den 2,9±4,3e istatistiksel anlamlı düşüş gösterirken (p<0,05), KABG hastalarında anlamlı düşüş gözlenmedi. Sonuç: Kardiyopulmoner rehabilitasyon ünitemizde, bisiklet ergometre sistemi kullanarak endurans eğitimini uyguladığımız KRP, KAH ve KABG hastalarımızın yaşam kalitesinde, fonksiyonel kapasitesinde düzelmeler sağlamıştır. Depresyon düzeyinde düzelme ise yalnız KAHda gözlemlenmiştir.

Anahtar Kelime:

Konular: Rehabilitasyon

Kardiyak Rehabilitasyon Sonrasında Yaşam Kalitesi, Fonksiyonel Kapasite ve Depresyon Düzeyinde Düzelme

Öz:

Objective: In cardiac rehabilitation program (CRP), patients are supported to achieve and maintain optimal physical and psychosocial health following a recent cardiac event or procedure. In this study, we aimed to retrospectively assess the effects of CRP in our cardiopulmonary rehabilitation unit. Material and Methods: Records of 40 patients with a diagnosis of coronary artery disease (CAD) and 10 patients who had undergone coronary artery bypass graft surgery (CABG) and who completed 30 sessions were evaluated. CRP comprised aerobic exercise with cycle ergometer and the upper and lower extremity strengthening exercises. The patients vital signs were monitored during the cycle ergometer exercise. The quality of life of the patients were evaluated with the Short Form-36 (SF-36), aerobic exercise capacity and metabolic equivalent (MET) levels were assessed with the effort test using the Bruce protocol, their functional capacity was assessed with a 6-min walk test, and depression levels were assessed with the Beck Depression Inventory. Results: After CRP, there were statistically significant differences in all subunits of SF-36 except social function, emotional role, and mental component in patients with CAD (p≤0.05). In patients with CABG, physical function, physical role, social function, and mental health subunits of SF-36 significantly improved (p≤0.05). The patients mean MET values significantly increased in both the groups (p≤0.05). The mean 6-MWT distances significantly increased from 455.3±66.4 to 522.7±68.5 m after CRP in patients with CAD (p<0.001). Furthermore, in patients with CABG, the mean 6-MWT distances significantly increased from 389.1±88.5 to 495.0±99.1 m (p≤0.05). There was significant decrease in BDI score from 4.3±7.1 to 2.9±4.3 in patients with CAD (p≤0.05). However, no significant change in mean BDI score was observed in patients with CABG. Conclusion: In our cardiopulmonary rehabilitation unit, CRP, comprising endurance exercise using cycle ergometer, improved the quality of life and functional capacity in patients with CAD and CABG. However, the improvement in depression level was observed only in patients with CAD.

Anahtar Kelime:

Konular: Rehabilitasyon

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Ades PA. Medical progress: cardiac rehabilitation and secondary prevention of coronary artery disease. N Eng J Med 2001;345:892- 902. [CrossRef]
2. World Health Organization Expert Committee On Rehabilitation: rehabilitation after cardiovascular diseases, with special emphasis on developing countries: report of a WHO Committee. World Health Organ Tech Rep Ser 1993;831:1-122.
3. Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction: combined experience of randomized clinical trials. JAMA 1988;260:945-50. [CrossRef]
4. OConnar GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS JR, et al. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 1989;80:234-44. [CrossRef]
5. Shepherd CW, While AE. Cardiac rehabilitation and quality of life: a systematic review. Int J Nurs Stud 2012;49:755-71. [CrossRef] 6. Ware JE Jr. SF-36 health survey update. Spine 2000;25:3130-39. [CrossRef]
7. Dempster M, Donnelly M. Measuring the health related quality of life of people with ischaemic heart disease. Heart 2000;83:641-4. [CrossRef]
8. Yohannes AM, Doherty P, Bundy C, Yalfani A. The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life. J Clin Nurse 2010;19:2806-13. [CrossRef]
9. Listerman J, Bittner V, Sanderson BK, Brown TM. Cardiac rehabilitation outcomes: impact of comorbidities and age. J Cardiopulm Rehabil Prev 2011;31:342-8. [CrossRef]
10. Bittner V. Six-minute walk test in patients with cardiac dysfunction. Cardiologia 1997;42:897-902.
11. Blumenthal JA, Babyak MA, OConnor C, Keteyian S, Landzberg J, Howlett J, et al. Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA 2012;308:465-74. [CrossRef]
12. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (KF-36)nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-6.
13. Robertson LD, Ewing AS, Bentley BJ. American thoracic society statement: Guidelines fort he six-minute walk test. Guidelines for pulmonary rehabilitation programs. Human Kinetics 2004;127-8.
14. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793-801. [CrossRef]
15. Beck AT, Steer RA, Garbin MG J. Psychometric properties of the Beck Depression Inventory twenty-five years of evaluation. Clin Psych 1988;8:77-100. [CrossRef]
16. Hsu CJ, Chen SY, Su S, Yang MC, Lan C, Chou NK, et al. The effect of early cardiac rehabilitation on health-related quality of life among heart transplant recipients and patients with coronary artery bypass graft surgery. Transplant Proc 2011;43:2714-7. [CrossRef]
17. Karapolat H, Eyigör S, Zoghi M, Yagdi T, Nalbangil S, Durmaz B. Comparison of hospital-supervised exercise versus home-based exercise in patients after orthotopic heart transplantation: effects on functional capacity, quality of life, and psychological symptoms. Transplant Proc 2007;39:1586-8. [CrossRef]
18. Stauber S, Guéra V, Barth J, Schmid JP, Saner H, Znoj H, et al. Psychosocial outcome in cardiovascular rehabilitation of peripheral artery disease and coronary artery disease patients. Vasc Med 2013;18:257-62. [CrossRef]
19. Sanderson BK, Schumann C, Breland J, Williams N, Saunders K, Bittner V. Six-minute walk assessment in cardiac rehabilitation: is there a standard for functional performance? Med Sci Sport 2005;37:1186. [CrossRef]
20. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Resp Crit Care Med 1998;158:1384-7. [CrossRef]
21. Stahle A, Mattson E, Ryden L, Unden A, Nordlander R. Improved physical fitness and quality of life following training of elderly patients after acute coronary events: a 1 year follow-up randomized controlled study. Eur Heart J 1999;20:1475-84. [CrossRef]
22. Karapolat H, Demir E, Bozkaya YT, Eyigör S, Nalbantgil S, Durmaz B, et al. Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters. Clin Res Cardiol 2009;98:635-42. [CrossRef]
23. Freyssin C, Verkindt C, Prieur F, Benaich P, Maunier S, Blanc P. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, highintensity interval training versus continuous training. Arch Phys Med Rehabil 2012;93:1359-64. [CrossRef]
24. Jelinek HF, Huang ZQ, Khandoker AH, Chang D, Kiat H. Cardiac rehabilitation outcomes following a 6- week program of PCI and CABG patients. Front Physiol 2013;4:302. [CrossRef]
25. Blumenthal JA, Sherwood A, Babyak A, Watkins LL, Smith PJ, Hoffman BM, et al. Exercise and pharmacological treatment of depressive symptoms in patients with coronary heart disease. J Am Coll Cardiol 2012;18:1053-63.
26. Milani RV, Lavie CJ. Impact of cardiac rehabilitation on depression and its associated mortality. Am J Med 2007;120:799-806. [CrossRef]
27. Karapolat H, Engin C, Eroğlu M, Yağdı T, Zoghi M, Nalbantgil S, et al. Efficacy of cardiac rehabilitation program in patients with endstage heart failure, heart transplant patients, and left ventricular assist device recipients. Transplant Proc 2013;45:3381-5. [CrossRef]
28. Kulcu DG, Yurtais Y, Tur BS, Gülec S, Seckin B. The effect of cardiac rehabilitation on quality of life, anxiety and depression in patients with congestive heart failure. A randomized controlled trial, shortterm results. Eura Medicophys 2007;43:489-97.
29. Sharif F, Shoul A, Janati M, Kojuri J, Zare N. The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran. BMC Cardiovasc Disord 2012;12:40. [CrossRef]
30. Adams BJ, Carr JG, Ozonoff A, Lauer MS, Balady GJ. Effect of exercise training supervised cardiac rehabilitation programs on prognostic variables from the exercise tolerance test. Am J Cardiol 2008;101:1403-7. [CrossRef]
31. Rechcinski T, Kalowski M, Kasprzak JD, Trzos E, Kurpesa M. Beneficial effects of cardiac rehabilitation in patients with incomplete revascularization after primary coronary angioplasty. Eur J Phys Rehabil Med 2013;49:785-91.
32. Shabani R, Gaeini AA, Nikoo MR, Nikbackt H, Sadegifar M. Effect of cardiac rehabilitation program on exercise capacity in women undergoing coronary artery bypass graft in Hamadan-İran. Int J Prev Med 2010;1:247-51.

APA	SOLAK Ö, YAMAN F, ULAŞLI A, EROĞLU S, AKÇİ Ö, ÖZKEÇECİ G, TOKTAŞ H, DÜNDAR Ü (2015). Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. , 130 - 135.
Chicago	SOLAK Özlem,YAMAN Fatima,ULAŞLI Alper Murat,EROĞLU SELMA,AKÇİ Önder,ÖZKEÇECİ Gülay,TOKTAŞ HASAN,DÜNDAR Ümit Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. (2015): 130 - 135.
MLA	SOLAK Özlem,YAMAN Fatima,ULAŞLI Alper Murat,EROĞLU SELMA,AKÇİ Önder,ÖZKEÇECİ Gülay,TOKTAŞ HASAN,DÜNDAR Ümit Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. , 2015, ss.130 - 135.
AMA	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. . 2015; 130 - 135.
Vancouver	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. . 2015; 130 - 135.
IEEE	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü "Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation." , ss.130 - 135, 2015.
ISNAD	SOLAK, Özlem vd. "Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation". (2015), 130-135.

APA	SOLAK Ö, YAMAN F, ULAŞLI A, EROĞLU S, AKÇİ Ö, ÖZKEÇECİ G, TOKTAŞ H, DÜNDAR Ü (2015). Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 61(2), 130 - 135.
Chicago	SOLAK Özlem,YAMAN Fatima,ULAŞLI Alper Murat,EROĞLU SELMA,AKÇİ Önder,ÖZKEÇECİ Gülay,TOKTAŞ HASAN,DÜNDAR Ümit Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 61, no.2 (2015): 130 - 135.
MLA	SOLAK Özlem,YAMAN Fatima,ULAŞLI Alper Murat,EROĞLU SELMA,AKÇİ Önder,ÖZKEÇECİ Gülay,TOKTAŞ HASAN,DÜNDAR Ümit Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.61, no.2, 2015, ss.130 - 135.
AMA	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2015; 61(2): 130 - 135.
Vancouver	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2015; 61(2): 130 - 135.
IEEE	SOLAK Ö,YAMAN F,ULAŞLI A,EROĞLU S,AKÇİ Ö,ÖZKEÇECİ G,TOKTAŞ H,DÜNDAR Ü "Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 61, ss.130 - 135, 2015.
ISNAD	SOLAK, Özlem vd. "Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 61/2 (2015), 130-135.