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Esra PEHLIVAN * Akif TURNA*, Atilla GURSES* H. Nilg ü n GURSES **

EFFECTS OF PREOPERATIVE INTENSIVE PULMONARY REHABILITATION FOR A WEEK ON RESPIRATORY FUNCTION AND EXERCISE CAPACITY OF PATIENTS WITH LUNG CANCER. Esra PEHLIVAN * Akif TURNA*, Atilla GURSES* H. Nilg ü n GURSES ** * Yedikule Chest Disease and Chest Surgery Hospital , Istanbul.

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Esra PEHLIVAN * Akif TURNA*, Atilla GURSES* H. Nilg ü n GURSES **

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  1. EFFECTS OF PREOPERATIVE INTENSIVE PULMONARY REHABILITATION FOR A WEEK ON RESPIRATORY FUNCTION AND EXERCISE CAPACITY OF PATIENTS WITH LUNG CANCER Esra PEHLIVAN * Akif TURNA*, Atilla GURSES* H. Nilgün GURSES ** * Yedikule Chest Disease and Chest Surgery Hospital , Istanbul. ** Istanbul Bilim University, School of Health, Department of Physical Therapy and      Rehabilitation, Istanbul.

  2. Objective The aim of this study was to investigate the effect of short and intensive preoperative pulmonary rehabilitation, on lung functions and exercise capacity of patients with lung cancer.

  3. Methods • January 2007- August 2008 • 60 patient • Prospective, randomized, controlled

  4. Inclusion Criteria • Planned to operete with thoracotomy • Clinical stage IA to IIIB • Detected lung tumour • >ASA II or better

  5. Exclusion Criteria • Severe cardiac diseases, • Severe cognitive problems and phychiatric diseases • Physical limitations

  6. IA-IIIB AC CA Mdx. First evaluation (Pre-operative,before rehabilitation) Hospital record number-single Hospital record number-dual 1 week hospital stay Home Physical Therapy Pre-operative 2. evaluation Operatation Post-operative physical therapy Final evaluation Algorithm of study

  7. Method • Parameters; • LFT • Effort capacity

  8. Method • Physical therapy • Pre-operative stage • Post-operative stage

  9. Pre-operative Physical Therapy and Rehabilitation • Breathing exercises • İncentive spirometry usage • Coughing technics • Walking training

  10. Diaphragmatic Breathing Exercise Pre-operative Physical Therapy and Rehabilitation Gürses HN, Astımlı hastaların Tedavisinde Fizyoterapi Rehabilitasyon. İn: Gürses HN, Polat MG, editör. Astımla Birlikte Sorunsuz Yaşamak. İstanbul: Türkiye Fizyoterapistler Derneği İstanbul Bölge Temsilciliği Yayını; 1995. pp. 10-25.

  11. Pursed Lip Breathing Pre-operative Physical Therapy and Rehabilitation Gürses HN. KOAH’da Fizyoterapi Rehabilitasyon ve Egzersiz Eğitimi. “KOAH’ta Solunum Rehabilitasyonu” TÜSAD 28. Ulusal Kongresi Antalya. 2006; 59-60.

  12. Segmental Breathing Exercise Pre-operative Physical Therapy and Rehabilitation Ralph Braunschweig. Physical Therapy for The Thoracic Surgical Patient. İn; Shields TW, ed.. General Thoracic Surgery. USA: Williams and Wilkins; 1994. pp. 371-378.

  13. İncentive spirometry usage Pre-operative Physical Therapy and Rehabilitation Weiner P. The Effect Of Incentive Spirometry And Inspiratory Muscle Training On Pulmonary Function After Lung Resection. J Thorac Cardiovasc Surg 1997; 113: 552-557.

  14. Pre-operative Physical Therapy and Rehabilitation • Coughing technics McCool FD, Rosen MJ.Nonpharmacologic Airway Clearance Therapies: ACCP Evidence-Based Clinical. Practice Guidelines. Chest 2006; 129: 250-259.

  15. Walking training Pre-operative Physical Therapy and Rehabilition Star JA. Choronic Pulmonary Disfunction. İn; O.’Sullivan SB, editör. Physical Rehabilitation Assesment and Treatment . Philadelphia: F.A.Davis Company; 1994. pp. 277-295.

  16. Pre-operative Physical Therapy and Rehabilitation • Control Group??

  17. Post-operative Physical Therapy and Rehabilitation • Breathing exercises, • İncentive spirometry usage, • Couphing, • Extremity and shoulder girdle exercises, • Postür exercises, • Positioning, • Walking, • TENS.

  18. Results Table 1 : Demographic characteristics of patients in study and control group.*. *Independent student t test, ** BMI: Body mass index

  19. ResultsTable 2: Preoperative respiration function parameter of the patients in study and control group-1.* *Independent student t test

  20. ResultsTable 3: Preoperative respiration function parameter of the patients in study and control group-2.* *Independent student t test

  21. Table 4: The pulmonary function parameters measured before pulmonary physical therapy, operation and before discharge-1.* Results *Covaryans analysis, ** Preop. : preoperative.

  22. Table 5: The pulmonary function parameters measured before pulmonary physical therapy, operation and before discharge-2.* Results *Covaryans analysis, ** Preop. : preoperative.

  23. Table 6: Percentage of postoperative pulmonary functions decrease in study and control groups.* Results * Independent student t test.

  24. Table 7: The value of study groups’ pulmonary function and arterial blood gases before and after preoperative pulmonary physical therapy and rehabilitation.* Results *Paired t test.

  25. Tablo 8: Walking heart rates, total walking duration, total walking distance and maximum speed which were recorded during the first and last walking settings.* Results *Paired t test.

  26. Table 9: Maximum heart rate, walking heart rate-percentages during walking education.* Results *Paired t test.

  27. Brief - 1 • Increased pulmonary function .

  28. Brief - 2 • Also had positive effects on effort capacity.

  29. THANKS…

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