Respiratoire revalidatie.

Transcriptie

1 Respiratoire revalidatie

2 Inactiviteit bij COPD Pitta, AJRCCM 2005

3 Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Deconditionering Inactiviteit Gedaald inspannings vermogen

4 Probability hospitalization free Gevolgen van inactiviteit: hospitalisatie Q4 VMU>270 Q3 Q2 Q1 VMU VMU VMU<130 Time (months) Garcia-Rio, Chest 2012

5 Gevolgen van inactiviteit: mortaliteit Probability of survival1.0 Q4 Q3 Q2 Q1 VMU>270 VMU VMU VMU< Time (months) Garcia-Rio, Chest 2012

6 Gevolgen van inactiviteit: longfunctie FEV 1 gedurende 20 jaar Pelkonen, AJRCCM 2003

7 Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Deconditionering Inactiviteit Gedaald inspannings vermogen

8 Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Exacerbaties Deconditionering Inactiviteit Gedaald inspannings vermogen

9 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

10 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

11 Δ 6 MWD (m) Δ CRDQ (punten) Effecten van revalidatie Start 6 18 Start 6 18 training controle Tijd (mnd) Tijd (mnd) Troosters, Am J Med 2000

12 Δ 6 MWD (m) Δ CRDQ (punten) Effecten van revalidatie Mc Carthy, Cochrane 2015

13 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

14 Effecten van revalidatie Statistisch niet significant Statistisch significant Adapted from Troosters, Eur Respir Rev 2010

15 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

16 Ergospirometrie Wandeltest

17 Perifere spierkrachtmeting

18 Respiratoire spierkrachtmeting

19 Vragenlijst fysieke activiteit Fysieke activiteit Levenkwaliteit (A) Hoeveel keer per week voert u gewoonlijk gedurende 20 minuten een hoog intense fysieke activiteit uit die u doet zweten, puffen of hijgen? (bijvoorbeeld joggen, snel fietsen, heffen van zware lasten, of graven) 3 keer/week (Score: 4) 1 2 keer/week (Score: 2) niet (Score: 0) (B) Hoeveel keer per week voert u gewoonlijk gedurende 30 minuten een matig intense fysieke activiteit uit die uw hartslag verhoogt of uw ademhaling versnelt? (bijvoorbeeld wandelen, fietsen, gras maaien) 5 keer/week (Score: 4) 3 4 keer/week (Score: 2) 1 2 keer/week (Score: 1) niet (Score: 0) Totaal: Score A + Score B: HOUDEN) doen) Score >4 Score 0 3 Voldoende actief (moedig de patiënt aan om VOL TE Onvoldoende actief (moedig de patiënt aan om MEER te Marshall, A. L. et al Br J Sports Med 39:

20 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

21 Inspanningstraining

22 Educatie

23 Gedragsverandering

24 Wat is respiratoire revalidatie? Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the longterm adherence of health-enhancing behaviors.

25 Revalidatie niet enkel bij COPD Interstitieel longlijden MWD(m) Rehab Control Perez, ERS 2011

26 Revalidatie niet enkel bij COPD t 6MWD %pred Training Control Pre Longtransplantatie * * Post 3mPost 1yPost Langer, Am J Transplant MWD(m) Interstitieel longlijden Rehab Control Perez, ERS 2011

27 Selectiecriteria voor revalidatie ESW < 30 % ESW 30 < 40 % ESW 40 < 50 % ESW + 50 % MWD (%) CRDQ (pts) QUADR (%) Revalis study group 2003

28 Selectiecriterium: spierkracht <40% 40-50% 50-60% 60-70% 70-80% 80-90% Nl Change 6MWD (m) Troosters J Cardiopul Rehab 2001

29 Δ 6 MWD (m) Revalidatie versus exacerbatie Mc Carthy, Cochrane 2015

30 Δ 6 MWD (m) Δ 6 MWD (m) Revalidatie versus exacerbatie Mc Carthy, Cochrane 2015 Puhan, Cochrane 2010

31 Revalidatie versus exacerbatie Moore, Chest 2016

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