Respiratoire revalidatie Iris.coosemans@uzleuven.be
Inactiviteit bij COPD Pitta, AJRCCM 2005
Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Deconditionering Inactiviteit Gedaald inspannings vermogen
Probability hospitalization free Gevolgen van inactiviteit: hospitalisatie Q4 VMU>270 Q3 Q2 Q1 VMU 200-270 VMU 130-200 VMU<130 Time (months) Garcia-Rio, Chest 2012
Gevolgen van inactiviteit: mortaliteit 0.8 0.6 0.4 Probability of survival1.0 Q4 Q3 Q2 Q1 VMU>270 VMU 200-270 VMU 130-200 VMU<130 0 20 40 60 80 Time (months) Garcia-Rio, Chest 2012
Gevolgen van inactiviteit: longfunctie FEV 1 gedurende 20 jaar Pelkonen, AJRCCM 2003
Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Deconditionering Inactiviteit Gedaald inspannings vermogen
Gevolgen van inactiviteit COPD Ventilatoire noden Flow limitatie Air Trapping Hyperinflatie Dyspnoe Exacerbaties Deconditionering Inactiviteit Gedaald inspannings vermogen
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.
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.
Δ 6 MWD (m) Δ CRDQ (punten) Effecten van revalidatie 150 100 50 0-50 -100-150 30 20 10 0-10 -20 Start 6 18 Start 6 18 training controle Tijd (mnd) Tijd (mnd) Troosters, Am J Med 2000
Δ 6 MWD (m) Δ CRDQ (punten) Effecten van revalidatie Mc Carthy, Cochrane 2015
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.
Effecten van revalidatie Statistisch niet significant Statistisch significant Adapted from Troosters, Eur Respir Rev 2010
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.
Ergospirometrie Wandeltest
Perifere spierkrachtmeting
Respiratoire spierkrachtmeting
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. 2005. Br J Sports Med 39:294-297.
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.
Inspanningstraining
Educatie
Gedragsverandering
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.
Revalidatie niet enkel bij COPD Interstitieel longlijden 70 60 50 40 30 20 10 0 10 20 30 6MWD(m) Rehab Control Perez, ERS 2011
Revalidatie niet enkel bij COPD t 6MWD %pred 100 90 80 70 60 50 40 Training Control Pre Longtransplantatie * * Post 3mPost 1yPost Langer, Am J Transplant 2012 6MWD(m) Interstitieel longlijden 70 60 50 40 30 20 10 0 10 20 30 Rehab Control Perez, ERS 2011
Selectiecriteria voor revalidatie 40 35 30 25 20 15 ESW < 30 % ESW 30 < 40 % ESW 40 < 50 % ESW + 50 % 10 5 0 6MWD (%) CRDQ (pts) QUADR (%) Revalis study group 2003
Selectiecriterium: spierkracht 180 160 140 120 100 80 <40% 40-50% 50-60% 60-70% 70-80% 80-90% Nl 60 40 20 0 Change 6MWD (m) Troosters J Cardiopul Rehab 2001
Δ 6 MWD (m) Revalidatie versus exacerbatie Mc Carthy, Cochrane 2015
Δ 6 MWD (m) Δ 6 MWD (m) Revalidatie versus exacerbatie Mc Carthy, Cochrane 2015 Puhan, Cochrane 2010
Revalidatie versus exacerbatie Moore, Chest 2016
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