PULMONARY REHABILITATION ON PATIENT S WITH TB MDR/XDR

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Amber Morris
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1 PULMONARY REHABILITATION ON PATIENT S WITH TB MDR/XDR SITTI NURUN NIKMAH, SPKFR, M.KES INSTALASI REHABILITASI MEDIK RS PARU ROTINSULU Download Materi di:

2 BACKGROUND The main factors that may affect the pulmonary function of patients who are treated for TB: the lack of adherence to drug therapy residual post-treatment lesions treatment duration the presence of other pulmonary diseases such as emphysema, COPD, asthma, and bronchiectasis There is no consensus concerning the predominant type of ventilatory disorder found in patients treated for TB

3 BACKGROUND Ramos et al Dhuria et al Guo et al recommended the early treatment of TB cases, which contributes to a decrease in sequelae and improves the patients quality of life. impact that TB has on patients quality of life, showing scores that were significantly lower than a control group TB has a substantial negative impact on the patients quality of life, even after the microbiological cure.

4 BACKGROUND the main impaired domains the physical domain the ability to perform daily activities the psychological domain There is that none of functional assessment was specific for TB patient s, making it difficult to understand the impact of the disease in such a group of patients MDR-TB cured patients with present impaired respiratory function and a mildly reduced functional capacity and quality of life, suggesting that a portion of these patients may require a pulmonary rehabilitation approach

5 BENEFIT OF PULMONARY REHABILITATION Patients with sequelae of pulmonary tuberculosis and its treatment underwent a rehabilitation programme which included respiratory muscle training as well as relaxation and exercise training. Improvements were seen in FEV1, FVC, PO2, maximal inspiratory mouth pressure, 6-min walking distance and quality of life. The principle of specific respiratory muscle training is that skeletal muscle deconditioning is reversible and that the contractile properties of the muscles can be improved by training

6 PULMONARY REHABILITATION Airway Clearance: Nebulization Postural drainage Effective cough : manual or machine assisted Breathing Exercise: breathing relaxation, breathing retraining, breathing pattern respiratory muscle training Physical Training: Flexibility exercise upper and lower limb strengthening aerobic exercise: treadmill, ergocycle Educational support: lifestyle and environment modification LTOT

7 FUNCTIONAL ASSEMENT 6MWT/D : because it reflects the patients performance of daily activities Respiratory Muscle Strength Nutritional Status Spirometry VO2 peak Quality of life questioners (e.i SF-36, SGRQ)

8 Reference Godoy, M., Mello, F., Lopes, A., Costa, W., Guimarães, F., Pacheco, A., Castanho, I. and Menezes, S. (2012). The Functional Assessment of Patients With Pulmonary Multidrug-Resistant Tuberculosis. Respiratory Care, 57(11), pp De Grass, D., Manie, S. and Amosum, S. (2015). Effectiveness of a home-based pulmonary rehabilitation programme in pulmonary function and health related quality of life for patients with pulmonary tuberculosis: a pilot study. African Health Sciences, 14(4), p.866. Donner, C., Ambrosino, N. and Goldstein, R. (2005). Pulmonary rehabilitation. London: Hodder Arnold. Muñoz-Torrico, M., Rendon, A., Centis, R., D'Ambrosio, L., Fuentes, Z., Torres-Duque, C., Mello, F., Dalcolmo, M., Pérez-Padilla, R., Spanevello, A. and Migliori, G. (2016). Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?. Jornal Brasileiro de Pneumologia, 42(5), pp

9 GEDUNG MDR TB LAMA ( PS RANAP)

10 GEDUNG MDR TB LAMA ( PS RANAP)

11 GEDUNG MDR TB LAMA ( PS RANAP)

12 Ps Tb ICU

13 GEDUNG MDR TB BARU ( PS RAJAL)

14 GEDUNG MDR TB BARU ( PS RAJAL)

Pulmonary Rehabilitation in Chronic Lung Disease; Components and Organization. Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept.

Pulmonary Rehabilitation in Chronic Lung Disease; Components and Organization Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept. Plan Chronic Respiratory Disease Definition Factors Contributing