The Effects of Home-Based Exercise Program on the Functional Parameters in Patients with Obstructive Sleep Apnea Syndrome

1
The Effects of Home-Based Exercise Program on
the Functional Parameters in Patients with
Obstructive Sleep Apnea Syndrome

• Sevgi Ozalevli, Duygu Ilgin, Hayriye Kul
  Karaali, Oya Itil, Ibrahim Oztura, Baris
  Baklan
• School of Physical Therapy and Rehabilitation,
  Dokuz Eylul University, Izmir-TURKEY.
• Department of Chest Diseases, Faculty of
  Medicine, Dokuz Eylul University, Izmir-TURKEY.
• Department of Neurology, Faculty of Medicine,
  Dokuz Eylul University, Izmir-TURKEY.

2
Introduction

• Anthropometric Characteristics
• Body weight
• BMI
• Body fat distribution
• Waist/Hip/Neck measurements
• Disease Severity/Sleep characteristics
• Stabilise Muscle Tone
• Exercise Capacity
• Quality of Life
• Netzer et al., Pneumologie, 1997
• Giebelhaus et al., Sleep Breath, 2000
• Norman et al., Sleep Res Online, 2000

3
Introduction

• Type, intensity, duration, frequency
• Life-style modifications
• Smith et al., Journal of Clinical Sleep Medicine,
  2007
• Quan et al., Sleep Breath, 2007
• Hong et al., MedicineScienceExercise, 2003

4
AIM

• the effects of supervised home-exercise program
• on the functional parameters
• in patients with obstructive sleep apnea syndrome
  (OSAS)

5
MATERIAL-METHOD

• 14 patients with moderate-to-severe OSAS (mean
  AHI 36.31 20.81)
• Stable clinical condition,
• No diagnosed cardiac, neurologic, or orthopedic
  disease
• No assistive device for mobilisation
• Agreed to participate

6
MATERIAL-METHOD
Characteristics of the Patients Age, height, body weight, body mass index (BMI) , gender, education status, medical history, cigarette consumption
Pulmonary Functions Pulmonary Function Test
Exercise Capacity 6 Minute Walking Test
Dyspnea and Leg Fatigue Severity Modified Borg Scale (0-10)
General Health Related Quality of Life Short Form-36 Quality of Life Questionnaire
Disease Related Quality of Life Functional Outcome of Sleep Questionnaire
7
MATERIAL-METHOD

• Home-exercise program
• Supervised
• 12 weeks
• 7 days/week
• 2-3 times/day
• 5-10 repetitions

8
Exercise Program

• Breathing exercises

9
Exercise Program

• Upper limb exercises combined with breathing
  exercises

10
Exercise Program

• Lower limb exercises combined with breathing
  exercises

11
Exercise Program

• Walking Program
• Submaximal
• 3-5 days/week
• 12 weeks

12
Patient Name Date
Monday Thuesday Wednesday Persembe Thursday Saturday Sunday
1. Week              
2. Week              
3. Week              
4. Week              
5. Week              
6. Week              
7. Week              
8. Week
9. Week
10. Week
11. Week
12. Week              
13
RESULTS

• n 14 OSAS
• n 3

14
RESULTS

• n11 OSAS
• Mean number of the exercise program sessions
  4.6 1.22 (67) sessions/ week
• Mean number of the walking program sessions 3.27
  0.47 (74) sessions/ week

15

• Table 1. Basic Characteristics of the Patients

n 11 (11 M) XSD Minimum-Maximum
Age (year) 51.64 12.46 (35-61)
Height (m) 1.69 0.06 (1.60-1.76)
Body Weight (kg) 88.0 21.01 (54-120)
BMI (kg/m2) 30.61 6.24 (19.83-39.18)
Disease Duration (year) 1.73 0.65 (1.0-3.0)
Cigarette Consumption (packxyear) 25.05 24.57 (0-86)
Desaturation percentage 74.20 12.47 (50-91)
Apnea-hypopnea index 36.31 20.81 (16.40-67.50)
16
Table 2. The Comparison of the Pulmonary Function
Test Results
Before the Exercise Program X SD After the exercise Program X SD p
FVC 84.71 11.37 87.00 14.56 0.18
FEV1 87.57 12.29 88.40 12.86 0.18
FEV1/FVC 83.86 6.09 84.00 4.83 1.00
17

• Table 3. The Comparison of the 6 Minute Walking
  Test Results
• plt0.05

Before Exercise Program X SD After Exercise Programi X SD p
6 MWT Distance (m) 481.91 115.74 556.67 80.42 0.046
18
Table 4. Dyspnea and Leg Fatigue Severity After
the 6 Minute Walking Test
Before Exercise Program X SD p After Exercise Program X SD p
Dyspnea Severity (Modified Borg Scale- 0/10) Dyspnea Severity (Modified Borg Scale- 0/10) Dyspnea Severity (Modified Borg Scale- 0/10) Dyspnea Severity (Modified Borg Scale- 0/10) Dyspnea Severity (Modified Borg Scale- 0/10)
Before 6 MWT After 6 MWT (After-Before) 6 MWT 0.27 0.47 1.91 1.81 1.64 1.50 0.017 0.00 0.00 0.75 0.99 0.75 0.99 0.102 0.104
Leg Fatigue Severity (Modified Borg Scale- 0/10) Leg Fatigue Severity (Modified Borg Scale- 0/10) Leg Fatigue Severity (Modified Borg Scale- 0/10) Leg Fatigue Severity (Modified Borg Scale- 0/10) Leg Fatigue Severity (Modified Borg Scale- 0/10)
Before 6 MWT After 6 MWT (After-Before) 6 MWT 0.09 0.30 1.91 2.07 1.81 2.09 0.027 0.00 0.00 0.75 1.17 0.75 1.17 0.109 0.078
Peripheral Oxygen Saturation () Peripheral Oxygen Saturation () Peripheral Oxygen Saturation () Peripheral Oxygen Saturation () Peripheral Oxygen Saturation ()
Before 6 MWT After 6 MWT (After-Before) 6 MWT 94.40 1.95 96.60 0.89 2.20 2.49 0.131 95.75 1.26 96.50 1.32 0.75 2.99 0.593 0.285
plt 0.05
19
Table 5. The Comparison of the Hemodynamic
Parameters After the 6 Minute Walking Test
Before the Exercise Program X SD p After the Exercise Program X SD p
Hearth Rate (beat/minute) Hearth Rate (beat/minute) Hearth Rate (beat/minute) Hearth Rate (beat/minute) Hearth Rate (beat/minute)
Before 6 MWT After 6 MWT (After-Before) 6 MWT 80.91 11.47 102.64 18.82 21.73 11.48 0.003 77.50 14.40 101.00 23.97 23.50 12.19 0.028 0.596
Sistolic Blood Pressurei (mmHg) Sistolic Blood Pressurei (mmHg) Sistolic Blood Pressurei (mmHg) Sistolic Blood Pressurei (mmHg) Sistolic Blood Pressurei (mmHg)
Before 6 MWT After 6 MWT (After-Before) 6 MWT 120.46 10.11 133.18 9.36 12.73 5.18 0.003 116.67 10.32 135.00 10.49 18.33 7.53 0.026 0.109
Diastolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg)
Before 6 MWT After 6 MWT (After-Before) 6 MWT 70.00 6.33 78.55 8.20 9.55 6.11 0.004 68.33 7.53 80.00 6.33 11.67 4.08 0.020 1.000
plt 0.05
20
Table 6. The Comparison of the ShortForm-36
Questionnaire Scores
SF-36 Quality of Life Questionanire (0-100) Before Exercise Program X SD After Exercise Program X SD p
Fiziksel Fonksiyon 69.50 20.06 76.00 18.97 0.003
Sosyal Fonksiyon 62.50 28.26 60.75 28.29 0.102
Fiziksel Sorunlara Bagli Rol Kisitliliklari 67.50 42.57 67.00 43.15 0.317
Emosyonel Sorunlara Bagli Rol Kisitliliklari 69.33 43.00 70.00 43.20 0.655
Mental Saglik 65.60 11.50 65.60 12.14 1.000
Enerji/Vitalite 62.00 26.69 69.50 27.23 0.010
Agri 78.90 30.32 89.80 19..33 0.068
Sagligin Genel Algilanmasi 54.60 27.14 59.40 21.67 0.115
plt 0.05
21
Table 7. The Comparison of Functional Outcome of
the Sleep Questionnaire Scores
Functional Outcome of the Sleep Questionnaire (4-16) Before Exercise Program After Exercise Program p
Activity Level 2.97 0.75 3.33 0.73 0.005
Vigility 3.00 0.92 3.33 0.68 0.004
Social Interaction 2.73 0.78 2.88 0.86 0.072
Outcomes 2.90 0.70 3.00 0.67 0.157
plt 0.05
22
CONCLUSION

• Adherence to the exercise program
• 67 exercise program
• 74 walking program
• Smith et al., Journal of Clinical Sleep Medicine,
  2007.

23
CONCLUSION

• BMI
• Giebelhaus et al., Sleep Breath, 2000.
• Peppard et al., Sleep, 2004
• Norman et al., Sleep Res Online, 2000
• Hong et al., Med Sci Sports Exerc, 2003

24
CONCLUSION

• Exercise capacity
• Aerobic exercises
• Strenthening exercises
• Norman et al., Sleep Res Online, 2000.
• Giebelhaus et al., Sleep Breath, 2000.
• Zerah-Lancner et al., Am J Respir Crit Care Med,
  1997.
• Nowinski et al., Pneumonol Alergol Pol, 2007.
• Breathing control exercises
• Symptom management

25
CONCLUSION

• QUALITY OF LIFE
• Physical function
• Energy
• Jenkinson et al., Lancet, 1999.
• Norman et al., Sleep Res Online, 2000.
• Activity
• Vigility
• Montserrat et al., Am J Respir Crit Care Med,
  2001.

26
CONCLUSION AND COMMENTS

• Exercise program X daily life activities
• Symptom management
• Exercise capacity
• Quality of life

27
CONCLUSION AND COMMENTS

• The number of the patients
• Control Group
• Metabolic parameters
• Long-term results

28
(No Transcript)