Grover Seema
Indrapratha Apollo Hospital, Mathura Rd, New Delhi, 110076, India.
Indian J Tuberc. 2022;69 Suppl 2:S280-S286. doi: 10.1016/j.ijtb.2022.10.021. Epub 2022 Nov 1.
Lung function is a convincing prognosticator of longevity. With advancing age, there are many irreversible functional and anatomic changes in the body, making elderly susceptible to disease processes. As people age, the respiratory system experiences a number of anatomical, physiological, and immunological changes, predisposing risk of many chronic lung diseases (CLDs). Respiratory tract infections, TB, chronic obstructive pulmonary disease (COPD), and interstitial pulmonary disease are examples of common respiratory diseases (CRDs). The risk factors are mainly smoking, exposure to air pollution both indoors and outdoors, allergies, occupational exposure, poor diet, obesity, inactivity. Between 25 and 80 years the lung function and aerobic capacity each decline by ∼40% limiting physical function and promoting multimorbidity. In elderly, skeletal muscle dysfunction causes age-related multifactorial health disorders such sarcopenia and frailty, a recognised symptom of chronic respiratory disease.
This perspective article highlights the importance of pulmonary physiotherapy in elderly with chronic lung disease and other chronic respiratory disorders. Common symptoms frequently experienced are dyspnoea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mental disturbances. An individual's symptoms, physical functioning, quality of life (QoL), hospitalisation, and morbidity goals are all addressed by a pulmonary rehabilitation programme (PRP). Pulmonary physiotherapy, an extensive patient-tailored intervention as exercise training, education, and life style modification is prescribed on the basis of a thorough personalised assessment.
Through pulmonary physiotherapy, the goal is to restore the quality of life of elderly with chronic respiratory diseases and to encourage their long-term adherence to health-improving behaviour. The older patients learn to accept and overcome the reality of their illness rather than sticking to its limits.
Multidisciplinary approach with a customized and comprehensive program makes the difference between living a fulfilling life and living a life with pulmonary disabilities.
肺功能是寿命的一个有说服力的预测指标。随着年龄的增长,身体会出现许多不可逆转的功能和解剖学变化,使老年人易患疾病。随着人们年龄的增长,呼吸系统会经历一些解剖学、生理学和免疫学变化,从而增加患多种慢性肺病(CLD)的风险。呼吸道感染、结核病、慢性阻塞性肺疾病(COPD)和间质性肺病是常见呼吸道疾病(CRD)的例子。风险因素主要包括吸烟、室内外空气污染暴露、过敏、职业暴露、不良饮食、肥胖、缺乏运动。在25岁至80岁之间,肺功能和有氧运动能力各自下降约40%,限制了身体功能并促进了多种疾病的发生。在老年人中,骨骼肌功能障碍会导致与年龄相关的多因素健康问题,如肌肉减少症和虚弱,这是慢性呼吸道疾病的一个公认症状。
这篇观点文章强调了肺部物理治疗在患有慢性肺病和其他慢性呼吸道疾病的老年人中的重要性。常见的症状包括呼吸困难、疲劳、运动耐力下降、外周肌肉功能障碍和精神障碍。肺部康复计划(PRP)解决了个体的症状、身体功能、生活质量(QoL)、住院和发病目标。肺部物理治疗是一种广泛的针对患者的干预措施,包括运动训练、教育和生活方式改变,是在全面的个性化评估基础上开出的处方。
通过肺部物理治疗,目标是恢复患有慢性呼吸道疾病的老年人的生活质量,并鼓励他们长期坚持改善健康的行为。老年患者学会接受并克服疾病的现实,而不是局限于疾病的限制。
采用定制化和全面的方案进行多学科治疗,是过上充实生活和带着肺部残疾生活之间的区别所在。