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Using Progressive Relaxation Exercises in Chronic Obstructive Lung Disease: Systematic Review

Year 2019, Volume: 6 Issue: 2, 65 - 74, 30.07.2019

Abstract

Aim: The aim of this study was to systematically investigate the effects of progressive muscle relaxation exercise (PMR) on patients with chronic obstructive pulmonary disease (COPD). Material and Methods: In order to determine the effects of PMR in COPD patients, 2553 studies were reviewed by using Ulakbim, PubMed and Science Direct databases with the last search date of July 2018 and 310 articles related to PMR were reached. 8 studies that met the study criteria were reviewed in terms of objectives, methods, findings and outcome. Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of PMR on COPD patients were included in the study. Results: In this study, seven RCTs and one quasi-experimental study were examined. The studies reported that PMR were effective in decreasing fatigue, anxiety and depression and increasing sleep quality in COPD patients. In addition, it was also found that PMR was effective on physiological parameters (blood pressure, heart beat rate, respiratory rate, oxygen saturation) and peak expiratory flow rate. Conclusion: Since PMR is effective in the management of many symptoms in COPD patients, it is recommended that that randomized controlled trials may be conducted to provide more evidence for the field.

References

  • 1. GOLD 2018, Global Initiative for Chronic Obstructive Lung Disease: Global Strategy For Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease [İnternet]. Updated 2018 [Erişim Tarihi 14 Ağustos 2018]. Erişim adresi: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf.
  • 2. Yürüktümen A, Karcıoğlu Ö, Topacoğlu H, Karbek F. Dispne ile başvuran geriatrik olgularda yakınma şiddeti ile klinik ve laboratuvar verilerinin değerlendirilmesi. Türkiye Acil Tıp Dergisi. 2009; 9(4):163-168.
  • 3. Türkiye İstatistik Kurumu ölüm nedenlerinin cinsiyete göre dağılımı, 2013–2014. www.tuik.gov.tr/PreHaberBultenleri.do?id=1885, Erişim: 30 Mart 2015.
  • 4. Akgün D. Isparta il merkezinde KOAH öntanı prevalansı ve ilişkili faktörler. Türk Toraks Dergisi. 2013;14:43-47.
  • 5. Deveci F, Deveci SE, Türkoğlu S ve ark. The prevalence of chronic obstructive pulmonary disease in Elazig, eastern Turkey. European Journal of Internal Medicine. 2011;22(2):172-176.
  • 6. Kocabaş A, Hancioglu A, Türkyılmaz S ve ark. Prevalence of COPD in Adana, Turkey (BOLD-Turkey Study). Proceedings of the American Thoracic Society. 2006;3:A543.
  • 7. Arslan S, Öztunç G. The effects of a walking exercise program on fatigue in the person with COPD. Rehabilitation Nurs. 2016;41(6):303-312.
  • 8. Wong CJ, Goodridge D, Marciniuk DD, Rennie, D. Fatigue in patients with COPD participating in a pulmonary rehabilitation program. International Journal of Chronic Obstructive Pulmonary Disease. 2010;5(5):319-326.
  • 9. Çınar S, Olgun N. Determining of fatigue and sleep disturbance in patients with chronic obstructive pulmonary disease. Türkiye Klinikleri, Journal of Nursing Sciences. 2012;2(1):12-20.
  • 10. Dayapoğlu N, Tan M. Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis. The Journal of Alternative and Complementary Medicine. 2012;18(10):983–987.
  • 11. McDonnell LM, Hogg L, McDonnell L, White P. Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease. NPJ Primary Care Respiratory Medicine. 2014;10;24:14028.
  • 12. Çiçek HS, Çiçek H, Deniz Ö ve ark. KOAH olan bireylerde yüksek protein içerikli beslenmenin arteryel kan gazları, solunum fonksiyon testleri ve yorgunluk üzerine etkileri. MN Dahili Tıp Bilimleri. 2007;2(3-4): 95-105.
  • 13. Garrow AP, Yorke J, Khan N et al. Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:293-307.
  • 14. Durna Z, Akın S. (2012). Kronik Hastalıklar ve Bakım. Nobel Tıp Kitabevleri, İstanbul.
  • 15. Çiçek HS, Akbayrak N. Kronik obstrüktif akciğer hastalığı olan bireylerde solunum egzersizlerinin kan gazları ve solunum fonksiyon testlerine etkisi. Gülhane Tıp Dergisi. 2004;46(1): 1-9.
  • 16. Polat H, Ergüney S. The effect of reflexology applied to patients with chronic obstructive pulmonary disease on dyspnea and fatigue. Rehabil Nurs. 2017; 42(1):14-21. doi: 10.1002/rnj.266.
  • 17. Leite, MR, Ramos EM, Kalva-Filho CA, Freire AP, de Alencar Silva BS, Nicolino J, de Toledo-Arruda AC, Papoti M, Vanderlei LC, Ramos D. Effects of 12 weeks of aerobic training on autonomic modulation, mucociliary clearance, and aerobic parameters in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:2549-557. doi: 10.2147/CO PD. S81363. eCollection 2015.
  • 18. Özkaptan, BB, Kapucu, S. Home nursing care with the self-care model improves self-efficacy of patients with chronic obstructive pulmonary disease. Japan Journal of Nursing Science. 2015;28.
  • 19. Carrie-Kolhman V, Donesky-Cuenco D, Neuhaus J. Impact of brief or extended exercise training on the benefit of a dyspnea self-management program in COPD. J Cardiopulm Rehabil. 2005; 25: 275-284.
  • 20. Demiralp M, Oflaz F, Komurcu S. Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal Clinical Nursing. 2010;19(7-8):1073-1083.
  • 21. Sun J, Kang J, Wang P, Zeng H. (2013). Self-relaxation training can improve sleep quality and cognitive functions in the older: a one-year randomised controlled trial. Journal Clinical Nursing. 2013;22(9-10):1270-280.
  • 22. Lolak S, Connors GL, Sheridan MJ, Wise TN. Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program. Psychother Psychosom. 2008;77(2):119-125.
  • 23. Nahcivan N, Seçginli S. Sistematik derlemeye dahil edilen nicel araştırmaların metodolojik kalitesi nasıl değerlendirilir? Turkiye Klinikleri Journal of Public Health Nursing-Special Topics. 2017;3(1):10-19.
  • 24. Chegeni PS, Gholami M, Azargoon A, Hossein Pour AH, Birjandi M, Norollahi H. The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice. 2018;31:64-70.
  • 25. Yılmaz CK, Kapucu S. The effect of progressive relaxation exercises on fatigue and sleep quality in ındividuals with COPD. Holist Nurs Pract. 2017; 31(6):369-377.
  • 26. Patimah S, Kusnanto, Rayasari F. the effect of progressive muscle relaxation with pursed lips breathing towards fatigue, depression and lung function of COPD patients in provincial hospital of Jayapura. International Journal of Science and Research (IJSR). 2319-7064. DOI: 10.21275/ART20177496.
  • 27. Şahin ZA, Dayapoğlu, N. Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD). Complementary Therapies in Clinical Practice. 2015; 21(4):277-281.
  • 28. Naveen Jebakumar M, Porkodi A, Akila P. Effectıveness of progressıve muscle relaxatıon on Psycho-physıologıcal parameters among patıents wıth copd at unıversıty teachıng hospıtal. Journal of Science. 2014; 4(1):23-26.
  • 29. Singh VP, RaoV, Prem V, Sahoo RC, Keshav Pai. Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD--A randomized controlled pilot study. Chron Respir Dis. 2009; 6(4):209-216.
  • 30. Gift AG, Moore T, Soeken K. Relaxation to reduce dyspnea and anxiety in COPD patients. Nursing Research. 1992; 41(4): 242-246.
  • 31. Akıncı ÇA, Pınar R. Kronik obstrüktif akciğer hastalarının günlük yaşam aktivitelerini yapma sırasında bağımlılık durumları ve etkileyen faktörler. e-Journal of New World Sciences Academy. 2011; 6(1).
  • 32. Pathak P, Mahal R, Kohli A, Nimbran V. Progressive muscle relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients receiving radiotherapy. International Journal of Advanced Nursing Studies. 2013; 2(2): 58-65.
  • 33. Dehkordi A.H, Jalali A. Effect of progressive muscle relaxation on the fatigue and quality of life among Iranian aging persons. Acta Med Iran. 2016; 54(7): 430-436.
  • 34. Li Y, Wang R, Tang J, Chen C, Tan L, Wu Z, et al. Progressive muscle relaxation improves anxiety and depression of pulmonary arterial hypertension patients. Evidence-Based Complementary and Alternative Medicine. 2015; 2015: 792895.
  • 35. Saeedi M, Ashktorab T, Saatchi K, Zayeri F, Akbari SAA. The effect of progressive muscle relaxation on sleep quality of patients undergoing hemodialysis. Iranian Journal of Critical Care Nursing. 2012; 5(1): 23-28.
  • 36. Yılmaz SG, Arslan S. Effects of progressive relaxation exercises on anxiety and comfort of Turkish breast cancer patients receiving chemotherapy. Asian Pac J Cancer Prev. 2015;16(1):217-220.
  • 37. Kütmeç Yılmaz C, Duru Aşiret G, Çetinkaya F, Oludağ G, Kapucu S. Effect of progressive muscle relaxation on caregiver burden and level of depression among caregivers of older stroke patients: a randomized controlled trial. Japan Journal of Nursing Science. Article DOI: 10.1111/jjns.12234.
  • 38. Ghafari S, Ahmadi F, Nabavi M, Anoshirvan K, Memarian R, Rafatbakhsh M. Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. Journal Clinical Nursing. 2009; 18(15):2171-2179.
  • 39. Nazik E, Öztunç G, Şahin B. Kemoterapi alan meme kanserli hastalarda progresif gevşeme egzersizlerinin uyku kalitesi ve ağrıya etkisi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2014; 17:23.
  • 40. Hermiz O, Comino E, Marks G, Daffurn K, Wilson S, Harris M. Randomized controlled trial of home-based care of patients with chronic obstructive pulmonary disease. British Medical Journal. 2002; 325(7370): 938-940.
  • 41. Taylor SJ, Candy B, Bryar RM, Ramsay J, Vrijhoef HJ, Esmond G, Wedzicha JA, Griffiths CJ. Effectiveness of innovations in nurse led chronic disease management for patients with chronic obstructive pulmonary disease, systematic review of evidence. British Medical Journal.2005; 331(485): 1-7.

Kronik Obstrüktif Akciğer Hastalarında Progresif Gevşeme Egzersizlerinin Kullanımı: Sistematik Derleme

Year 2019, Volume: 6 Issue: 2, 65 - 74, 30.07.2019

Abstract






Bu çalışmada Kronik Obstrüktif Akciğer Hastalığı (KOAH) olan hastalarda progresif kas gevşeme egzersizi (PGE) kullanımının etkisini inceleyen çalışmaların sistematik olarak incelenmesi amaçlanmıştır.
Gereç ve Yöntem: KOAH hastalarında PGE’nin etkisini ortaya koyabilmek için ULAKBİM, PubMed ve Science Direct veri tabanları kullanılarak Temmuz 2018 tarihine kadar yayınlanmış 2553 çalışma taranmış ve PGE ile ilgili 310 makaleye ulaşılmıştır. Bunlardan çalışma kriterlerini karşılayan 8 çalışma amaç, yöntem, bulgular ve sonuç açısından incelenmiştir. Çalışmaya KOAH hastalarında PGE’nin etkisini inceleyen randomize kontrollü çalışmalar (RKÇ) ve yarı deneysel çalışmalar dahil edilmiştir. Seçilen araştırmalar, anahtar kelimelerin seçimi için PICO, kalite kontrolü için ise Joanna Briggs Enstitüsü (JBI) eleştirel değerlendirme listelerine göre değerlendirilmiştir.
Bulgular: Bu çalışmada yedi RKÇ ve bir yarı deneysel çalışma olmak üzere sekiz çalışma incelenmiştir. Çalışmalarda KOAH hastalarına uygulanan PGE‘nin yorgunluk, anksiyete ve depresyon düzeyini azaltmada, uyku kalitesini arttırmada etkili olduğu saptanmıştır. Ayrıca PGE’nin fizyolojik parametreler (kan basıncı, kalp atım hızı, solunum hızı, oksijen satürasyonu) ile pik ekspiratuar akım hızı üzerine de etkili olduğu belirlenmiştir.
Sonuç: KOAH hastalarına uygulanan PGE birçok semptomun yönetiminde etkili olduğu görülmektedir. Alana daha fazla kanıt oluşturabilecek randomize kontrollü çalışmaların yapılması önerilmektedir.

References

  • 1. GOLD 2018, Global Initiative for Chronic Obstructive Lung Disease: Global Strategy For Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease [İnternet]. Updated 2018 [Erişim Tarihi 14 Ağustos 2018]. Erişim adresi: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf.
  • 2. Yürüktümen A, Karcıoğlu Ö, Topacoğlu H, Karbek F. Dispne ile başvuran geriatrik olgularda yakınma şiddeti ile klinik ve laboratuvar verilerinin değerlendirilmesi. Türkiye Acil Tıp Dergisi. 2009; 9(4):163-168.
  • 3. Türkiye İstatistik Kurumu ölüm nedenlerinin cinsiyete göre dağılımı, 2013–2014. www.tuik.gov.tr/PreHaberBultenleri.do?id=1885, Erişim: 30 Mart 2015.
  • 4. Akgün D. Isparta il merkezinde KOAH öntanı prevalansı ve ilişkili faktörler. Türk Toraks Dergisi. 2013;14:43-47.
  • 5. Deveci F, Deveci SE, Türkoğlu S ve ark. The prevalence of chronic obstructive pulmonary disease in Elazig, eastern Turkey. European Journal of Internal Medicine. 2011;22(2):172-176.
  • 6. Kocabaş A, Hancioglu A, Türkyılmaz S ve ark. Prevalence of COPD in Adana, Turkey (BOLD-Turkey Study). Proceedings of the American Thoracic Society. 2006;3:A543.
  • 7. Arslan S, Öztunç G. The effects of a walking exercise program on fatigue in the person with COPD. Rehabilitation Nurs. 2016;41(6):303-312.
  • 8. Wong CJ, Goodridge D, Marciniuk DD, Rennie, D. Fatigue in patients with COPD participating in a pulmonary rehabilitation program. International Journal of Chronic Obstructive Pulmonary Disease. 2010;5(5):319-326.
  • 9. Çınar S, Olgun N. Determining of fatigue and sleep disturbance in patients with chronic obstructive pulmonary disease. Türkiye Klinikleri, Journal of Nursing Sciences. 2012;2(1):12-20.
  • 10. Dayapoğlu N, Tan M. Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis. The Journal of Alternative and Complementary Medicine. 2012;18(10):983–987.
  • 11. McDonnell LM, Hogg L, McDonnell L, White P. Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease. NPJ Primary Care Respiratory Medicine. 2014;10;24:14028.
  • 12. Çiçek HS, Çiçek H, Deniz Ö ve ark. KOAH olan bireylerde yüksek protein içerikli beslenmenin arteryel kan gazları, solunum fonksiyon testleri ve yorgunluk üzerine etkileri. MN Dahili Tıp Bilimleri. 2007;2(3-4): 95-105.
  • 13. Garrow AP, Yorke J, Khan N et al. Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:293-307.
  • 14. Durna Z, Akın S. (2012). Kronik Hastalıklar ve Bakım. Nobel Tıp Kitabevleri, İstanbul.
  • 15. Çiçek HS, Akbayrak N. Kronik obstrüktif akciğer hastalığı olan bireylerde solunum egzersizlerinin kan gazları ve solunum fonksiyon testlerine etkisi. Gülhane Tıp Dergisi. 2004;46(1): 1-9.
  • 16. Polat H, Ergüney S. The effect of reflexology applied to patients with chronic obstructive pulmonary disease on dyspnea and fatigue. Rehabil Nurs. 2017; 42(1):14-21. doi: 10.1002/rnj.266.
  • 17. Leite, MR, Ramos EM, Kalva-Filho CA, Freire AP, de Alencar Silva BS, Nicolino J, de Toledo-Arruda AC, Papoti M, Vanderlei LC, Ramos D. Effects of 12 weeks of aerobic training on autonomic modulation, mucociliary clearance, and aerobic parameters in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:2549-557. doi: 10.2147/CO PD. S81363. eCollection 2015.
  • 18. Özkaptan, BB, Kapucu, S. Home nursing care with the self-care model improves self-efficacy of patients with chronic obstructive pulmonary disease. Japan Journal of Nursing Science. 2015;28.
  • 19. Carrie-Kolhman V, Donesky-Cuenco D, Neuhaus J. Impact of brief or extended exercise training on the benefit of a dyspnea self-management program in COPD. J Cardiopulm Rehabil. 2005; 25: 275-284.
  • 20. Demiralp M, Oflaz F, Komurcu S. Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal Clinical Nursing. 2010;19(7-8):1073-1083.
  • 21. Sun J, Kang J, Wang P, Zeng H. (2013). Self-relaxation training can improve sleep quality and cognitive functions in the older: a one-year randomised controlled trial. Journal Clinical Nursing. 2013;22(9-10):1270-280.
  • 22. Lolak S, Connors GL, Sheridan MJ, Wise TN. Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program. Psychother Psychosom. 2008;77(2):119-125.
  • 23. Nahcivan N, Seçginli S. Sistematik derlemeye dahil edilen nicel araştırmaların metodolojik kalitesi nasıl değerlendirilir? Turkiye Klinikleri Journal of Public Health Nursing-Special Topics. 2017;3(1):10-19.
  • 24. Chegeni PS, Gholami M, Azargoon A, Hossein Pour AH, Birjandi M, Norollahi H. The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice. 2018;31:64-70.
  • 25. Yılmaz CK, Kapucu S. The effect of progressive relaxation exercises on fatigue and sleep quality in ındividuals with COPD. Holist Nurs Pract. 2017; 31(6):369-377.
  • 26. Patimah S, Kusnanto, Rayasari F. the effect of progressive muscle relaxation with pursed lips breathing towards fatigue, depression and lung function of COPD patients in provincial hospital of Jayapura. International Journal of Science and Research (IJSR). 2319-7064. DOI: 10.21275/ART20177496.
  • 27. Şahin ZA, Dayapoğlu, N. Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD). Complementary Therapies in Clinical Practice. 2015; 21(4):277-281.
  • 28. Naveen Jebakumar M, Porkodi A, Akila P. Effectıveness of progressıve muscle relaxatıon on Psycho-physıologıcal parameters among patıents wıth copd at unıversıty teachıng hospıtal. Journal of Science. 2014; 4(1):23-26.
  • 29. Singh VP, RaoV, Prem V, Sahoo RC, Keshav Pai. Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD--A randomized controlled pilot study. Chron Respir Dis. 2009; 6(4):209-216.
  • 30. Gift AG, Moore T, Soeken K. Relaxation to reduce dyspnea and anxiety in COPD patients. Nursing Research. 1992; 41(4): 242-246.
  • 31. Akıncı ÇA, Pınar R. Kronik obstrüktif akciğer hastalarının günlük yaşam aktivitelerini yapma sırasında bağımlılık durumları ve etkileyen faktörler. e-Journal of New World Sciences Academy. 2011; 6(1).
  • 32. Pathak P, Mahal R, Kohli A, Nimbran V. Progressive muscle relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients receiving radiotherapy. International Journal of Advanced Nursing Studies. 2013; 2(2): 58-65.
  • 33. Dehkordi A.H, Jalali A. Effect of progressive muscle relaxation on the fatigue and quality of life among Iranian aging persons. Acta Med Iran. 2016; 54(7): 430-436.
  • 34. Li Y, Wang R, Tang J, Chen C, Tan L, Wu Z, et al. Progressive muscle relaxation improves anxiety and depression of pulmonary arterial hypertension patients. Evidence-Based Complementary and Alternative Medicine. 2015; 2015: 792895.
  • 35. Saeedi M, Ashktorab T, Saatchi K, Zayeri F, Akbari SAA. The effect of progressive muscle relaxation on sleep quality of patients undergoing hemodialysis. Iranian Journal of Critical Care Nursing. 2012; 5(1): 23-28.
  • 36. Yılmaz SG, Arslan S. Effects of progressive relaxation exercises on anxiety and comfort of Turkish breast cancer patients receiving chemotherapy. Asian Pac J Cancer Prev. 2015;16(1):217-220.
  • 37. Kütmeç Yılmaz C, Duru Aşiret G, Çetinkaya F, Oludağ G, Kapucu S. Effect of progressive muscle relaxation on caregiver burden and level of depression among caregivers of older stroke patients: a randomized controlled trial. Japan Journal of Nursing Science. Article DOI: 10.1111/jjns.12234.
  • 38. Ghafari S, Ahmadi F, Nabavi M, Anoshirvan K, Memarian R, Rafatbakhsh M. Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. Journal Clinical Nursing. 2009; 18(15):2171-2179.
  • 39. Nazik E, Öztunç G, Şahin B. Kemoterapi alan meme kanserli hastalarda progresif gevşeme egzersizlerinin uyku kalitesi ve ağrıya etkisi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2014; 17:23.
  • 40. Hermiz O, Comino E, Marks G, Daffurn K, Wilson S, Harris M. Randomized controlled trial of home-based care of patients with chronic obstructive pulmonary disease. British Medical Journal. 2002; 325(7370): 938-940.
  • 41. Taylor SJ, Candy B, Bryar RM, Ramsay J, Vrijhoef HJ, Esmond G, Wedzicha JA, Griffiths CJ. Effectiveness of innovations in nurse led chronic disease management for patients with chronic obstructive pulmonary disease, systematic review of evidence. British Medical Journal.2005; 331(485): 1-7.
There are 41 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Cemile Kütmeç Yılmaz 0000-0003-1827-5187

Sevgisun Kapucu 0000-0003-3908-3846

Publication Date July 30, 2019
Submission Date August 14, 2018
Published in Issue Year 2019 Volume: 6 Issue: 2

Cite

Vancouver Kütmeç Yılmaz C, Kapucu S. Kronik Obstrüktif Akciğer Hastalarında Progresif Gevşeme Egzersizlerinin Kullanımı: Sistematik Derleme. JOHUFON. 2019;6(2):65-74.