Determination of Functional Exercise Capacity, Peripheral Muscle Strength, Respiratory Muscle Endurance and Parameters Affecting Quality of Life in Idiopathic Pulmonary Fibrosis

6 Minute Walk Test (6MWT)

Time Frame: 1 month

6 MWT is a submaximal test that evaluates the functional exercise capacity of individuals. Individuals will walk along a 30-meter corridor at their maximum speed. Individuals will be asked to walk as much distance as possible within the given time without running or jumping.The time will be started as soon as individuals start walking. Before and after the test, O2 saturation with pulse oximeter, heart rate, dyspnea and fatigue severity with Borg scale will be evaluated between 0 and 10 points (0; no symptoms, 10; most severe symptoms). Individuals will be asked to stop the test if they do not feel well during the test. When the time is up, participants will be asked to leave the sign given for marking purposes on the ground and the walking distance will be evaluated with the sign.

6 Minute Pegboard and Ring Test

Time Frame: 1 month

This test will be used to measure upper extremity function. The test will be performed using a Pegboard with two upper and two lower pegs placed at the patients shoulder level and above shoulder level (20 cm). Ten rings will be placed on each lower peg. During the test, patients move each of the rings on the lower pegs to the upper pegs using both hands simultaneously, and then move the rings back from the upper pegs to the lower pegs. The goal is to move as many rings as possible for six minutes. The score will be reported as the number of rings moved simultaneously. Patients will be allowed to stop and rest during the test if they experience severe shortness of breath, fatigue, or other discomfort, and to resume moving the rings as soon as possible. Scores will be measured for heart rate, blood pressure, perception of dyspnea, and upper extremity fatigue before and immediately after each test.

30-second sit to stand test

Time Frame: 1 month

This test reflects the strength of the lower extremities. The individual sits in the middle of a chair with no armrests and a sitting height of 43 cm, with his back straight and straight, his arms crossed in front, and his feet touching the floor. With the start command, he stands up and sits down completely. The individual who learns the test with a stopwatch is asked to sit down and stand up for 30 seconds and the score obtained is recorded as the number of repetitions in the evaluation form.

Forced Vital Capasity

Time Frame: 1 month

Forced vital capacity (FVC) is the volume of air that is exhaled quickly and forcefully following a deep inspiration. It is a pulmonary function test parameter and performed using spirometry. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height.

Respiratory Muscle Strength Assessment

Time Frame: 1 month

Respiratory muscle strength will be determined by measuring the maximal inspiratory pressure (MIP) created in the mouth using a mouth pressure device and the maximum expiratory pressure (MEP) with personal antibacterial and antiviral disposable filters. During the MIP measurement, the patient is asked to make a maximum expiration, and the patient\'s nose is closed with a clip and then the patient\'s nose is closed with a clip and then the patient is asked to make a maximum inspiration for 1-3 seconds. During the MEP measurement, the patient is asked to make a maximum inspiration, and the patient\'s nose is closed with a clip and then the patient\'s nose is closed with a clip and then the patient\'s nose is closed with a clip and then the tests are repeated until no further improvement is observed and there is no difference of more than 5% between the 2 best values.

Respiratory Muscle Endurance Test

Time Frame: 1 month

It is applied at 60% of maximal inspiratory pressure. After the device is placed in the mouth, the nose is closed with a clamp. The patient is asked to breathe in and out through the mouth for 10 minutes. Before starting the test, patients are informed that if they feel too much shortness of breath during the test, they can remove the device and the test will end in this way. Before and after the test, the SpO2 value is measured with a portable pulse oximeter attached to the finger; dyspnea perception is measured and recorded with the Modified Borg Scale.

Hand Grip Strength

Time Frame: 1 month

A Jamar Hydraulic Hand Dynamometer (Jamar Hydraulic Hand Dynamometer, Cedarburg, England) will be used to measure hand grip strength. The Jamar hand dynamometer is considered the most reliable tool for measuring grip strength. Individuals are asked to sit with the shoulder adducted, the elbow flexed at 90°, the forearm in the middle position, and the wrist in a neutral position. Participants are asked to hold the handle and squeeze with the maximum force they can. The measurement begins with the dominant hand. Three consecutive measurements are taken for the dominant and non-dominant hands, with a 1-minute interval between measurements. The highest value of the three measurements is recorded.

Quadriceps Strength

Time Frame: 1 month

Measurements will be made with a portable digital muscle strength tester (01165 manual muscle tester, Lafayette Instrument Co. Lafayette, USA) to evaluate knee extensor muscle strength. It will be applied while individuals are in a sitting position on the edge of the bed with their knees bent to 90° and the space between the back of the knee and the bed filled with a towel. Individuals are asked to cross their hands on their chest and sit with their bodies upright. When the test begins, the knee is bent and the knee is straightened. The researcher measures the knee extensor muscle strength by applying force slightly above the ankle and trying to push downward in order to overcome the straight knee force. The test is repeated three times to measure the right and left knee extensor muscle strength and the highest value obtained is recorded in kilograms (kg) and Newtons (N).

Respiratory Function Testing

Time Frame: 1 month

It is performed using a spirometer. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height. The patient must be in an upright sitting position during the test.

Forced expiratory volume in 1 second

Time Frame: 1 month

forced expiratory volume in 1 second (FEV1) is the volume of air exhaled in the first second from the beginning of the forced vital capacity maneuver. In general, it provides information about the restriction in the large airways. It is a pulmonary function test parameter and performed using spirometry. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height.

Forced expiratory flow between 25 and 75% of vital capacity (FEF 25-75)

Time Frame: 1 month

Forced expiratory flow between 25 and 75% of vital capacity (FEF 25-75) is the average flow rate at 50% of the forced vital capacity maneuver. It provides information about the obstruction in medium and small bronchi. It is a pulmonary function test parameter and performed using spirometry. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height.

Peak expiratory flow

Time Frame: 1 month

Peak expiratory flow (PEF) is measured with a maximum inspiration followed by a maximum exhalation maneuver. It provides information about obstruction in the large airways. It is a pulmonary function test parameter and performed using spirometry. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height.

FEV1/FVC

Time Frame: 1 month

A low FEV1/FVC ratio (\<80%) is used as a primary obstruction parameter. It is a pulmonary function test parameter and performed using spirometry. The best value obtained from three technically acceptable measurements is expressed as a percentage of the expected value calculated from age, gender and height.