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Sharma Y, Alam T, Gupta S, Fatima A. Effect of pulmonary rehabilitation on functional status dyspnea and quality of life among post COVID-19 patients. J Asthma 2024; 61:1235-1241. [PMID: 38527173 DOI: 10.1080/02770903.2024.2334899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/10/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES To determine the Effect of pulmonary rehabilitation on functional status dyspnea and quality of life among post-COVID-19 patients. METHODS The study utilized an experimental study design with a total of 120 participants to examine the effects of pulmonary rehabilitation. The participants were divided into two groups: Group A (experimental group) and Group B (control group). Demographic variables such as age, weight, and height were collected. Health-related quality of life (HRQL), post-COVID-19 functional status, and perceived exertion were assessed before and after the intervention. RESULTS Group A demonstrated a higher mean age than Group B, indicating a significant age difference between the two groups, with no significant difference observed in weight and height. Following the intervention, Group A exhibited significant improvement in HRQL, post-COVID-19 functional status, and perceived exertion compared to Group B. CONCLUSION Pulmonary rehabilitation had positive effects on health-related quality of life, post-COVID-19 functional status, and perceived exertion. The experimental group benefited from improved HRQL, suggesting an overall enhancement in their well-being. The study provides preliminary evidence supporting the effectiveness of pulmonary rehabilitation as an intervention for improving outcomes in individuals post-COVID-19.
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Affiliation(s)
- Yatesh Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Tanveer Alam
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Sachin Gupta
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Ambreen Fatima
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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2
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van Bavel D, de Steiger R, McKenzie D. Is a patient self-recorded 6 minute walk test equivalent to a formally recorded 6 minute walk test. ANZ J Surg 2024; 94:1511-1517. [PMID: 39254036 DOI: 10.1111/ans.19213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/23/2024] [Accepted: 08/05/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Functional tests such as the 6-minute walk test (6MWT) are used in many areas of medicine to monitor disease progression and outcomes of treatment. They are particularly helpful in Orthopaedic surgery as the outcomes have been shown to be responsive to recovery over time. The 6MWT is typically performed in a controlled supervised environment which may limit its widespread use (Terwee et al., Rheumatology (Oxford), 2006, 45, 890-902). The primary aim is to investigate if a patient measured 6MWT is comparable to a 6MWT performed under formal testing conditions (Täger et al., Int. J. Cardiol. 2014, 176, 94-98). METHODS A total of 55 patients undergoing elective primary hip or knee replacement were instructed to use a smart watch to record a 6MWT in their home community environment (C-6MWT). These measurements were compared to a formally tested 6MWT (F-6MWT) at 2 separate time periods-6 and 12 weeks post-surgery. RESULTS At 6 weeks post operation the Intraclass Correlation Coefficient between a formally tested and a patient self-administered 6MWT was 0.928 (95% CI 0.832-0.970) and at 12 weeks it was 0.831 (0594-0.935). CONCLUSION A patient recorded 6 minute walk test shows high agreement with a formally recorded one under research conditions. This makes this test a suitable way to monitor rehabilitation progression and research outcomes at multiple time periods and in remote situations.
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Affiliation(s)
- Dirk van Bavel
- Epworth Healthcare, St Vincent's Public Hospital (Melbourne), Melbourne Hip and Knee, Melbourne, Victoria, Australia
| | - Richard de Steiger
- Epworth Victor Smorgan Chair of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dean McKenzie
- Research Governance and Development Unit, Epworth Healthcare, Melbourne, Victoria, Australia
- Health Sciences and Boistatistics, Swinburne University of Technology, Melbourne, Victoria, Australia
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3
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Wang Y, Li W, Zhou CM, Zhao Z, Ma J, Jiang H, Wei M, Gao Y, Dai Y, Zhang X, Yang N, Feng F, Zhang J, Ji Y, Liu J, Zhang C, Li L, Jiang X, Li Z, Zhao Z. Mortality risk of patients with intestinal obstruction. BMC Cancer 2024; 24:1062. [PMID: 39198804 PMCID: PMC11351352 DOI: 10.1186/s12885-024-12834-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Intestinal obstruction represents a severe intestinal disease associated with higher mortality rates. However, the determinants of mortality in patients with intestinal obstruction remain inadequately understood. This study sought to elucidate the potential risk factors associated with mortality in the context of intestinal obstruction during the COVID-19 pandemic. METHODS A retrospective analysis was performed on a cohort of 227 patients diagnosed with intestinal obstruction at the First Hospital of Hebei Medical University, spanning the period from September 7, 2022, to January 7, 2023. The primary endpoint of the study was mortality within four weeks following discharge. Univariate and multivariable logistic regression models were utilized to evaluate the risk factors associated with mortality outcomes. RESULTS A cohort of 227 patients diagnosed with intestinal obstruction (median age, 59.02 years [IQR, 48.95-70.85 years]) was included in our study. Malignant bowel obstruction (MBO) and COVID-19 were identified as independent risk factors for mortality among these patients. Notably, the mortality rate increased significantly to 38.46% when MBO was concomitant with COVID-19. Furthermore, postoperative pulmonary complications (PPC) (OR, 54.21 [death]; 95% CI, 3.17-926.31), gastric cancer (OR, 9.71 [death]; 95% CI, 1.38-68.18), VTE (Caprini Score ≥ 5) (OR, 7.64 [death]; 95% CI, 1.37-42.51), and COVID-19 (OR, 5.72 [death]; 95% CI, 1.01-32.29) were all determined to be independent risk factors for postoperative mortality. Additionally, gastric cancer could have emerged as one of the most severe risk factors for mortality in individuals with intestinal obstruction within the cohort of cancer patients, of which gastric cancer exhibited higher mortality rates compared to individuals with other forms of cancer. CONCLUSION The study identifies MBO, gastric cancer, COVID-19, PPC, and VTE as potential risk factors for mortality in cases of intestinal obstruction. These findings highlight the necessity for continuous monitoring of indicators related to these mortality risk factors and their associated complications, thereby offering valuable insights for the management and treatment of intestinal obstruction.
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Affiliation(s)
- Yuanyuan Wang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Wei Li
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Chuan-Min Zhou
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Zifeng Zhao
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Jianwei Ma
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Haibo Jiang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Ming Wei
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Yingchao Gao
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Yongjun Dai
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Xing Zhang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Ning Yang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Feng Feng
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Jian Zhang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Yiding Ji
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Jianjie Liu
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Chao Zhang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Like Li
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Xia Jiang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China
| | - Zhongxin Li
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China.
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China.
| | - Zengren Zhao
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Hebei, China.
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Hebei, China.
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Müller K, Ottiger M, Poppele I, Wastlhuber A, Stegbauer M, Schlesinger T. Physical Health in Patients with Post-COVID-19 6 and 12 Months after an Inpatient Rehabilitation: An Observational Study. J Clin Med 2024; 13:3988. [PMID: 38999552 PMCID: PMC11242682 DOI: 10.3390/jcm13133988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Rehabilitation is an effective and feasible approach for post-COVID patients to improve physical health. However, knowledge regarding the long-term impact of rehabilitation on the physical health of these patients is lacking. Methods: Changes in physical health of 127 patients with COVID-19 as an occupational disease or work accident were assessed in a longitudinal observational study. Post-COVID symptoms, functional status, functional exercise capacity, endurance capacity, physical performance, quadricep strength, handgrip strength, motor balance ability, and self-reported physical performance were examined at the beginning as well as 6 and 12 months after the rehabilitation. Group differences concerning sex, age, acute COVID status, comorbidities prior to COVID-19, and aftercare interventions were also analysed. Results: Even 12 months after rehabilitation, the prevalence of post-COVID symptoms (28.6-94.7%) remained remarkably high in the study population. Significant improvements in various aspects of physical health were observed 6 (r = 0.288-0.755) and 12 months (r = 0.189-0.681) after the rehabilitation. Participants demonstrated enhanced endurance, strength, and balance function, as well as improvement in subjective physical ability. Significant group differences were observed between younger and older patients, those with mild-moderate and severe-critical COVID-19, and patients with and without pre-existing cardiovascular disease, metabolic disease, psychological disease, neuro-sensory disease, musculoskeletal disease, and exercising in an outpatient group. Conclusions: The study identifies persistent challenges in COVID-19 recovery, despite significant improvements in physical health 6 and 12 months after rehabilitation. Further research and the implementation of standardised approaches are required to enhance the outcomes of post-COVID rehabilitation, with a focus on developing personalised care strategies for long-term recovery.
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Affiliation(s)
- Katrin Müller
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (M.O.); (I.P.); (T.S.)
| | - Marcel Ottiger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (M.O.); (I.P.); (T.S.)
| | - Iris Poppele
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (M.O.); (I.P.); (T.S.)
| | - Alois Wastlhuber
- BG Hospital for Occupational Disease Bad Reichenhall, 83435 Bad Reichenhall, Germany; (A.W.); (M.S.)
| | - Michael Stegbauer
- BG Hospital for Occupational Disease Bad Reichenhall, 83435 Bad Reichenhall, Germany; (A.W.); (M.S.)
| | - Torsten Schlesinger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (M.O.); (I.P.); (T.S.)
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Lee JS, Baek CY, Kim HD, Kim DY. Effect of robot-assisted stair climbing training as part of a rehabilitation program to improve pulmonary function, gait performance, balance, and exercise capacity in a patient after severe coronavirus disease 2019: a case report. Physiother Theory Pract 2024; 40:1628-1634. [PMID: 36752656 DOI: 10.1080/09593985.2023.2175188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Severe coronavirus disease 2019 (COVID-19) infection may decrease respiratory and physical functions. OBJECTIVE To evaluate whether robot-assisted stair climbing training (RASCT) would improve pulmonary and physical functions in a patient post-severe COVID-19 infection. CASE DESCRIPTION A 48-year-old woman who had experienced severe COVID-19 underwent a 6-week inpatient rehabilitation. She persistently exhibited impaired pulmonary and physical functions, including walking and balance impairment. We provided a 30-min outpatient RASCT biweekly for 6 weeks. OUTCOMES After training, maximal inspiratory and maximal expiratory pressures improved from 81 and 74 cmH2O to 104 and 81 cmH2O, respectively. The walking speed improved from 1.15 to 1.21 m/s. In balance ability, physical performance battery score and timed up-and-go test improved from 8 to 11 s and 10.89 to 9.95 s, respectively. Regarding exercise capacity, the 6-min walk test distance improved from 453 to 482 m, and the number of 1-min sit-to-stand test improved from 20 to 23, with improved pulse rate and saturation level. The physical and psychological domain scores of the World Health Organization Quality-of-Life Scale-BREF improved from 44 to 63 and 69 to 81, respectively; Falls Efficacy Scale-International scores improved from 38 to 21. CONCLUSION RASCT, as part of a rehabilitation plan, was feasible and effective for this patient after severe COVID-19 infection.
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Affiliation(s)
- June Sung Lee
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
| | - Chang Yoon Baek
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Hyeong Dong Kim
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Dong Yeong Kim
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
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Michalas M, Katsaras S, Spetsioti S, Spaggoulakis D, Antonoglou A, Asimakos A, Katsaounou P, Christakou A. The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome. J Pers Med 2024; 14:515. [PMID: 38793097 PMCID: PMC11121916 DOI: 10.3390/jpm14050515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome. METHODS The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups. RESULTS No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02). CONCLUSIONS Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.
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Affiliation(s)
- Michail Michalas
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stefanos Katsaras
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stavroula Spetsioti
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Dimitrios Spaggoulakis
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Archontoula Antonoglou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Andreas Asimakos
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Paraskevi Katsaounou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Anna Christakou
- Department Physiotherapy, Lab Biomechanics, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece
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Tofiq A, Eriksson Crommert M, Zakrisson AB, von Euler M, Nilsing Strid E. Physical functioning post-COVID-19 and the recovery process: a mixed methods study. Disabil Rehabil 2024; 46:1570-1579. [PMID: 37078388 DOI: 10.1080/09638288.2023.2201512] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/06/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE To describe physical functioning after severe COVID-19-infection. MATERIALS AND METHOD An explanatory sequential mixed method design was used. Thirty-nine participants performed tests and answered questionnaires measuring physical functioning six months after hospitalisation due to COVID-19. Thirty of these participants participated in semi-structured interviews with questions regarding how they perceived their physical functioning and recovery from COVID-19 at 12 months post-hospitalisation. RESULTS At six months, physical functioning measured via chair stand test and hip-worn accelerometers was lower than normal reference values. There was a reduction in breathing muscle strength. Participants estimated their functional status during different activities as lower compared to those before COVID-19-infection, measured with a patient-specific functional scale. At one year after infection, there were descriptions of a rough recovery process and remaining symptoms. CONCLUSION Patients recovering from severe COVID-19 seem to have reduced physical functioning and activity levels, and they perceive their recovery to be slow and difficult. They experienced a lack of clinical support and contradictory advice regarding rehabilitation. Coaching in returning to physical functioning after the infection needs to be better co-ordinated and there is a need for guidelines for health professionals to avoid patients receiving contradictory advice.
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Affiliation(s)
- Avin Tofiq
- Department of Neurology and Rehabilitation, School of Medicine, Örebro University, Sweden
| | | | | | - Mia von Euler
- Department of Neurology and Rehabilitation, School of Medicine, Örebro University, Sweden
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Peroy-Badal R, Sevillano-Castaño A, Torres-Castro R, García-Fernández P, Maté-Muñoz JL, Dumitrana C, Sánchez Rodriguez E, de Frutos Lobo MJ, Vilaró J. Comparison of different field tests to assess the physical capacity of post-COVID-19 patients. Pulmonology 2024; 30:17-23. [PMID: 36117103 PMCID: PMC9339971 DOI: 10.1016/j.pulmoe.2022.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/01/2022] [Accepted: 07/25/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In coronavirus disease (COVID-19), physical capacity is one of the most impaired sequelae. Due to their simplicity and low cost, field tests such as the six-minute walk test (6MWT) are widely used However, in many places it is difficult to perform them and alternatives can be used such as the 1 min sit-to-stand test (1min-STST) or the Chester step test (CST). Therefore, our objective was to compare the 6MWT, 1min-STST and the CST in post-COVID-19 patients. METHODS We conducted a cross-sectional analysis in post-COVID-19 patients, compared with matched controls (CG). Demographic characteristics and comorbidities were collected. We analysed oxygen saturation (SpO2), heart rate (HR), and the modified Borg scale in the 6MWT, 1min-STST, and CST. Additionally, the correlations between tests were analysed. RESULTS We recruited 27 post-COVID-19 patients and 27 matched controls. The median age was 48 (IQR 43-59) years old (44% female). The median distance walked in 6MWT was 461 (IQR 415-506) m in post-COVID-patients and 517 (IQR 461-560) m in CG (p = 0.001). In 1min-STST, the repetitions were 21.9 ± 6.7 and 28.3 ± 7.1 in the post-COVID-19 group and CG, respectively (p = 0.001). In the CST, the post-COVID-19 group performed 150 (86-204) steps vs the CG with 250 (250-250) steps (p < 0.001). We found correlations between the 6MWT with the 1min-STST in COVID-19 patients (r = 0.681, p < 0.001) and CG (r = 0.668, p < 0.001), and between the 6MWT and the CST in COVID-19 patients (r = 0.692, p < 0.001). CONCLUSION The 1min-STST and the CST correlated significantly with the 6MWT in patients post-COVID-19 being alternatives if the 6MWT cannot be performed.
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Affiliation(s)
- R Peroy-Badal
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain; Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - A Sevillano-Castaño
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain; Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - R Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain.
| | - P García-Fernández
- Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - J L Maté-Muñoz
- Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - C Dumitrana
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
| | - E Sánchez Rodriguez
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M J de Frutos Lobo
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Vilaró
- International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain; Facultad de Ciencias de la Salud Blanquerna, Global Research on Wellbeing (GRoW), Universidad Ramon Llull, Barcelona, Spain
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9
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Polastri M, Ciasca A, Nava S, Andreoli E. Two years of COVID-19: Trends in rehabilitation. Pulmonology 2024; 30:1-3. [PMID: 35190299 PMCID: PMC8856133 DOI: 10.1016/j.pulmoe.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy.
| | - A Ciasca
- Health Professions Direction Service, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
| | - S Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy; Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
| | - E Andreoli
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
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10
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Mavronasou A, Asimakos A, Vasilopoulos A, Katsaounou P, Kortianou EA. Remote administration of the short physical performance battery, the 1-minute sit to stand, and the Chester step test in post-COVID-19 patients after hospitalization: establishing inter-reliability and agreement with the face-to-face assessment. Disabil Rehabil 2023:1-11. [PMID: 38156771 DOI: 10.1080/09638288.2023.2297928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To assess the inter-reliability of the Short Physical Performance Battery (SPPB), the 1-min Sit to Stand test (1-MSTS), and the Chester Step Test (CST) via remote assessment in post-COVID-19 patients after hospitalization. METHODS Twenty-five post-COVID-19 patients randomly performed the functional tests via remote assessment using a software platform at home and via face-to-face assessment at the rehabilitation center 24-72 h apart. One day before the remote assessment, all participants had a 1-h guidance session regarding the platform use, safety instructions, and home equipment preparation. RESULTS Participants completed all tests for both assessment procedures without experience of adverse events. The mean age was 53 (SD = 10) years old, and the median days of hospitalization were 23 (IQR = 10-33). The inter-reliability was moderate for the total score in the SPPB: Cohen's kappa = 0.545 (95% CI: 0.234 to 0.838), excellent for the number of repetitions in the 1-MSTS: ICC = 0.977 (95% CI: 0.948 to 0.990) and good for the total number of steps in the CST: ICC = 0.871 (95% CI: 0.698 to 0.944). CONCLUSION Remote functional assessments for SPPB, 1-MSTS, and CST indicated moderate to excellent inter-reliability in post-COVID-19 patients after hospitalization.
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Affiliation(s)
- Aspasia Mavronasou
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
| | - Andreas Asimakos
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, Athens, Greece
| | - Aristeidis Vasilopoulos
- Health Assessment and Quality of Life Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
| | - Paraskevi Katsaounou
- Pulmonary & Respiratory Failure Department, First ICU, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni A Kortianou
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
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Köseoğlu BF, Sonel Tur B, Kutay Ordu Gökkaya N, Güneş Gökmen İ, Nur Kesiktaş F, Bilir Kaya B, Önal R, Tuncay F, Genç A, Findikoglu G, Koldaş Doğan Ş, Tomruk Sütbeyaz S, Sarıkaya S, Tıkız C, Özdemir H, Demirbağ Kabayel D, Örücü Atar M, Atan T, Yüksel S. Applying the WHO ICF framework to long COVID patients with persistent respiratory symptoms. Turk J Phys Med Rehabil 2023; 69:410-423. [PMID: 38766576 PMCID: PMC11099857 DOI: 10.5606/tftrd.2023.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/12/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives The aim of this study was to evaluate long COVID patients with persistent respiratory symptoms through the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) framework. Patients and methods This national, prospective, multicenter, cross-sectional study was conducted with 213 patients (118 females, 95 males; median age 56 years; range, 20 to 85 years) with long COVID between February 2022 and November 2022. The ICF data were primarily collected through patient interviews and from the acute medical management records, physical examination findings, rehabilitation outcomes, and laboratory test results. Each parameter was linked to the Component Body Functions (CBF), the Component Body Structures (CBS), the Component Activities and Participation (CAP), the Component Environmental Factors (CEF), and Personal Factors according to the ICF linking rules. Analysis was made of the frequency of the problems encountered at each level of ICF category and by what percentage of the patient sample. Results In the ICF, 21 categories for CBF, 1 category for CBS, and 18 categories of CAP were reported as a significant problem in a Turkish population of long COVID patients with persistent respiratory symptoms. Furthermore, eight categories for CEF were described as a facilitator, and four as a barrier. Conclusion These results can be of guidance and provide insight into the identification of health and health-related conditions of long COVID patients with persistent respiratory symptoms beyond the pathophysiological aspects, organ involvement, and damage of COVID-19. The ICF can be used in patients with long COVID to describe the types and magnitude of impairments, restrictions, special needs, and complications.
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Affiliation(s)
- Belma Füsun Köseoğlu
- Department of Physical Medicine and Rehabilitation, TOBB University of Economics and Technology School of Medicine, Ankara, Türkiye
| | - Birkan Sonel Tur
- Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Nilüfer Kutay Ordu Gökkaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Health Training and Research Center, Ankara, Türkiye
| | - İsmail Güneş Gökmen
- Department of Physical Medicine and Rehabilitation, Eskişehir City Hospital, Eskişehir, Türkiye
| | - Fatma Nur Kesiktaş
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Türkiye
| | - Başak Bilir Kaya
- Department of Physical Medicine and Rehabilitation, Turkish Ministry of Health, Erenköy Physical Therapy and Rehabilitation Hospital, Istanbul, Türkiye
| | - Refiye Önal
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Health Training and Research Center, Ankara, Türkiye
| | - Figen Tuncay
- Department of Physical Medicine and Rehabilitation, Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
| | - Aysun Genç
- Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Gulin Findikoglu
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Şebnem Koldaş Doğan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Hamidiye Faculty of Medicine, Antalya Health Reserch Center, Antalya, Türkiye
| | - Serap Tomruk Sütbeyaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Kayseri City Health Training and Research Hospital, Kayseri, Türkiye
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Zonguldak Bülent Ecevit University School of Medicine, Zonguldak, Türkiye
| | - Canan Tıkız
- Department of Physical Medicine and Rehabilitation, Manisa Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Hande Özdemir
- Department of Physical Medicine and Rehabilitation, Trakya University Faculty of Medicine, Edirne, Türkiye
| | - Derya Demirbağ Kabayel
- Department of Physical Medicine and Rehabilitation, Trakya University Faculty of Medicine, Edirne, Türkiye
| | - Merve Örücü Atar
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye
| | - Tuğba Atan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yıldırım Beyazıt University Medical School, Ankara, Türkiye
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12
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Romano J, Ribeiro P, Alberto J, Almeida P, Dantas D. A Prospective Study of Patients with Persistent Symptoms after SARS-CoV-2 Infection Referred to Physical Medicine and Rehabilitation. ACTA MEDICA PORT 2023; 36:639-646. [PMID: 37466050 DOI: 10.20344/amp.19382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 04/17/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION New evidence and extrapolated data from other coronaviruses suggest that symptoms and consequences of COVID-19 may persist beyond the cure. The aims of this study were to evaluate persistent symptoms after SARS-CoV-2 infection and its impact on physical condition, activities of daily living, and quality-of-life; establish whether symptom persistence is associated with higher disability; and document the evolution of the multiple domains after a home exercise program. METHODS Prospective study with patients referred to a Physical and Rehabilitation Medicine clinic, after SARS-CoV-2 infection. Patient evaluations, including a symptom questionnaire, the 1-Min Sit-to-stand test (1-MSTS), the EQ-5D questionnaire and the London Chest Activity Daily Living (LCA-DL) questionnaire, were performed before and after a home exercise program. RESULTS Seventy-four patients were included. The majority (n = 71) had been hospitalized (mean stay 19.66 ± 13.35 days), 51% required intensive care. At first evaluation, 54 days after symptom onset, a mean of 18.6 repetitions in the 1-MSTS were performed. The percentage of LCA-DL was above 28% in 23% of the patients. Impairments on EQ-5D were present in 44% for mobility and 44% for anxiety/depression. Mean EQ-5D VAS was 66.5 out of 100. Fifty-one (70%) had at least one persistent symptom (Symptomatic Group), while 22 (30%) were asymptomatic (Asymptomatic Group). The Symptomatic Group had statistically significantly worse mean results on 1-MSTS (16.8 vs 22.9; p < 0.001), % LCA-DL score, EQ-D5 (7.8 vs 5.7; p < 0.001) and EQ-D5-VAS. No patient characteristic, clinical background, comorbidity, or hospitalization characteristics was significantly different between groups. Every patient was given a home exercise program; 47 patients joined an additional rehabilitation program or were clinically discharged and were therefore excluded from the second evaluation. Twenty-seven patients participated in a second evaluation. In the matched analysis, mean 1-MSTS improved by 3.4 repetitions. Mean LCA-DL, mean EQ-5D score (7.1 to 6.6) and EQ-VAS score changed favourably and significantly. CONCLUSION Two months after infection by SARS-CoV-2, persistent symptoms were frequent in patients referred to a Physical Medicine and Rehabilitation clinic. Additionally, the SARS-CoV-2 infection, as well as the persistence of symptoms, had a negative impact in the physical condition and functionality in ADL and quality-of-life. With a home exercise program in place, a statistically significant improvement was observed. Referral of patients with persistent symptoms to Physical and Rehabilitation Medicine may be warranted.
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Affiliation(s)
- Joana Romano
- Serviço de Medicina Física e de Reabilitação. Hospital de Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal
| | - Pedro Ribeiro
- Serviço de Medicina Física e de Reabilitação. Hospital de Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal
| | - Joana Alberto
- Serviço de Medicina Física e de Reabilitação. Hospital de Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal
| | - Paula Almeida
- Serviço de Medicina Física e de Reabilitação. Hospital de Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal
| | - Duarte Dantas
- Serviço de Medicina Física e de Reabilitação. Hospital de Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal
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Visca D, Centis R, Pontali E, Zampogna E, Russell AM, Migliori GB, Andrejak C, Aro M, Bayram H, Berkani K, Bruchfeld J, Chakaya JM, Chorostowska-Wynimko J, Crestani B, Dalcolmo MP, D'Ambrosio L, Dinh-Xuan AT, Duong-Quy S, Fernandes C, García-García JM, de Melo Kawassaki A, Carrozzi L, Martinez-Garcia MA, Martins PC, Mirsaeidi M, Mohammad Y, Naidoo RN, Neuparth N, Sese L, Silva DR, Solovic I, Sooronbaev TM, Spanevello A, Sverzellati N, Tanno L, Tiberi S, Vasankari T, Vasarmidi E, Vitacca M, Annesi-Maesano I. Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease. Int J Tuberc Lung Dis 2023; 27:729-741. [PMID: 37749839 PMCID: PMC10519381 DOI: 10.5588/ijtld.23.0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient's needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.
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Affiliation(s)
- D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese
| | - R Centis
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - E Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate
| | - A-M Russell
- Faculty of Health and Life Sciences, University of Exeter, Exeter, Royal Devon University Hospitals NHS Trust, Exeter, North Bristol NHS Trust, Bristol, UK
| | - G B Migliori
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - C Andrejak
- Respiratory Department, Centre Hospitalier Universitaire Amiens Picardie, Amiens, Unité de Recherche 4294, Agents Infectieux, Résistance et Chimiothérapie, Picardie Jules Verne University, Amiens, GREPI (Group pour la Recherche et enseignement en pneumo-infectiologie) Work group of French society of respiratory diseases, Paris, France
| | - M Aro
- Finnish Lung Health Association (FILHA), Helsinki, Finland
| | - H Bayram
- Department of Pulmonary Medicine, Koc University Research Center for Translational Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - K Berkani
- Pierre de Soleil Clinic, Respiratory Rehabilitation, Vetraz Monthoux, France
| | - J Bruchfeld
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - J M Chakaya
- Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - J Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - B Crestani
- Université Paris Cité, Physiopathologie et épidémiologie des maladies respiratoires, Institut national de la santé et de la recherche médicale (INSERM), Paris, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Bichat, Service de Pneumologie A, FHU APOLLO, Paris, France
| | - M P Dalcolmo
- Hélio Fraga Reference Center, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - A-T Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, APHP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - S Duong-Quy
- Respiratory Department, Lam Dong Medical College, Dalat, Vietnam
| | - C Fernandes
- Heart Institute, Cardio-pulmonology Department, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - J-M García-García
- Tuberculosis Research Programme (PII-TB), Sociedad Española de Neumología y Cirugía Torácica, Barcelona, Spain
| | - A de Melo Kawassaki
- Serviço de Pneumologia, Instituto do Câncer do Estado de São Paulo (ICESP) e do ambulatÓrio de Doenças Pulmonares Intersticiais, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - L Carrozzi
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - M A Martinez-Garcia
- Respiratory Department, University and Polytechnic La Fe Hospital, Valencia, Centro de InvestigaciÓn Biomédica en Red, Respiratory Disorders, Madrid, Spain
| | - P Carreiro Martins
- Allergy and Clinical Immunology Department, Dona Estefânia Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, NOVA Medical School-Comprehensive Health Research Center, Lisbon, Portugal
| | - M Mirsaeidi
- Division of Pulmonary and Critical Care, University of Florida, Jacksonville, FL, USA
| | - Y Mohammad
- Al Sham private University, Faculty of Medicine and Pharmacy, Damascus and Latakia, Centre for Research on Chronic Respiratory Diseases, Tishreen University, Lattakia, Syria
| | - R N Naidoo
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - N Neuparth
- Allergy and Clinical Immunology Department, Dona Estefânia Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, NOVA Medical School-Comprehensive Health Research Center, Lisbon, Portugal
| | - L Sese
- Department of Physiology and Functional Explorations, Hôpital Avicenne, INSERM, Unité mixte de recherche 1272 Hypoxia and the Lung, Université Sorbonne Paris Nord, Bobigny, Department of Pneumology, Centre Constitutif de référence des maladies pulmonaires rares, Hôpital Avicenne, Bobigny, France
| | - D R Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - I Solovic
- National Institute for TB, Lund Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ruzomberok, Slovakia
| | - T M Sooronbaev
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - A Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese
| | - N Sverzellati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Tanno
- Institut Desbrest of Epidemiology and Santé Publique, INSERM & Montpellier University, Montpellier and Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - S Tiberi
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - T Vasankari
- FILHA, Helsinki, University of Turku, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland
| | - E Vasarmidi
- Department of Respiratory Medicine and Laboratory of Molecular and Cellular Pneumonology, School of Medicine, University of Crete, Heraklion, Greece
| | - M Vitacca
- ICS Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
| | - I Annesi-Maesano
- Institut Desbrest of Epidemiology and Santé Publique, INSERM & Montpellier University, Montpellier and Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
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Vigna M, Ceriana P, Santomassimo M, Vitacca M, Maniscalco M, Ambrosino N. Effects of pulmonary rehabilitation in survivors of severe acute respiratory syndrome coronavirus 2. Role of vaccination. Monaldi Arch Chest Dis 2023. [PMID: 37732337 DOI: 10.4081/monaldi.2023.2738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Survivors of severe COVID-19 requiring hospital admission may suffer from short- and long-term sequelae, including disability and reduced physical performance. Vaccination and pulmonary rehabilitation (PR) are effective tools against COVID-19 effects. While the beneficial effect of each of these treatments is known, there are no data about their combined effect. In people admitted to PR hospitals after severe COVID-19 disease, we retrospectively analyzed whether PR outcome might be influenced by vaccination status. Ninety-six individuals were studied (46 vaccinated, 50 unvaccinated). Unvaccinated individuals were younger and less comorbid than vaccinated ones and had needed more intensive care support during the previous hospitalization. Measures of disability and physical performance did not differ between groups at the beginning and at the end of the PR program. However, each group showed a statistically significant improvement in all outcome measures (6-minute walking test, short physical performance battery, Barthel Index). We conclude that vaccination status does not influence the outcome of in-patient PR programs for survivors of severe COVID-19.
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Affiliation(s)
- Matteo Vigna
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Piero Ceriana
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Mara Santomassimo
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Michele Vitacca
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Lumezzane (BS).
| | - Mauro Maniscalco
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Telese (BN).
| | - Nicolino Ambrosino
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Montescano (PV).
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Kocaman H, Soslu R, Gökşen A, Uysal A. COVID-19 and postural sway: a comparison of individuals with a SARS-CoV-2 history and healthy sedentary women. Somatosens Mot Res 2023; 40:90-96. [PMID: 36787216 DOI: 10.1080/08990220.2023.2175810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE The aim of the study was to evaluate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postural sway in subjects who have recently recovered from infection. MATERIALS AND METHODS Fifty-six female individuals with a mild to moderate history of SARS-CoV-2 (n = 25, mean age; 21.13 ± 0.64 years) and healthy sedentary controls (n = 31, mean age; 20.09 ± 1.05 years) were included in the study. Postural sway tests were performed in double and single-leg stance on a force plate with eyes open before and after the neuromuscular fatigue test. The Wingate test was used to induce neuromuscular fatigue. To evaluate the change of the variables determined by the measurements of the groups over time and the group-time interactions, a two-way analysis of variance in repeated measures (mixed design repeated measures ANOVA) was used. RESULTS It was found that the SARS-CoV-2 group showed increased total sway path, velocity, and area than those in the healthy group on double and single-leg (right-left) stance (p < 0.05). CONCLUSIONS Even if SARS-CoV-2 group individuals have been reported in a mild to moderate outpatient COVID-19 process, they showed deterioration in postural control compared to healthy individuals. In addition, it was found that SARS-CoV-2 accelerated neuromuscular fatigue effects. This can cause more fatigue during activities than individuals who have not had SARS-CoV-2.
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Affiliation(s)
- Hikmet Kocaman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Recep Soslu
- Faculty of Sports Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Ayşenur Gökşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Turkey
| | - Abdullah Uysal
- Faculty of Sports Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
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Yilmaz Gokmen G, Durmaz D, Demir C, Yilmaz FN. Determining Post-COVID-19 Symptoms and Rehabilitation Needs in Hospitalized and Nonhospitalized COVID-19 Survivors with Tele-Assessment Methods. Telemed J E Health 2023; 29:1312-1323. [PMID: 36757300 DOI: 10.1089/tmj.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Objectives: This study aimed to evaluate the post-COVID-19 symptoms, the severity of symptoms, and functional capacities seen in hospitalized and nonhospitalized COVID-19 survivors according to time periods (total 6, 1-3, and 3-6 months) by tele-assessment methods and to predict the need for periodic rehabilitation of COVID-19 survivors. Methods: Three hundred ninety-four COVID-19 survivors (50.18 ± 15.14 years) who were between 1 and 6 months after PCR(+) were included in the study, and their ongoing symptoms and the severity of these symptoms (0-10 points) were assessed with COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) Tool, and the 30-s Chair Stand Test (CST) was applied by tele-assessment methods. Results: In hospitalized and nonhospitalized survivors of COVID-19, 87% experienced at least one symptom within the first 6 months. The most prevalent symptoms were anxiety (47.7%), fatigue (46.7%), and muscle pain (45.7%). The most common symptom in the nonhospitalized group was fatigue (52.6%), whereas anxiety was 46.8% in the hospitalized group. The 30-s CST score of the nonhospitalized group was significantly higher than the hospitalized group (p < 0.001). Conclusions: In the first 6 months post-COVID-19, musculoskeletal problems, anxiety, fatigue, and muscle pain were observed to be the most prevalent symptoms, regardless of time, in hospitalized and nonhospitalized survivors. There was a serious decrease in their functional capacity. Priority should be given to psychiatric, cardiopulmonary, and musculoskeletal rehabilitation in post-COVID-19. Inclusion of hospitalized/nonhospitalized COVID-19 survivors in a comprehensive rehabilitation program tailored to their needs by following a comprehensive tele-assessment by a multidisciplinary team will reduce the "long COVID-19 syndrome." ClinicalTrials.gov Registration Number: NCT04900441.
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Affiliation(s)
- Gulhan Yilmaz Gokmen
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Dilber Durmaz
- Department of Chest Diseases, Faculty of Medicine, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Canan Demir
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Fatma Nur Yilmaz
- Department of Neurologic Physiotherapy and Rehabilitation, Faculty of Medicine, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
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Qorolli M, Beqaj S, Ibrahimi‐Kaçuri D, Murtezani A, Krasniqi V, Mačak Hadžiomerović A. Functional status and quality of life in post-COVID-19 patients two to three weeks after hospitalization: A cross-sectional study. Health Sci Rep 2023; 6:e1510. [PMID: 37621387 PMCID: PMC10444983 DOI: 10.1002/hsr2.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Background and Aims Extended hospitalization due to coronavirus disease 2019 (COVID-19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post-hospitalized patients are promptly assessed. The aim of this study was to identify post-COVID-19 patients' functional status and quality of life, as well as to investigate their inter-relatedness 2-3 weeks after hospital discharge. Methods The study included 39 post-COVID-19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio-demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6-min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5-Dimension 5-Level (EQ-5D-5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing. Results The median (interquartile range [IQR]) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0-3), 3 (1-6), 9 (8-10), 30.5 (23.2-43.5) kg, 344.5 (312.7-381.7) m respectively, while the mean (SD) for EQ-5D-5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ-5D-5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = -0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = -0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg-CR10, and 6MWT were found to be strongly predictive of SPPB total score. Conclusion In post-COVID-19 patients' functional status and quality of life were impaired 2-3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.
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Affiliation(s)
- Merita Qorolli
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Samire Beqaj
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
| | | | - Ardiana Murtezani
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Valon Krasniqi
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
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Teraž K, Šimunič B, Peskar M, Marusic U, Pišot S, Šlosar L, Gasparini M, Pišot R. Functional characteristics and subjective disease perception in patients with COVID-19 two months after hospital discharge. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1209900. [PMID: 37546579 PMCID: PMC10401436 DOI: 10.3389/fresc.2023.1209900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023]
Abstract
Introduction Although early inpatient and post-hospital rehabilitation is recognized as necessary, not all COVID-19 patients have access to rehabilitation. There are no published reports in the literature that investigate the outcomes of patients who do not receive rehabilitation after COVID-19. Our aim was to evaluate possible improvements in determinate functional and psychological parameters in COVID-19 patients two months after their hospital discharge. Methods On both time points various motor, cognitive, and clinical measurements such as body composition, tensiomyography, blood pressure, spirometry, grip strength test, Timed Up and Go test, gait speed, 30-second chair-stand test, and Montreal Cognitive Assessment, were performed. Additionally, questionnaires such as the SARC-CalF test, Edmonton frail scale, International Physical Activity questionnaire andThe Mediterranean Lifestyle index were conducted to assess lifestyle characteristics. Results A total of 39 patients (87.2% male; mean age of 59.1 ± 10.3 years), who were hospitalized due to COVID-19 at the Izola General Hospital (IGH), Slovenia between December 2020 and April 2021, were included. Patients were assessed at two time points (T1 and T2): T1 was taken after receiving a negative COVID-19 test and T2 was taken two months after T1. After two months of self-rehabilitation, we have detected a BMI increase (p < .001), fat free mass increase (p < .001), better Edmonton frail scale (p < .001), SARC-CalF score (p = .014) and MoCA score (p = .014). There were no detected changes in lifestyle habits nor in physical performance tests. Discussion It is already known that COVID-19 has long-term negative consequences regardless of the stage of the disease. Our findings support the notion that patients cannot fully regain all their functions within a two-month period without receiving structured or supervised rehabilitation. Therefore, it is crucial to offer patients comprehensive and structured rehabilitation that incorporates clinical, cognitive, and motor exercises.
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Affiliation(s)
- Kaja Teraž
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Manca Peskar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Saša Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Malden Gasparini
- Department of General Surgery, General Hospital Izola, Izola, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
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Honchar O, Ashcheulova T. Spontaneous physical functional recovery after hospitalization for COVID-19: insights from a 1 month follow-up and a model to predict poor trajectory. Front Med (Lausanne) 2023; 10:1212678. [PMID: 37547607 PMCID: PMC10399450 DOI: 10.3389/fmed.2023.1212678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background Long COVID syndrome has emerged as a new global healthcare challenge, with impaired physical performance being a prominent debilitating factor. Cardiopulmonary rehabilitation is a mainstay of management of symptomatic post-COVID patients, and optimization of candidate selection might allow for more effective use of available resources. Methods In order to study the natural dynamics and to identify predictors of physical functional recovery following hospitalization for COVID-19, 6 min walk test was performed pre-discharge in 176 patients (40% hypertensive, 53% female, mean age 53.2 ± 13.5 years) with re-evaluation at 1 month. Results Six min walk distance and the reached percent of predicted distance (6MWD%) were suboptimal at both visits-396 ± 71 m (68.7 ± 12.4%) pre-discharge and 466 ± 65 m (81.8 ± 13.6%) at 1 month. Associated changes included significant oxygen desaturation (2.9 ± 2.5 and 2.3 ± 2.2%, respectively) and insufficient increment of heart rate during the test (24.9 ± 17.5 and 28.2 ± 12.0 bpm) that resulted in low reached percent of individual maximum heart rate (61.1 ± 8.1 and 64.3 ± 8.2%). Automatic clusterization of the study cohort by the 6MWD% changes has allowed to identify the subgroup of patients with poor "low base-low increment" trajectory of spontaneous post-discharge recovery that were characterized by younger age (38.2 ± 11.0 vs. 54.9 ± 12.1, p < 0.001) but more extensive pulmonary involvement by CT (43.7 ± 8.8 vs. 29.6 ± 19.4%, p = 0.029) and higher peak ESR values (36.5 ± 9.7 vs. 25.6 ± 12.8, p < 0.001). Predictors of poor recovery in multivariate logistic regression analysis included age, peak ESR, eGFR, percentage of pulmonary involvement by CT, need for in-hospital oxygen supplementation, SpO2 and mMRC dyspnea score pre-discharge, and history of hypertension. Conclusion COVID-19 survivors were characterized by decreased physical performance pre-discharge as assessed by the 6 min walk test and did not completely restore their functional status after 1 month of spontaneous recovery, with signs of altered blood oxygenation and dysautonomia contributing to the observed changes. Patients with poor "low base-low increment" trajectory of post-discharge recovery were characterized by younger age but more extensive pulmonary involvement and higher peak ESR values. Poor post-discharge recovery in the study cohort was predictable by the means of machine learning-based classification model that used age, history of hypertension, need for oxygen supplementation, and ESR as inputs.
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20
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Larrateguy S, Vinagre J, Londero F, Dabin J, Ricciardi E, Jeanpaul S, Torres-Castro R, Núñez-Cortés R, Sánchez-Ramírez D, Gimeno-Santos E, Blanco I. Clinical Variables Related to Functional Capacity and Exertional Desaturation in Patients with COVID-19. Biomedicines 2023; 11:2051. [PMID: 37509690 PMCID: PMC10377716 DOI: 10.3390/biomedicines11072051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Impaired functional capacity is one of the most commonly reported consequences among post-COVID-19 patients. This study aimed to analyse the clinical variables related to functional capacity and exertional desaturation in post-COVID-19 patients at the time of hospital discharge. A cross-sectional study was conducted on patients recovering from COVID-19 pneumonia. The main outcomes measures were functional capacity, assessed using the 1 min sit-to-stand test (1 min STST), and exertional desaturation, defined as a drop of ≥4% in the arterial oxygen saturation. Factors used to characterise the participant outcomes included the use of a high-flow nasal cannula (HFNC), prolonged hospitalisation, occurrence of pulmonary embolism during hospitalisation, and underlying comorbidities. A total of 381 participants (mean age = 53.7 ± 13.2 years, 65.6% men) were included. Participants completed a mean of 16.9 ± 6.2 repetitions in the 1 min STST. Exertional desaturation was observed in 51% of the patients. Higher odds of exertional desaturation were found in the participants who used a HFNC (OR = 3.6; 95%CI: 1.6 to 7.8), were admitted in the hospital >10 days (OR = 4.2; 95%CI: 2.6 to 6.8), and had a pulmonary embolism (OR = 3.5; 95%CI: 2.2. to 5.3). Use of a HFNC (β = -3.4; 95%CI: -5.3 to -1.44), a hospital stay >10 days (β = -2.2; 95%CI: -3.4 to -0.9), and a history of pulmonary embolism (β = -1.4; 95%CI: -2.6 to -0.2) were also negatively associated with the 1 min STST. Most post-COVID-19 patients exhibited reduced functional capacity at the time of hospital discharge, and approximately half had exertional desaturation after the 1 min STST. The use of a HFNC, prolonged hospitalisation and pulmonary embolism were the main clinical variables associated with worse a 1 min STST performance and a higher likelihood of exertional desaturation.
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Affiliation(s)
- Santiago Larrateguy
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin 3103, Argentina
| | - Julian Vinagre
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Federico Londero
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Johana Dabin
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Evangelina Ricciardi
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Santiago Jeanpaul
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile; (R.T.-C.); (R.N.-C.)
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile; (R.T.-C.); (R.N.-C.)
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46003 Valencia, Spain
| | - Diana Sánchez-Ramírez
- Department of Respiratory Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Elena Gimeno-Santos
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), 30627 Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Isabel Blanco
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), 30627 Madrid, Spain
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21
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Ahmad AM, Nawar NM, Dabess HM, Gallab MA. Effect of diaphragm manual release versus conventional breathing exercises and prone positioning on physical functional performance in women with COVID-19: A randomized trial. J Bodyw Mov Ther 2023; 35:311-319. [PMID: 37330786 PMCID: PMC10121151 DOI: 10.1016/j.jbmt.2023.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/22/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Manual therapy has recently gained much interest in managing COVID-19 patients. This study aimed to mainly compare the effect of diaphragm manual release to the effect of conventional breathing exercises and prone positioning on physical functional performance in women with COVID-19. METHODS Forty COVID-19 women patients completed this study. They were randomly assigned to two groups. Group A received diaphragm manual release, and group B received conventional breathing exercises and prone positioning. Both groups received pharmacological treatment. Inclusion criteria were moderate COVID-19 illness, women patients, and ages from 35 to 45 years. The outcome measures were 6-min walk distance (6MWD), chest expansion, Barthel index (BI), oxygen saturation, fatigue Assessment Scale (FAS), and Medical Research Council (MRC) dyspnea scale. RESULTS Both groups showed significant improvements in all outcome measures compared to the baseline (p < 0.001). Compared to group B, group A showed more significant improvements in the 6MWD (MD, 22.75 m; 95% CI, 15.21 to 30.29; p < 0.001), chest expansion (MD, 0.80 cm; 95% CI, 0.46 to 1.14; p < 0.001), BI (MD, 9.50; 95% CI, 5.69 to 13.31; p < 0.001), the O2 saturation (MD, 1.3%; 95% CI, 0.71 to 1.89; p < 0.001), the FAS (MD, -4.70; 95% CI, -6.69 to -2.71; p < 0.001), and dyspnea severity assessed by the MRC dyspnea scale (p = 0.013) post-intervention. CONCLUSION Combined with pharmacological treatment, diaphragm manual release could be superior to conventional breathing exercises and prone positioning in improving physical functional performance, chest expansion, daily living activities, O2 saturation, and measures of fatigue and dyspnea in middle-aged women with moderate COVID-19 illness. TRIAL REGISTRATION Pan African Clinical Trial Registry (PACTR), retrospective, PACTR202302877569441.
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Affiliation(s)
- Ahmad Mahdi Ahmad
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | | | | | - Mona Abulraouf Gallab
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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22
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Nascimento LFED, Mendes LA, Torres-Castro R, Fregonezi GA, Gimeno-Santos E, Vilaró J, Resqueti VR. Physical performance testing in post-COVID-19 patients: protocol for a systematic review of psychometric measurement properties. BMJ Open 2023; 13:e067392. [PMID: 37055197 PMCID: PMC10105913 DOI: 10.1136/bmjopen-2022-067392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION COVID-19 is an infectious disease that causes severe acute respiratory syndrome. A large variety of exercise capacity tests are used for the evaluation of post-COVID-19 patients, but the psychometric properties of these exercise tests remain undetermined in this population. This study aims to critically appraise, compare and summarise the psychometric properties (validity, reliability and responsiveness) of all physical performance tests that are used to assess exercise capacity in post-COVID-19 patients. METHODS AND ANALYSIS This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will include studies with hospitalised adult post-COVID-19 patients (aged 18 years or older and with a confirmed diagnosis of COVID-19). The research will cover randomised controlled trials (RCTs), quasi-RCTs and observational studies published in English and performed in the following settings: hospital, rehabilitation centre, outpatient clinic. We will search the following databases with no date restrictions: PubMed/MEDLINE, EMBASE, SciELO, Cochrane Library, CINAHL and Web of Science. Two authors will independently assess the risk of bias (using the Consensus-Based Standards for the Selection of Health Measurement Instruments Risk of bias checklist) and the certainty of evidence (using the Grading of Recommendations, Assessment, Development and Evaluations). According to the results obtained, data will be meta-analysed or reported narratively. ETHICS AND DISSEMINATION No ethical approval is required for this publication since it will be based on published data. Results of this review will be disseminated via peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021242334.
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Affiliation(s)
- Larissa Fernanda Estevam do Nascimento
- Laboratório de Inovação Tecnológica em Reabilitação e PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Luciana Andrade Mendes
- Departamento de Engenharia Biomédica, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Guilherme Af Fregonezi
- Laboratório de Inovação Tecnológica em Reabilitação e PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Elena Gimeno-Santos
- Respiratory Institute, Hospital Clinic of Barcelona, Institut dInvestigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - J Vilaró
- Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Vanessa R Resqueti
- Laboratório de Inovação Tecnológica em Reabilitação e PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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23
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Torres-Castro R, Núñez-Cortés R, Larrateguy S, Alsina-Restoy X, Barberà JA, Gimeno-Santos E, García AR, Sibila O, Blanco I. Assessment of Exercise Capacity in Post-COVID-19 Patients: How Is the Appropriate Test Chosen? Life (Basel) 2023; 13:621. [PMID: 36983777 PMCID: PMC10054514 DOI: 10.3390/life13030621] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
There is a wide range of sequelae affecting COVID-19 survivors, including impaired physical capacity. These sequelae can affect the quality of life and return to work of the active population. Therefore, one of the pillars of following-up is the evaluation of physical capacity, which can be assessed with field tests (such as the six-minute walk test, the one-minute standing test, the Chester step test, and the shuttle walking test) or laboratory tests (such as the cardiopulmonary exercise test). These tests can be performed in different contexts and have amply demonstrated their usefulness in the assessment of physical capacity both in post-COVID-19 patients and in other chronic respiratory, metabolic, cardiologic, or neurologic diseases. However, when traditional tests cannot be performed, physical function can be a good substitute, especially for assessing the effects of an intervention. For example, the Short Physical Performance Battery assessment and the Timed Up and Go assessment are widely accepted in older adults. Thus, the test should be chosen according to the characteristics of each subject.
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Affiliation(s)
- Rodrigo Torres-Castro
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46003 Valencia, Spain
| | - Santiago Larrateguy
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin 3103, Argentina
| | - Xavier Alsina-Restoy
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Joan Albert Barberà
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
| | - Elena Gimeno-Santos
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Agustin Roberto García
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
| | - Oriol Sibila
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Isabel Blanco
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
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24
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Vitacca M, Paneroni M, Salvi B, Spanevello A, Ceriana P, Bruschi C, Balbi B, Aliani M, Ambrosino N. Airflow grades, outcome measures and response to pulmonary rehabilitation in individuals after an exacerbation of severe chronic obstructive pulmonary disease. Eur J Intern Med 2023; 107:81-85. [PMID: 36396523 DOI: 10.1016/j.ejim.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with COPD may be staged according to symptoms and exacerbation history (GOLD groups: A-D) and on airflow obstruction (GOLD grades: 1-4). Guidelines recommend pulmonary rehabilitation (PR) for these individuals, including those recovering from an exacerbation (ECOPD) OBJECTIVE: To evaluate whether in individuals with clinically severe COPD, recovering from an ECOPD, the effect size of an in-hospital PR program would be affected by airflow severity grades and assessed outcome measures. METHODS Retrospective, multicentre study. Participants were compared according to different GOLD airflow grades. In addition to the MRC dyspnoea scale, six-minute walking distance test and COPD assessment test (CAT), Barthel dyspnoea index (Bid), and Short Physical Performance Battery (SPPB) were assessed, evaluating the proportion of individuals reaching the minimum clinically important difference (MCID) (responders). RESULTS Data of 479 individuals, completing the program were evaluated. Most of the participants were allocated in GOLD grades 4, (57.6%) and 3 (22.1%). All outcome measures significantly improved after PR (p < 0.05), without any significant difference in the proportion of responders in any measure. CONCLUSIONS in individuals with severe COPD, recovering from ECOPD the success rate of PR does not depend on airflow severity, or outcome measure assessed. In addition to the most used outcome measures, also Bid and SPPB are sensitive to PR.
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Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Beatrice Salvi
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Antonio Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Piero Ceriana
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Claudio Bruschi
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Bruno Balbi
- Respiratory Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy
| | - Maria Aliani
- Respiratory Rehabilitation of the Institute of Bari, Istituti Clinici Scientifici Maugeri IRCCS, Bari, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Martínez Rolando L, Villafañe JH, Cercadillo García S, Sanz Argüello A, Villanueva Rosa M, Sánchez Romero EA. Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12396. [PMID: 36231696 PMCID: PMC9566039 DOI: 10.3390/ijerph191912396] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 05/10/2023]
Abstract
COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.
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Affiliation(s)
- Lidia Martínez Rolando
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | | | - Soledad Cercadillo García
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Ana Sanz Argüello
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Marta Villanueva Rosa
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Eleuterio A. Sánchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
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op ‘t Hoog SAJJ, Eskes AM, van Oers JAH, Boerrigter JL, Prins-Smulders MWJC, Oomen M, van der Hoeven JG, Vermeulen H, Vloet LCM. A Quality Improvement Project to Support Post-Intensive Care Unit Patients with COVID-19: Structured Telephone Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9689. [PMID: 35955045 PMCID: PMC9368104 DOI: 10.3390/ijerph19159689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND More than 50% of intensive care unit (ICU) survivors suffer from long-lasting physical, psychosocial, and cognitive health impairments, also called "post-intensive care syndrome" (PICS). Intensive care admission during the COVID-19 pandemic was especially uncertain and stressful, both for patients and for their family. An additional risk of developing symptoms of PICS was feared in the absence of structural aftercare for the patient and family shortly after discharge from the hospital. The purpose of this quality improvement study was to identify PICS symptoms and to support post-intensive care patients and families in the transition from the hospital to the home. Therefore, we offered post-ICU patients and families structured telephone support (STS). METHODS This was a quality improvement study during the 2019 COVID-19 pandemic. A project team developed and implemented a tool to structure telephone calls to identify and order symptoms according to the PICS framework and to give individual support based on this information. We supported post-ICU patients diagnosed with COVID-19 pneumonia and their family caregivers within four weeks after hospital discharge. The reported findings were both quantitative and qualitative. RESULTS Forty-six post-ICU patients received structured telephone support and reported symptoms in at least one of the three domains of the PICS framework. More than half of the patients experienced a loss of strength or condition and fatigue. Cognitive and psychological impairments were reported less frequently. Family caregivers reported fewer impairments concerning fatigue and sleeping problems and expressed a need for a continuity of care. Based on the obtained information, the ICU nurse practitioners were able to check if individual care plans were optimal and clear and, if indicated, initiated disciplines to optimize further follow-up. CONCLUSIONS The implementation of the STS tool gave insight in the impairments of post-ICU patients. Surprisingly, family caregivers expressed fewer impairments. Giving support early after hospital discharge in a structured way may contribute to providing guidance in the individual care plans and treatment of the early symptoms of PICS (-F).
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Affiliation(s)
- Sabine A. J. J. op ‘t Hoog
- Department of Intensive Care, Elisabeth-Tweesteden Hospital, 5022 GC Tilburg, The Netherlands
- Research Department of Emergency and Critical Care, HAN University of Applied Science, 6525 EN Nijmegen, The Netherlands
| | - Anne M. Eskes
- Department of Surgery, Amerstam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4222, Australia
| | - Jos A. H. van Oers
- Department of Intensive Care, Elisabeth-Tweesteden Hospital, 5022 GC Tilburg, The Netherlands
| | - José L. Boerrigter
- Department of Surgery, Amerstam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Meike W. J. C. Prins-Smulders
- Department of Intensive Care, Elisabeth-Tweesteden Hospital, 5022 GC Tilburg, The Netherlands
- Research Department of Emergency and Critical Care, HAN University of Applied Science, 6525 EN Nijmegen, The Netherlands
| | - Margo Oomen
- Department of Intensive Care, Elisabeth-Tweesteden Hospital, 5022 GC Tilburg, The Netherlands
| | - Johannes G. van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, 6500 HB Nijmegen, The Netherlands
- Foundation Family and Patient Centered Intensive Care, 1801 GB Alkmaar, The Netherlands
| | - Lilian C. M. Vloet
- Research Department of Emergency and Critical Care, HAN University of Applied Science, 6525 EN Nijmegen, The Netherlands
- Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, 6500 HB Nijmegen, The Netherlands
- Foundation Family and Patient Centered Intensive Care, 1801 GB Alkmaar, The Netherlands
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Polastri M, Carbonara P, Prediletto I, Gardini A, Venturoli F, Tagariello F, Neri L, Carpano M, Pacilli AMG, Nava S. Effects of early rehabilitation on motor function, dyspnoea intensity, respiratory muscle performance and handgrip strength in patients with COVID-19: an observational study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background/Aims Although an increasing volume of research is emerging, rehabilitative treatment of patients with COVID-19 still continues to be a matter of great importance that must be explored further. The purpose of the present study was to describe the effects of inpatient rehabilitation in acute patients treated in a sub-intensive hospital setting during the COVID-19 pandemic. Methods A retrospective analysis was conducted based on the prospectively collected data of 192 patients with COVID-19 undergoing a physiotherapeutic regimen during their hospitalisation. Patients were admitted because of COVID-19-related pneumonia from the periods of 25 March–12 June 2020 and 2 November 2020–9 June 2021. This study investigated dyspnoea intensity using the modified Borg scale, motor function through the 1-minute sit-to-stand test, and daily walked distance. In a subset of 57 patients, handgrip strength and respiratory muscle function was also evaluated. Measurements were taken at baseline and discharge. Results Patients were classified according to the severity of their ratio of arterial oxygen partial pressure to fractional inspired oxygen (mean 225 ± 82 mmHg). At discharge to home or to another hospital facility, patients performed a mean of 12 repetitions (1-minute sit-to-stand test); dyspnoea intensity was 1.4 (modified Borg scale), and they were able to walk a mean distance of 266.7 metres. The mean handgrip strength of the dominant hand was 29.3 kg, the maximal inspiratory pressure was 43.5 cmH2O, and the maximal expiratory pressure was 59.1 cmH2O. Overall, significant differences before and after treatment were detected for all clinical variables. Dyspnoea improved by 0.7 points; walked distance by 200 metres; the number of repetitions at the 1-minute sit-to-stand test by 5.6; the handgrip strength by 1.2 kg (right hand) and 1.7 kg (left hand); maximal inspiratory pressure by 7.7 cmH2O; and maximal expiratory pressure by 9.5 cmH2O. Conclusions Patients obtained significant improvements in functional capacity, dyspnoea perception, handgrip strength and respiratory muscle function. In addition, the treatment was feasible and well tolerated by patients, and no adverse related events were observed in a sub-intensive care setting.
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Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paolo Carbonara
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Irene Prediletto
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Aldo Gardini
- Department of Statistical Sciences ‘P. Fortunati’, University of Bologna, Bologna, Italy
| | - Francesca Venturoli
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Tagariello
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lucia Neri
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marco Carpano
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Angela Maria Grazia Pacilli
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Videon TM, Rosati RJ, Landers SH. Early versus late COVID‐19 Home Health Care patient population: Shifting sociodemographics and comparable outcomes. Res Nurs Health 2022; 45:446-455. [PMID: 35462419 PMCID: PMC9088655 DOI: 10.1002/nur.22230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Tami M. Videon
- The Visiting Nurse Association Health Group Inc. Holmdel New Jersey USA
| | - Robert J. Rosati
- The Visiting Nurse Association Health Group Inc. Holmdel New Jersey USA
| | - Steven H. Landers
- The Visiting Nurse Association Health Group Inc. Holmdel New Jersey USA
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Sevillano-Castaño A, Peroy-Badal R, Torres-Castro R, Gimeno-Santos E, García Fernández P, Garcia Vila C, Ariza Alfaro A, De Dios Álvarez R, Vilaró J, Blanco I. Is there a learning effect on 1-min sit-to-stand test in post-COVID-19 patients? ERJ Open Res 2022; 8:00189-2022. [PMID: 36171984 PMCID: PMC9511157 DOI: 10.1183/23120541.00189-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
The 1-min sit-to-stand test is a repeatable field test without differences between the first and second tests. Hence, conducting one attempt of the 1-min STST would be enough to evaluate functional capacity in patients recovered from #COVID19. https://bit.ly/3y3ycAP.
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Affiliation(s)
- Ana Sevillano-Castaño
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
- Both authors contributed equally
| | - Renata Peroy-Badal
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
- Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
- Both authors contributed equally
| | - Rodrigo Torres-Castro
- Dept of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
- International Physiotherapy Research Network (PhysioEvidence)
- Dept of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Gimeno-Santos
- Dept of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Pablo García Fernández
- Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Garcia Vila
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Rosalia De Dios Álvarez
- Hospital Virgen de La Torre - Hospital Universitario Infanta Leonor, Madrid, Spain
- Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Jordi Vilaró
- International Physiotherapy Research Network (PhysioEvidence)
- Facultad de Ciencias de la Salud Blanquerna, Global Research on Wellbeing (GRoW), Universidad Ramon Llull, Barcelona, Spain
| | - Isabel Blanco
- Dept of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain
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Ambrosino N. Long COVID: Impact and Comprehensive Management. A Never Ending Story? Arch Bronconeumol 2022; 58:469-470. [PMID: 35095170 PMCID: PMC8784615 DOI: 10.1016/j.arbres.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Nicolino Ambrosino
- Chief Editor of Pulmonology
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Pavia, Italy
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Vitacca M, Paneroni M, Salvi B, Comini L, Ambrosino N. In-Patient Trajectories and Effects of Training in Survivors of COVID-19-Associated Acute Respiratory Failure. Respir Care 2022; 67:657-666. [PMID: 35440497 PMCID: PMC9994203 DOI: 10.4187/respcare.09808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) is useful in survivors of COVID-19-associated acute respiratory failure (ARF). The aim of this retrospective study on in-patient PR was to report rehabilitative trajectories and effects of cycle training. METHODS According to the Short Physical Performance Battery (SPPB) score at admission (T0), participants were allocated to stage 1 (SPPB < 6), stage 2 (SPPB ≥ 6 and < 10), or stage 3 (SPPB ≥ 10) and performed increasing level of activities from passive exercises to free walking, balance exercises, strength exercises, and tailored cycle-ergometer endurance training. The primary outcome was SPPB. 6-min walk distance (6MWD), Medical Research Council score, Barthel dyspnea index, and rate of subjects able to cycling were also assessed. RESULTS Data of 123 participants were analyzed. At T0, 44 (35.8%), 50 (40.6%), and 29 (23.6%) participants were allocated to stages 1-3, respectively. At discharge, participants showed significant improvements in SPPB, independent of the initial stage, 81 (65.8%) improving more than its minimal clinically important difference. At T1, the proportion of participants in stages 1 and 2 decreased, whereas significantly increased in stage 3 (P = .003), (being 9.8%, 33.3%, and 56.9% for stages 1-3, respectively; P <.001). Sixty-nine of 123 participants (56.1%) underwent cycle exercise training. In participants able to perform it, 6MWD improved by 115 (65-240) m and 60 (40-118) m in participants with and without exercise-induced desaturation, respectively, with significant difference between groups (P = .044). CONCLUSIONS In-patient PR could be tailored and progressively increased to survivors of COVID-19-associated ARF; cycle training was feasible in half of the participants. Benefits were independent of initial stage of physical performance and allowed participants to move from lower to higher levels of activities.
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Affiliation(s)
- Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
| | - Mara Paneroni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
| | - Beatrice Salvi
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
| | - Laura Comini
- Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute Lumezzane, Brescia, Italy
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Pavia, Italy
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Yanamandra U, Saxena P, Srinath R, Sawant A, Singh A, Aggarwal N, Pavan B, Duhan G, Aggarwal B, Kaur P. Assessment of Six-Minute Walk Test Among Discharge-Ready Severe COVID-19 Patients: A Cross-Sectional Study. Cureus 2022; 14:e25108. [PMID: 35733480 PMCID: PMC9205384 DOI: 10.7759/cureus.25108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 01/08/2023] Open
Abstract
Background Among patients hospitalized for severe pneumonia due to coronavirus disease (COVID-19), clinical stability and normal resting peripheral oxygen saturation (SpO2) levels are widely used as a discharge criterion after recovery. It is unknown whether a test to assess the functional exercise capacity, like a six-minute walk test (6MWT), can add to the appropriateness of discharge criteria. Methods A cross-sectional study was conducted at a tertiary care COVID-19 hospital in India from 01st to 31st May 2021. All patients considered fit for discharge after recovery from "severe" COVID-19 pneumonia were subjected to 6MWT. Fitness for discharge was assessed by clinical stability and resting SpO2 above 93% for three consecutive days. Patients were considered to have failed the 6MWT if there was ≥4% fall in SpO2 or if they could not complete the test. Serum samples were analyzed for levels of C-reactive protein (CRP), interleukin-6 (IL-6), and lactate dehydrogenase (LDH) at the time of discharge. Results Fifty-three discharge-ready patients with a mean age of 54.54 ± 14.35 years with a male preponderance (60.38%) were analyzed. Thirty-three (62.26%) patients failed the 6MWT with a median six-minute walk distance (6MWD) of 270 m (60-360). A total of 45 (84.91%) patients had a fall in SpO2 during the test. The median change in SpO2 (∆SpO2) was 5% ranging from -6% to 8%. Serum LDH was significantly higher among patients who failed the 6MWT with a median LDH of 334 IU/L (38.96-2339) versus 261 IU/L (49.2-494) (p = 0.02). The difference was not significant for CRP or IL-6. There was no statistically significant correlation between the inflammatory markers with either 6MWD or (∆SpO2). Conclusion Two-thirds of the patients considered fit for discharge after recovery from severe COVID-19 pneumonia failed 6MWT, implying reduced functional exercise capacity and exertional hypoxia. Serum LDH levels were higher in these patients but not in other inflammatory markers. None of the inflammatory markers at discharge correlated with 6MWD or ∆SpO2 of 6MWT.
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Allado E, Poussel M, Albuisson E, Paysant J, Temperelli M, Hily O, Moussu A, Benhajji N, Gauchard G, Chenuel B. Physical Activity Capacity Assessment of Patients With Chronic Disease and the 1-Minute Sit to Stand Test: Is There an Interest? Front Sports Act Living 2022; 4:839509. [PMID: 35368419 PMCID: PMC8970334 DOI: 10.3389/fspor.2022.839509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to evaluate the efficacy of the 1-minute Sit to Stand test (1MSTS) to determine physical activity capacities for patients with chronic disease. Methods For this cross-sectional study, we studied fifty patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test to determine maximal oxygen uptake (V'O2max). We considered two groups of patients based on the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max <80% of the theoretical value). All patients also received an 1MSTS on the same day. Results We found 22 (44.0%) patients with normal exercise capacity and 28 (56.0%) patients with limited exercise performance. In this sample, mean 1MSTS repetitions were 27.1 (7.1) and 25.2 (8.7), respectively. There were no significant differences between the two groups for repetition and Borg Scale end test. The correlation between V'O2max measured during the exercise test and 1MSTS repetitions displayed a positive slope [r = 0.401 (95% CI 0.114–625)]. Conclusion This study demonstrated a moderate relationship between 1MSTS and V'O2max for patients with chronic disease. 1MSTS did not permit the precise determination of physical activity capacities in this sample.
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Affiliation(s)
- Edem Allado
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
- OMEOS, Nancy, France
- *Correspondence: Edem Allado
| | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Nancy, France
- Université de Lorraine, CNRS, IECL, Nancy, France
- Université de Lorraine, Faculté de Médecine, Département du Grand Est de Recherche en Soins Primaires: DEGERESP, Nancy, France
| | - Jean Paysant
- Université de Lorraine, DevAH, Nancy, France
- Université de Lorraine, CHRU-Nancy, Rehabilitation Medicine Department, Nancy, France
| | - Margaux Temperelli
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Oriane Hily
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Anthony Moussu
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- OMEOS, Nancy, France
| | - Noura Benhajji
- OMEOS, Nancy, France
- Université de Lorraine, CNRS, IECL, Nancy, France
| | | | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
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Shabat S, Meiner Z, Tsenter J, Schwartz I, Portnoy S. Correlations between Electro-Diagnostic Findings, the Severity of Initial Infection, and the Rehabilitation Outcomes among COVID-19 Patients. BIOLOGY 2022; 11:277. [PMID: 35205144 PMCID: PMC8869409 DOI: 10.3390/biology11020277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
Patients with Coronavirus-2019 (COVID-19) manifest many neuromuscular complications. We evaluated the correlations between electromyography and nerve conduction measurements among COVID-19 patients and the severity of the initial infection, as well as the rehabilitation outcomes, and searched for the factors which best predict the rehabilitation outcomes. A total of 19 COVID-19 patients (16 men; mean ± SD age 59.1 ± 10.4), with WHO clinical progression scale of 6.8 ± 2.3, received rehabilitation for 3.9 ± 2.5 months. The Functional Independence Measure (FIM), the 10 m walk test, the 6 minute walk test, and grip force were collected before and after the rehabilitation period. Motor Nerve Conduction (MNC), Sensory Nerve Conduction (SNC) and electromyographic abnormalities were measured. All of the MNC measures of the median nerve correlated with the WHO clinical progression scale and duration of acute hospitalization. The MNC and SNC measures correlated with the rehabilitation duration and with FIM at discharge. The MNC distal latency of the median and the peroneal nerves and the MNC velocity of the median and tibial nerves predicted 91.6% of the variance of the motor FIM at discharge. We conclude that nerve conduction measurements, especially in COVID-19 patients with severe illness, are important in order to predict prognosis and rehabilitation outcomes.
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Affiliation(s)
- Sheer Shabat
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Zeev Meiner
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Jeanna Tsenter
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Isabella Schwartz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Sigal Portnoy
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Botek M, Krejčí J, Valenta M, McKune A, Sládečková B, Konečný P, Klimešová I, Pastucha D. Molecular Hydrogen Positively Affects Physical and Respiratory Function in Acute Post-COVID-19 Patients: A New Perspective in Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1992. [PMID: 35206179 PMCID: PMC8872486 DOI: 10.3390/ijerph19041992] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/15/2022]
Abstract
Molecular hydrogen (H2) is potentially a novel therapeutic gas for acute post-coronavirus disease 2019 (COVID-19) patients because it has antioxidative, anti-inflammatory, anti-apoptosis, and antifatigue properties. The aim of this study was to determine the effect of 14 days of H2 inhalation on the respiratory and physical fitness status of acute post-COVID-19 patients. This randomized, single-blind, placebo-controlled study included 26 males (44 ± 17 years) and 24 females (38 ± 12 years), who performed a 6-min walking test (6 MWT) and pulmonary function test, specifically forced vital capacity (FVC) and expiratory volume in the first second (FEV1). Symptomatic participants were recruited between 21 and 33 days after a positive polymerase chain reaction test. The experiment consisted of H2/placebo inhalation, 2 × 60 min/day for 14 days. Results showed that H2 therapy, compared with placebo, significantly increased 6 MWT distance by 64 ± 39 m, FVC by 0.19 ± 0.24 L, and, in FEV1, by 0.11 ± 0.28 L (all p ≤ 0.025). In conclusion, H2 inhalation had beneficial health effects in terms of improved physical and respiratory function in acute post-COVID-19 patients. Therefore, H2 inhalation may represent a safe, effective approach for accelerating early function restoration in post-COVID-19 patients.
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Affiliation(s)
- Michal Botek
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Jakub Krejčí
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Michal Valenta
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Andrew McKune
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT 2617, Australia;
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Barbora Sládečková
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Petr Konečný
- Faculty of Health Sciences, Palacký University Olomouc, 775 15 Olomouc, Czech Republic;
| | - Iva Klimešová
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Dalibor Pastucha
- Clinic of Rehabilitation and Physical Medicine, University Hospital Ostrava, 708 52 Ostrava, Czech Republic;
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De Michele L, Pierucci P, Giovannetti G, De Ceglie M, Dimitri M, Mirabile A, Quaranta V, Scardapane A, D'Agostino C, Carpagnano GE. Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up. Monaldi Arch Chest Dis 2022; 92. [PMID: 35044135 DOI: 10.4081/monaldi.2022.2142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
The correct type and time of follow-up for patients affected by COVID19 ARDS is still unclear. The aim of this study was to evaluate at the survivors to COVID19 ARDS requiring non-invasive respiratory support (NRS) admitted to a Respiratory Intensive care unit (RICU) from March 8th till May 31th 2020 looking at all sequelae via a comprehensive follow up. All patients underwent a multi-disciplinary instrumental and clinical assessment within three months form admission to evaluate all infection related sequelae. Thirty-eight patients were enrolled Lung-Ultrasound (LUS) showed an outstanding discrimination ability (ROC AUC: 0.95) and a substantial agreement rate (Cohen's K: 0.74) compared to chest CT-scan detecting improvement of lung consolidations. Youden's test showed a cut-off pressure of 11 cmH2O ExpiratoryPAP-Continuous-PAP-max (EPAP-CPAP) applied at the airways during hospitalization to be significantly correlated (p value: 0.026) to the increased pulmonary artery common trunk diameter. A total of 8/38 patients (21.8%), 2 of whom during follow-up, were diagnosed with Pulmonary Emboli (PE) and started anticoagulant treatment. Patients with PE had a statistically significant shorter length of time of hospitalization, time to negative swab, CPAP/NIV duration, P/F ratio and D-dimers at follow-up compared to non PE. A comprehensive approach to patients with ARDS COVID19 requiring NRS is necessary. This study highlighted cardiopulmonary impairment related to the ARDS and to the high-EPAP-CPAP-max greater than 11mmHg provided during admission, the usefulness of LUS in monitoring post-infection recovery and the correct identification and treatment of patients with PE during follow up.
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Affiliation(s)
- Lucrezia De Michele
- Cardio Thoracic and Vascular Department, University Hospital Policlinic of Bari.
| | - Paola Pierucci
- Cardiothoracic Department, Respiratory and Critical Care Unit, Bari Policlinic University Hospital, Bari; Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari.
| | - Guido Giovannetti
- Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro' Medical School, Bari .
| | - Michele De Ceglie
- DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari .
| | - Michela Dimitri
- Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari.
| | - Alessandra Mirabile
- DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari .
| | | | - Arnaldo Scardapane
- DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari.
| | - Carlo D'Agostino
- DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari.
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Arbillaga-Etxarri A, Lista-Paz A, Alcaraz-Serrano V, Escudero-Romero R, Herrero-Cortina B, Balañá Corberó A, Sebio-García R, Vilaró J, Gimeno-Santos E. [Respiratory physiotherapy in post-COVID-19: a decision-making algorithm for clinical practice]. OPEN RESPIRATORY ARCHIVES 2022; 4:100139. [PMID: 38620962 PMCID: PMC8507569 DOI: 10.1016/j.opresp.2021.100139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/13/2021] [Indexed: 01/06/2023] Open
Abstract
The outbreak of COVID-19 has posed a great challenge for the healthcare system which has been later aggravated by the need of managing clinical manifestations and potential sequelae in COVID-19 survivors. In this context, respiratory Physiotherapy emerges as a cornerstone in the interdisciplinary management warranted in this population. Given that the implementation and resources available for the interdisciplinary therapeutic interventions in Spain is scarce, it is essential to perform a comprehensive, exhaustive and personalised assessment. This will allow us to establish more accurate selection criteria in order to optimise the use of existing human and material resources. To this end, we propose here a decision-making algorithm for clinical practice to assess the clinical manifestations in people recovered from COVID-19 based on well-established, validated tests and assessment tools. This algorithm can be used at any clinical practice environment (primary care/community or hospital-based), combined with a patient-centered model and the use of community and e-Health resources and its application to improve the Physiotherapy care of these patients in the COVID-19 era.
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Affiliation(s)
- Ane Arbillaga-Etxarri
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Deusto, Gipuzkoa, España
| | - Ana Lista-Paz
- Facultad de Fisioterapia, Universidade da Coruña, A Coruña, España
| | - Victoria Alcaraz-Serrano
- Fundación Clínic para la Investigación Biomédica, Hospital Clínic de Barcelona, Barcelona, España
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, España
- Facultad de Ciencias de la Salud Blanquerna, Universidad Ramon Llull, Barcelona, España
| | | | - Beatriz Herrero-Cortina
- Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
- Universidad San Jorge, Campus Universitario, Zaragoza, España
| | - Ana Balañá Corberó
- Facultad de Ciencias de la Salud Blanquerna, Universidad Ramon Llull, Barcelona, España
- Servicio de Neumología, Hospital del Mar-IMIM, Barcelona, España
| | - Raquel Sebio-García
- Servicio de Rehabilitación, Hospital Clínic de Barcelona, Barcelona, España
- Instituto de Investigaciones Biomédicas Agustí Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Jordi Vilaró
- Facultad de Ciencias de la Salud Blanquerna, Universidad Ramon Llull, Barcelona, España
- Global Research on Wellbeing (GRoW), Universidad Ramon Llull, Barcelona, España
| | - Elena Gimeno-Santos
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, España
- Facultad de Ciencias de la Salud Blanquerna, Universidad Ramon Llull, Barcelona, España
- Servicio de Rehabilitación, Hospital Clínic de Barcelona, Barcelona, España
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Di Paco A, Mazzoleni S, Vitacca M, Comini L, Ambrosino N. Lung function and ventilatory response to exercise in asymptomatic elite soccer players positive for COVID-19. Pulmonology 2021; 28:148-151. [PMID: 34876375 PMCID: PMC8598945 DOI: 10.1016/j.pulmoe.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- A Di Paco
- Lung Unit, Casa di Cura San Rossore, Pisa, Italy
| | - S Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - M Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
| | - L Comini
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - N Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
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Vitacca M, Paneroni M, Malovini A, Carlucci A, Binda C, Sanci V, Ambrosino N. Clusters of Survivors of COVID-19 Associated Acute Respiratory Failure According to Response to Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211868. [PMID: 34831623 PMCID: PMC8622806 DOI: 10.3390/ijerph182211868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 survivors are associated with acute respiratory failure (ARF) and show a high prevalence of impairment in physical performance. The present studied aimed to assess whether we may cluster these individuals according to an exercise test. The presented study is a retrospective analysis of 154 survivors who were admitted to two hospitals of Istituti Clinici Scientifici Maugeri network, Italy. Clinical characteristics, walked distance, heart rate (HR), pulse oximetry (SpO2), dyspnoea, and leg fatigue (Borg scale: Borg-D and Borg-F, respectively) while performing the six-minute walking test (6MWT) were entered into unsupervised clustering analysis. Multivariate linear regression identified variables that were informative for the set of variables used for cluster definition. Cluster 1 (C1: 86.4% of participants) and Cluster 2 (C2: 13.6%) were identified. Compared to C1, the individuals in C2 were significantly older, showed significantly higher increase in fatigue and in dyspnoea, greater reduction in SpO2, and a lower HRpeak during the test. The need of walking aids, time from admission to acute care hospitals, age, body mass index, endotracheal intubation, baseline HR and baseline Borg-D, and exercise-induced SpO2 change were significantly associated with the variables that were used for cluster definition. Different characteristics and physiological parameters during the 6MWT characterise survivors of COVID-19-associated ARF. These results may help in the management of the long-term effects of the disease.
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Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy;
- Correspondence:
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy;
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy;
| | - Annalisa Carlucci
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (A.C.); (C.B.); (V.S.)
- Department of Medicine and Surgery, Università Insubria, 21100 Varese, Italy
| | - Chiara Binda
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (A.C.); (C.B.); (V.S.)
- Department of Medicine and Surgery, Università Insubria, 21100 Varese, Italy
| | - Vincenzo Sanci
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (A.C.); (C.B.); (V.S.)
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy;
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40
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Marques A. Functional status in the COVID-19 era: ALERT, ALERT, ALERT! Pulmonology 2021; 27:481-483. [PMID: 34635466 PMCID: PMC8437814 DOI: 10.1016/j.pulmoe.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
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41
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Zampogna E, Ambrosino N, Migliori GB, Visca D. Time course of exercise capacity in patients recovering from COVID-19-associated pneumonia. Authors' reply. J Bras Pneumol 2021; 47:e20210328. [PMID: 34495184 PMCID: PMC8979662 DOI: 10.36416/1806-3756/e20210328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Elisabetta Zampogna
- . Divisione di Pneumologia Riabilitativa, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | - Nicolino Ambrosino
- . Divisione di Pneumologia Riabilitativa, Istituti Clinici Scientifici Maugeri - IRCCS - Montescano, Italia
| | - Giovanni Battista Migliori
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | - Dina Visca
- . Divisione di Pneumologia Riabilitativa, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia.,. Dipartimento di Medicina e Chirurgia, Malattie Respiratorie, Università degli Studi dell'Insubria, Varese/Como, Italia
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