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Wu MP, Hsiaog SH, Huang TC, Chu DC, Liu CY. Impacts of COVID-19 pandemic prevention measures to the palliative care in Taiwan. Front Public Health 2024; 12:1411185. [PMID: 39118972 PMCID: PMC11309006 DOI: 10.3389/fpubh.2024.1411185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Background Prevention measures for palliative care and the provision of discharge planning services for inpatients in Taiwan before and during the COVID-19 pandemic had not been investigated. This study was aimed to investigate the factors associated with heightened palliative care needs and increased mortality rates. Methods This research adopts a retrospective case-control study design. The investigation encompasses patients admitted before the pandemic (from January 1, 2019, to May 31, 2019) and during the COVID-19 pandemic (from January 1, 2020, to May 31, 2020). The case group consisted of 231 end-of-life inpatients during the pandemic, control group was composed of the pool of inpatients with pre-pandemic and matched with cases by sex and age in a 1:1 ratio. Results The results showed that the prevalence of respiratory failure symptoms (p = 0.004), residing in long-term care facilities (p = 0.017), palliative care needs assessment scores (p = 0.010), as well as the provision of guidance for nasogastric tube feeding (p = 0.002), steam inhalation (p = 0.003), turning and positioning (p < 0.001), percussion (p < 0.001), passive range of motion (p < 0.001), and blood pressure measurement (p < 0.001). Furthermore, the assessment of the necessity for assistive devices, including hospital beds, also exhibited statistically significant variations (p < 0.001). Further investigation of the factors associated with high palliative care needs and the risk of mortality for both the case and control groups. Risk factors for high palliative care needs encompassed assessments of daily activities of living, the presence of pressure ulcers, and the receipt of guidance for ambulation. Risk factors for mortality encompassed age, a diagnosis of cancer, palliative care needs assessment scores, and the provision of guidance for disease awareness. Conclusion This research highlights the heightened risk of COVID-19 infection among end-of-life inpatients during the COVID-19 pandemic. The findings of this study may advance care planning to alleviate avoidable suffering. To meet the needs of inpatients during pandemic, healthcare professionals should undergo comprehensive palliative care training and receive policy support.
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Affiliation(s)
- Meng-Ping Wu
- Department of Nursing, Taipei City Hospital, Taipei City, Taiwan
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- Department of Psychology and Counseling, University of Taipei, Taipei City, Taiwan
| | | | - Tsun-Cheng Huang
- Administrative Deputy Superintendent Office, Taipei City Hospital, Taipei City, Taiwan
| | | | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- Department of Research and Development, Taipei City Hospital, Taipei City, Taiwan
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van Tol LS, Haaksma ML, Cesari M, Dockery F, Everink IHJ, Francis BN, Gordon AL, Grund S, Matchekhina L, Bazan LMP, Schols JMGA, Topinková E, Vassallo MA, Caljouw MAA, Achterberg WP. Post-COVID-19 patients in geriatric rehabilitation substantially recover in daily functioning and quality of life. Age Ageing 2024; 53:afae084. [PMID: 38725361 PMCID: PMC11082471 DOI: 10.1093/ageing/afae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND After an acute infection, older persons may benefit from geriatric rehabilitation (GR). OBJECTIVES This study describes the recovery trajectories of post-COVID-19 patients undergoing GR and explores whether frailty is associated with recovery. DESIGN Multicentre prospective cohort study. SETTING 59 GR facilities in 10 European countries. PARTICIPANTS Post-COVID-19 patients admitted to GR between October 2020 and October 2021. METHODS Patients' characteristics, daily functioning (Barthel index; BI), quality of life (QoL; EQ-5D-5L) and frailty (Clinical Frailty Scale; CFS) were collected at admission, discharge, 6 weeks and 6 months after discharge. We used linear mixed models to examine the trajectories of daily functioning and QoL. RESULTS 723 participants were included with a mean age of 75 (SD: 9.91) years. Most participants were pre-frail to frail (median [interquartile range] CFS 6.0 [5.0-7.0]) at admission. After admission, the BI first steeply increased from 11.31 with 2.51 (SE 0.15, P < 0.001) points per month and stabilised around 17.0 (quadratic slope: -0.26, SE 0.02, P < 0.001). Similarly, EQ-5D-5L first steeply increased from 0.569 with 0.126 points per month (SE 0.008, P < 0.001) and stabilised around 0.8 (quadratic slope: -0.014, SE 0.001, P < 0.001). Functional recovery rates were independent of frailty level at admission. QoL was lower at admission for frailer participants, but increased faster, stabilising at almost equal QoL values for frail, pre-frail and fit patients. CONCLUSIONS Post-COVID-19 patients admitted to GR showed substantial recovery in daily functioning and QoL. Frailty at GR admission was not associated with recovery and should not be a reason to exclude patients from GR.
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Affiliation(s)
- Lisa S van Tol
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector South-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Miriam L Haaksma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector South-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Matteo Cesari
- IRCCS Istituti Clinici Maugeri, University of Milan, Milan, Italy
| | - Frances Dockery
- Beaumont Hospital & Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Irma H J Everink
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Bahaa N Francis
- Fliman Geriatric Rehabilitation Hospital, Zalman Shneur Street, Haifa, 31021, Israel
- Geriatric Division, Holy Family Hospital, Bar Ilan University, Safad, Israel
| | - Adam L Gordon
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Medical School, Nottingham, NG7 2UH, UK
| | - Stefan Grund
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany
| | - Luba Matchekhina
- Russian Gerontology Research and Clinical Centre, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Laura Monica Perez Bazan
- RE-FiT Barcelona Research Group, Parc Sanitari Pere Virgili Hospital and Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Jos M G A Schols
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Eva Topinková
- Department of Geriatrics, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
- Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | | | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector South-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector South-Holland, Leiden University Medical Center, Leiden, The Netherlands
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3
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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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4
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Ikenouchi K, Takahashi D, Mandai S, Watada M, Koyama S, Hoshino M, Takahashi N, Shoda W, Kuyama T, Mori Y, Ando F, Susa K, Mori T, Iimori S, Naito S, Sohara E, Fushimi K, Uchida S. Impact of COVID-19 versus other pneumonia on in-hospital mortality and functional decline among Japanese dialysis patients: a retrospective cohort study. Sci Rep 2024; 14:5177. [PMID: 38431709 PMCID: PMC10908858 DOI: 10.1038/s41598-024-55697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) affects both life and health. However, the differentiation from other types of pneumonia and effect of kidney disease remains uncertain. This retrospective observational study investigated the risk of in-hospital death and functional decline in ≥ 20% of Barthel Index scores after COVID-19 compared to other forms of pneumonia among Japanese adults, both with and without end-stage kidney disease (ESKD). The study enrolled 123,378 patients aged 18 years and older from a national inpatient administrative claims database in Japan that covers the first three waves of the COVID-19 pandemic in 2020. After a 1:1:1:1 propensity score matching into non-COVID-19/non-dialysis, COVID-19/non-dialysis, non-COVID-19/dialysis, and COVID-19/dialysis groups, 2136 adults were included in the analyses. The multivariable logistic regression analyses revealed greater odds ratios (ORs) of death [5.92 (95% CI 3.62-9.96)] and functional decline [1.93 (95% CI 1.26-2.99)] only in the COVID-19/dialysis group versus the non-COVID-19/non-dialysis group. The COVID-19/dialysis group had a higher risk of death directly due to pneumonia (OR 6.02, 95% CI 3.50-10.8) or death due to other diseases (OR 3.00, 95% CI 1.11-8.48; versus the non-COVID-19/non-dialysis group). COVID-19 displayed a greater impact on physical function than other types of pneumonia particularly in ESKD.
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Affiliation(s)
- Ken Ikenouchi
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Daiei Takahashi
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Shintaro Mandai
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
| | - Mizuki Watada
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Sayumi Koyama
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Motoki Hoshino
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Naohiro Takahashi
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Wakana Shoda
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Tamaki Kuyama
- Department of Nephrology, Musashino Red Cross Hospital, 1-26-1, Kyonann-cho, Musashino-shi, Tokyo, 180-8610, Japan
| | - Yutaro Mori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Fumiaki Ando
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Koichiro Susa
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Takayasu Mori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Soichiro Iimori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Shotaro Naito
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Eisei Sohara
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan
| | - Shinichi Uchida
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
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Tramonti C, Graziani F, Pasqualone E, Ricci E, Moncini C, Lombardi B. Outpatient rehabilitation in post-acute COVID-19 patients: a combined progressive treatment protocol. Disabil Rehabil 2024:1-11. [PMID: 38407196 DOI: 10.1080/09638288.2024.2316797] [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: 04/20/2023] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE to investigate the effectiveness of a 4-week combined progressive program on functional abilities, disability status and quality of life (QoL) in COVID-19 recovered patients. MATERIALS & METHODS 18 COVID-19 recovered patients performed a combined rehabilitation treatment accounting for 12 sessions, including both respiratory and motor training sessions. A careful monitoring of exercise intensity, duration and progression to tailor complexity evolution on patients' competencies was carried out. Patients were monitored with different functional scales and self-reported questionnaires before (T0) and after (T1) rehabilitation. RESULTS 6-Minutes Walk Test, Timed Up and Go Test and Short Physical Performance Battery significantly improved, while Physiological Cost Index presented a significant reduction after rehabilitation. Moreover, Barthel Index significantly improved and patients presented significantly increased upper and lower limbs strength at T1. Furthermore, mMRC Dyspnoea Scale presented a significant reduction after training. Finally, physical and psychological well-being scales improved according to Short-Form 36; while, self-reported questionnaires related to mood and depression showed no significant modification after rehabilitation. CONCLUSIONS results evidenced the efficacy of the combined progressive intervention in COVID-19 recovered patients. The specific customization on patients' needs and the careful exercise monitoring promoted improvements on functional abilities and disability status, with positive impact on QoL.
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Affiliation(s)
- Caterina Tramonti
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
- Levante Ligure Rehabilitation Center, Fondazione Don C. Gnocchi Onlus, La Spezia, Italy
| | | | | | - Eleonora Ricci
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
| | - Cristina Moncini
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
| | - Bruna Lombardi
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
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6
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Pietranis KA, Izdebska WM, Kuryliszyn-Moskal A, Dakowicz A, Ciołkiewicz M, Kaniewska K, Dzięcioł-Anikiej Z, Wojciuk M. Effects of Pulmonary Rehabilitation on Respiratory Function and Thickness of the Diaphragm in Patients with Post-COVID-19 Syndrome: A Randomized Clinical Trial. J Clin Med 2024; 13:425. [PMID: 38256559 PMCID: PMC10815944 DOI: 10.3390/jcm13020425] [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: 11/24/2023] [Revised: 12/22/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Rehabilitation is an effective method for improving the overall health of patients who have experienced the long-term effects of COVID-19. METHODS The double-blind, randomized prospective study assessed the effectiveness of a 6-week rehabilitation program among post-COVID-19 patients. A total of 59 patients under treatment following COVID-19 were randomly divided into two groups. Both groups completed the same six-week comprehensive exercise training program supported by a respiratory muscle trainer (Threshold IMT) during out-patient sessions. The control group performed placebo IMT. Respiratory muscle strength, chest wall expansion, spirometry, and diaphragm ultrasonography measurements were taken before and after the six weeks. RESULTS The applied rehabilitation program improved respiratory muscle strength in both the study and control groups (p < 0.001). There was a significant chest circumference increase in the study group (p < 0.001). Spirometric parameters improved in both groups, with the study group showing a greater improvement: 8.02% in FEV1 (p < 0.001), 13.24% in FVC EX (p < 0.001) and 9.67% in PEF (p < 0.001). Rehabilitation also increased diaphragm thickness during maximum inhalation in both groups. CONCLUSIONS Based on the study findings, the specialized outpatient rehabilitation program developed for post-COVID-19 patients has proven to be effective and safe.
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Affiliation(s)
- Katarzyna Anna Pietranis
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Wiktoria Maria Izdebska
- Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland;
| | - Anna Kuryliszyn-Moskal
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Agnieszka Dakowicz
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Mariusz Ciołkiewicz
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Katarzyna Kaniewska
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Zofia Dzięcioł-Anikiej
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
| | - Mariusz Wojciuk
- Department of Rehabilitation, Medical University of Bialystok, 24A M. Skłodowskiej-Curie St., 15-276 Bialystok, Poland; (K.A.P.); (A.K.-M.); (A.D.); (M.C.); (K.K.); (M.W.)
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7
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Mansour ZM, Al Nassan S, Hawamdeh M, Al Bustanji S, Alshammari F. The impact of COVID-19 on neck pain intensity and onset: A systematic review. Work 2024; 77:455-462. [PMID: 37742680 DOI: 10.3233/wor-220713] [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: 09/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had significant impacts on most aspects of life, including physical and psychological wellbeing. Neck pain is a very common musculoskeletal complaint worldwide, and one that has been impacted by COVID-19. Such impacts have been studied by a few researchers, but not without inconstancies. Moreover, understanding those impacts in relation to rehabilitation is not fully comprehended. OBJECTIVE The aim of this study was to systematically examine the impacts of COVID-19 on neck pain intensity and onset pre and post the pandemic. METHODS This study was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A systematic literature search was conducted on PubMed-MEDLINE, EMBASE, and Cochrane Library. Keywords used were "COVID-19" and "Neck Pain". Risk of bias was assessed using the Joanna Briggs Institute Checklist for prevalence studies. RESULTS A total of five studies were included with an overall sample size of 2618 participants. Three studies were at moderate risk and two were at high risk of bias. Results from three studies reported an increase in neck pain intensity and onset, while the other two did not report an increase. CONCLUSION The impact of COVID-19 on neck pain is unclear. The inconsistency in results sheds the light on the importance of having future research (including longitudinal studies) to help guide us towards understanding the real impacts of COVID-19 on neck pain.
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Affiliation(s)
- Zaid M Mansour
- Department of Physical and Occupational Therapy, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Saad Al Nassan
- Department of Physical and Occupational Therapy, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
- Department of Physiotherapy, Faculty of Allied Health Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohannad Hawamdeh
- Department of Physical and Occupational Therapy, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Shaden Al Bustanji
- Department of Physical and Occupational Therapy, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Faris Alshammari
- Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
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8
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Rutsch M, Frommhold J, Buhr-Schinner H, Gross T, Schüller PO, Deck R. [Pneumological Rehabilitation in Patients with Long Covid - Health Changes at the End of the Inpatient Rehabilitation Measure]. DIE REHABILITATION 2023; 62:359-368. [PMID: 36649730 DOI: 10.1055/a-1964-7401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Some people suffering from Covid-19 can be affected by persistent symptoms and long-term consequences of the disease (Long Covid) beyond their acute phase. Consequently, this can lead to restrictions in participation. Therefore, the focus is on medical rehabilitation in which Long Covid is treated as a new challenge. METHODS A prospective, exploratory observational study will be conducted. The written survey of Long Covid rehabilitants takes place at the beginning and end of the pneumological rehabilitation. The aim of the study is to describe the rehabilitation contents and goals, the subjective burdens, the social and occupational participation as well as the health-related changes. Among other factors, disease-specific symptoms, quality of life, participation, psychological impairments, fatigue, and performance were recorded. RESULTS Long Covid rehabilitants (N=221) participate in the written survey. At the end of rehabilitation, the questionnaire survey indicated significant improvements in almost all outcome parameters with a large effect (p<0.01; ES between 0.76 (anxiety) and 1.30 (fatigue)). All corona symptoms, such as breathlessness on exertion, fatigue or lack of strength improved significantly at the end of rehabilitation. Moreover, the rehabilitants most frequently name the improvement of their health (92%), the increase of their performance (92%) and the improvement of the respiratory muscle strength (78%) as rehabilitation goals. In fact, these goals are achieved by 60 to 70%, significantly fewer rehabilitation patients reach the restoration of their ability to work (32%) or a better ability to concentrate (17%). Respiratory physiotherapy, endurance training and medical training therapy are described as most helpful. At the end of rehabilitation, 76% rated their rehabilitation success as good to excellent based on a single question. CONCLUSION The first data of the study reveal that Long Covid rehabilitants are exposed to substantial burdens. Through medical rehabilitation, the patients experience medical and social support and experience significant improvements in all recorded health-related outcomes.
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Affiliation(s)
- Mercedes Rutsch
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Jördis Frommhold
- Abteilung für Atemwegserkrankungen und Allergien, MEDIAN Klinik Heiligendamm, Heiligendamm, Germany
| | - Heike Buhr-Schinner
- Abteilung Innere Medizin/Pneumologie, Ostseeklinik Schönberg-Holm, Schönberg-Holm, Germany
| | - Thomas Gross
- Abteilung für Innere Medizin und Pneumologie, Reha-Zentrum Schömberg, Klinik Schwarzwald, Schömberg, Germany
| | - Per Otto Schüller
- Abteilung Kardiologie und Pneumologie, MEDIAN Klinik Flechtingen, Flechtingen, Germany
| | - Ruth Deck
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
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9
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Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
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Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
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10
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Ceravolo MG, Anwar F, Andrenelli E, Udensi C, Qureshi J, Sivan M, Kiekens C, Zampolini M. Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2023; 59:789-799. [PMID: 38214046 DOI: 10.23736/s1973-9087.23.08315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.
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Affiliation(s)
- Maria G Ceravolo
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy
| | - Fahim Anwar
- Department of Rehabilitation Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy -
| | - Cynthia Udensi
- Department of Rehabilitation Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jawaria Qureshi
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds General Infirmary, University of Leeds, Leeds, UK
| | | | - Mauro Zampolini
- Department of Rehabilitation, Hospital of Foligno, USL Umbria2, Perugia, Italy
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11
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Salem MR, Hegazy N, Abd El Fatah SAM, Shahib AEM, Hejazi AM. COVID-19 prevention and rehabilitation related knowledge and practices among Egyptian post-COVID-19 patients. PLoS One 2023; 18:e0292247. [PMID: 37801438 PMCID: PMC10558073 DOI: 10.1371/journal.pone.0292247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 09/17/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Even with the mild form of COVID-19, people need to practice the proper preventive measures to achieve health, safety and control spread of infection. Few studies assessed sound disinfection and rehabilitative knowledge. This study aims to assess the self-reported, knowledge of specific disinfection measures among post-recovery COVID-19 patients and identifying the most requested knowledge items regarding the prevention and post COVID rehabilitation measures. METHODS This is an exploratory cross-sectional study using an electronically open survey. A pre-tested e-questionnaire was employed for data assembling. The sample size was calculated and a total of 417 people completed the questionnaire. Knowledge score was calculated for preventive and disinfection measures during and after COVID 19 infection. It comprised three sections: socio-demographics, study participants' knowledge regarding precautions, disinfection, and rehabilitation measures, as well as sources of knowledge about COVID-19. RESULTS All participants infected with COVID-19 (82%) reported self-isolation for ten days after confirming the infection, with only 18% required hospitalization. Regarding the information needed by the participants, the highest requests were for the rehabilitation information after COVID-19 and preventive measures. Females under 30 years old and those with a college education or higher were significantly more likely to request rehabilitation information after COVID-19 (P-value 0.05). Nevertheless, males were significantly more interested in information regarding preventive measures; They were over 30 years old and had education below university (P-value 0.05). Participants (above 30 years old) had significantly higher knowledge of preventive and disinfection measures during and after COVID-19 infection (P = 0.030). CONCLUSION After the COVID-19 experience, most participants demonstrated a great desire for rehabilitation information and proper preventive measures. This paves the way for delivering self-management and rehabilitation knowledge and emphasizing the significance of various prevention modalities.
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Affiliation(s)
- Marwa Rashad Salem
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nelly Hegazy
- Public Health, and Community Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | | | | | - Ahmad Mohamad Hejazi
- Sixth Grade Medical Student, Faculty of Medicine, Cairo University, Cairo, Egypt
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12
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Derksen C, Rinn R, Gao L, Dahmen A, Cordes C, Kolb C, Becker P, Lippke S. Longitudinal Evaluation of an Integrated Post-COVID-19/Long COVID Management Program Consisting of Digital Interventions and Personal Support: Randomized Controlled Trial. J Med Internet Res 2023; 25:e49342. [PMID: 37792437 PMCID: PMC10563866 DOI: 10.2196/49342] [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: 05/25/2023] [Revised: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The postacute COVID-19 syndrome (PACS) can be addressed with multidisciplinary approaches, including professional support and digital interventions. OBJECTIVE This research aimed to test whether patients who received a health care facilitation program including medical internet support from human personal pilots and digital interventions (intervention group [IG] and active control group [ACG]) would experience fewer symptoms and have higher work ability and social participation than an untreated comparison group (CompG). The second objective was to compare the impact of a diagnostic assessment and digital interventions tailored to patients' personal capacity (IG) with that of only personal support and digital interventions targeting the main symptoms (ACG). METHODS In total, 1020 patients with PACS were recruited. Using a randomized controlled trial design between the IG and the ACG, as well as propensity score matching to include the CompG, analyses were run with logistic regression and hierarchical-linear models. RESULTS Symptoms decreased significantly in all groups over time (βT1-T2=0.13, t549=5.67, P<.001; βT2-T4=0.06, t549=2.83, P=.01), with a main effect of the group (β=-.15, t549=-2.65, P=.01) and a more pronounced effect in the IG and ACG compared to the CompG (between groups: βT1-T2=0.14, t549=4.31, P<.001; βT2-T4=0.14, t549=4.57, P<.001). Work ability and social participation were lower in the CompG, but there was no significant interaction effect. There were no group differences between the IG and the ACG. CONCLUSIONS Empowerment through personal pilots and digital interventions reduces symptoms but does not increase work ability and social participation. More longitudinal research is needed to evaluate the effects of a diagnostic assessment. Social support and digital interventions should be incorporated to facilitate health care interventions for PACS. TRIAL REGISTRATION ClinicalTrials.gov NCT05238415; https://classic.clinicaltrials.gov/ct2/show/NCT05238415. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12879-022-07584-z.
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Affiliation(s)
- Christina Derksen
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Robin Rinn
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Lingling Gao
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Alina Dahmen
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Cay Cordes
- Dr. Becker Kiliani-Klinik, Dr. Becker Klinikgruppe, Bad Windsheim, Germany
| | | | | | - Sonia Lippke
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
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13
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Torres G, Gradidge P. The quality and pattern of rehabilitation interventions prescribed for post-COVID-19 infection patients: A systematic review and meta-analysis. Prev Med Rep 2023; 35:102395. [PMID: 37705882 PMCID: PMC10495653 DOI: 10.1016/j.pmedr.2023.102395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Patients with prior COVID-19 infection may present with lasting multisystem symptoms that require intervention and includes exercise rehabilitation. The aim of this systematic review was to investigate the quality of articles, with emphasis on exercise rehabilitation, and conduct a meta-analysis on experimental and observational rehabilitation intervention studies on cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for evaluating rehabilitation interventions in clinical practice. A methodical search of cohort and experimental studies occurred from January 2019 up to March 2023. Thirty-two studies were included for complete analysis. The quality of the eligible studies for complete review was fair overall. The studies did not provide a detailed account of key descriptors of exercise such as volume, progression, motivational strategies, adherence and replication. There was a significant difference in the 6-minute walk test (Mean difference (MD) = 51.69 m; confidence intervals (CIs) = 36.99 to 66.38; p < 0.001, level of heterogeneity (I2) = 0), percent of predicted forced expiratory volume in one second (MD = 7.95%; CIs = 3.46 to 12.44; p = 0.0005, I2 = 65%) and percent of predicted forced vital capacity (MD = 3.49%; 95% CI = 1.25 to 5.73; p = 0.002; I2 = 37%) between the experiment and control groups. The current evidence suggests that rehabilitation interventions significantly improve cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients; however, there is a need for conceptualising high-quality and long-term rehabilitation interventions, especially exercise interventions.
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Affiliation(s)
- G. Torres
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - P.J. Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
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14
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Wasilewski MB, Szigeti Z, Simpson R, Minezes J, Mayo AL, Robinson LR, Lung M, Hitzig SL. Characteristics and healthcare utilization of COVID-19 rehabilitation patients during the first and second waves of the pandemic in Toronto, Canada. Int J Rehabil Res 2023; 46:258-263. [PMID: 37345433 DOI: 10.1097/mrr.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
The objective of this study is to describe the healthcare utilization, and clinical and sociodemographic features of a cohort of 74 coronavirus disease 2019 (COVID-19) patients admitted to a tertiary rehabilitation hospital in Toronto, Canada. A retrospective chart review was performed using 74 charts from patients admitted to a COVID-19 rehabilitation unit between 11 April 2020 and 30 April 2021. Measures of central tendency, SDs, interquartile ranges, frequencies, and proportions were calculated to analyze clinical and sociodemographic data. A total of 74 patients were included in this study, including 33 males and 41 females. The mean age was 72.8 years, with Wave 1 patients being younger than Wave 2 patients. Sixty-six percent of total patients experienced hypertension. Mean functional independence measure score across both waves was 78 at admission and 100 at discharge. Mean length of stay was 14.6 days in Wave 1 and 18.8 days in Wave 2. This study represents some of the first data on the characteristics and outcomes of COVID-19 patients admitted to inpatient rehabilitation in Toronto, Canada across the initial waves of the COVID-19 pandemic.
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Affiliation(s)
- Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre
- Department of Occupational Science and Occupational Therapy
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto
| | - Zara Szigeti
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre
| | - Robert Simpson
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John's Rehab, Sunnybrook Health Sciences Centre
| | - Jacqueline Minezes
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John's Rehab, Sunnybrook Health Sciences Centre
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre
- Department of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto
| | - Maria Lung
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John's Rehab, Sunnybrook Health Sciences Centre
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre
- Department of Occupational Science and Occupational Therapy
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15
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Taha P, Tahir A, Ahmed F, Radha R, Taha A, Slewa-Younan S. Depression and Generalized Anxiety as Long-Term Mental Health Consequences of COVID-19 in Iraqi Kurdistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6319. [PMID: 37444166 PMCID: PMC10341427 DOI: 10.3390/ijerph20136319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/25/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has been associated with a variety of psychiatric symptoms. However, COVID-19's association with psychiatric symptoms after the acute illness phase is not fully understood. Thus, this study sought to examine symptoms of depression and generalized anxiety and associated factors in the period following COVID-19 infection. A cross-sectional study design was conducted in three governorates of the Iraqi Kurdistan region. Face-to-face interviews were held between the period of 15 September and 20 December 2021 with both those who had been infected with COVID-19 and those who had not. Depression symptomology was assessed using the 9-item Patient Health Questionnaire and levels of anxiety were measured using the 7-item Generalized Anxiety Disorder scale. A total of 727 participants were recruited. The bulk of the respondents (n = 454) reported having a past COVID-19 infection, of whom a considerable proportion (82%) had mild-moderate symptoms. More than half of the infected respondents (53.3%) stated they were treated at home. The mean score of generalized anxiety was higher among the infected group compared to the non-infected group t(725) = 2.538, p = 0.011. Factors such as older age, female gender, unemployment, previous psychological problems, and diabetes mellitus were strongly associated with symptoms of depression and anxiety post-COVID-19 infection. Additionally, anxiety was associated with a longer duration of post-COVID symptoms. The majority of the study population had mild to moderate levels of post-COVID-19 depression and anxiety. Psychological education and interventions are required to reduce the psychological burden of post-COVID-19 symptoms among the general population.
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Affiliation(s)
- Perjan Taha
- Psychiatry Unit, Department of Medicine, College of Medicine, University of Duhok, Duhok 42001, Kurdistan Region, Iraq
| | - Arazoo Tahir
- Community Health, Public Health Department, College of Health and Medical Technology, Shekhan, Duhok Polytechnic University, Duhok 42001, Kurdistan Region, Iraq;
| | - Fatima Ahmed
- Clinical Biochemistry, Medical Laboratory Technology Department, College of Health and Medical Technology, Shekhan, Duhok Polytechnic University, Duhok 42001, Kurdistan Region, Iraq;
| | - Runak Radha
- Biology Department, Shorsh General Hospital, Sulaymaniyah Governorate, Sulaymaniyah 46001, Kurdistan Region, Iraq;
| | - Ari Taha
- Cardiac Center, Erbil, Erbil Governorate, Erbil 44001, Kurdistan Region, Iraq;
| | - Shameran Slewa-Younan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 1797, Australia;
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16
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Ravara B, Giuriati W, Maccarone MC, Kern H, Masiero S, Carraro U. Optimized progression of Full-Body In-Bed Gym workout: an educational case report. Eur J Transl Myol 2023. [PMID: 37358234 PMCID: PMC10388607 DOI: 10.4081/ejtm.2023.11525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 06/27/2023] Open
Abstract
People suffering from fatigue syndromes spend less time exercising each day, thus aggravating their motor difficulties. Indeed, muscles and mobility deteriorate with age, while exercising muscles is the only sure countermeasure. It is useful to offer a safe and toll-free rehabilitation training: Full-Body In-Bed Gym, easy to learn and performe at home. We suggest a 10-20 min daily routine of easy and safe physical exercises that may improve the main 200 skeletal muscles used for every-day activities. Many of the exercises can be performed in bed (Full-Body In-Bed Gym), so hospital patients can learn this light workout before leaving the hospital. The routine consists of series of repetitions of 15 bodyweight exercises to be performed one after the other without time breaks in between. Alternating sequences of arm and leg exercises are followed by moving body parts in lying and sitting positions in bed. These are followed by series of tiptoeing off the bed. Progressive improvements can be tested by a series of push-ups on the floor. Starting from 3-5, number of repetitions are increased by adding 3 more every week. To maintain or even shorten total daily time of workout each movement is weekly speeded up. The devoted time every morning (or at least five days a week) to train all the major muscles of the body can remain under 10 minutes. Because there are no breaks during and between sets, the final push-ups become very challenging: at the end of the daily workout heart rate, depth and number of ventilations and frontal perspiration increase for a few minutes. We here provide an example of how to implement the progression of the Full-Body In-Bed Gym presenting an educational Case Report of a trained 80-year old person in stable pharmacological managements. In addition to strengthening the main muscles, including the ventilatory muscles, Although performed in bed, Full-Body In-Bed Gym is a resistance training equivalent to a short jog.. Started in early winter and continued regularly throughout spring and summer, Full-Body In-Bed Gym can help maintain independence of frail people, including those younger persons suffering with the fatigue syndrome related to the viral infection of the recent COVID-19 pandemic.
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Affiliation(s)
- Barbara Ravara
- Department of Biomedical Sciences, University of Padova, Padua, Italy; CIR-Myo-Interdepartmental Research Center of Myology, University of Padova, Padua, Italy; A&C M-C Foundation for Translational Myology, Padua.
| | - Walter Giuriati
- Department of Biomedical Sciences, University of Padova, Padua.
| | - Maria Chiara Maccarone
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy; Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Helmut Kern
- Ludwig Boltzmann Institute for Rehabilitation Research, St. Pölten, Austria; Institute of Physical Medicine and Rehabilitation, Prim. Dr. H Kern GmbH, Amstetten.
| | - Stefano Masiero
- CIR-Myo-Interdepartmental Research Center of Myology, University of Padova, Padua, Italy; Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Ugo Carraro
- Department of Biomedical Sciences, University of Padova, Padua, Italy; CIR-Myo-Interdepartmental Research Center of Myology, University of Padova, Padua, Italy; A&C M-C Foundation for Translational Myology, Padua.
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17
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Kızılırmak D, Fidan U, Sarı S, Havlucu Y. [Functional parameters and affecting factors in post-COVID period]. Tuberk Toraks 2023; 71:123-130. [PMID: 37345394 PMCID: PMC10854064 DOI: 10.5578/tt.20239915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
Introduction Post-COVID period is considered to be 12 weeks after the COVID-19 infection. Patients in the post-COVID period may have prolonged or newly developed symptoms. Depending on the prolonged effects of the disease, respiratory and functional parameters may be affected. The aim of the study is to investigate the effect of COVID-19 infection on respiratory and functional parameters in the post-COVID period. Materials and Methods A cross-sectional study was conducted to evaluate the functional parameters of patients with COVID-19 in the post-COVID period. Subjects with a history of microbiologically proven COVID-19 infection were evaluated with 6-minute walk test results, Borg, and MRC results at least 12 weeks after COVID-19 infection. The relationship between demographic characteristics, comorbidities, vaccination status, and severity of disease with 6-minute walk test results and dyspnea scales in the post-COVID period was investigated. Result Two hundred seventeen patients were included in the study. The mean age of the patients was 48.6 ± 14.9 years and 126 (58.1%) of them were female. 142 (65.4%) of the patients were completely vaccinated against COVID-19 and 75 (34.6%) patients were incompletely vaccinated or unvaccinated. 158 (72.8%) patients had mild disease, 51 (23.5%) patients had moderate disease, and eight (3.7%) patients had severe disease. Those with a history of moderate or severe disease had significantly worsened functional parameters in the postCOVID period compared to those with mild COVID-19. The Borg scale and MRC dyspnea scale values were significantly higher in women (p= 0.008, p= 0.002, respectively). Functional parameters of those who were completely vaccinated against COVID-19 and those who were incompletely or unvaccinated individuals in the post-COVID period were similar. Conclusions The functional parameters of people with moderate or severe COVID-19 disease were found to be significantly impaired in the post-COVID period. While the effect of smoking and vaccination status on functional parameters in the post-COVID period could not be demonstrated, disease severity and accompanying comorbidity were found to be effective.
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Affiliation(s)
- Deniz Kızılırmak
- Manisa Celal Bayar University Faculty of Medicine, Department of Chest Diseases, Manisa, Türkiye
| | - Uğur Fidan
- Manisa Celal Bayar University Faculty of Medicine, Department of Chest Diseases, Manisa, Türkiye
| | - Seçil Sarı
- Therapist Celal Bayar University Manisa Hafsa Sultan Hospital, Respiratory Manisa, Türkiye
| | - Yavuz Havlucu
- Manisa Celal Bayar University Faculty of Medicine, Department of Chest Diseases, Manisa, Türkiye
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Aydın N, Cihan Ç, Çelik Ö, Aslan AF, Odabaş A, Alataş F, Yıldırım H. [Segmentation of acute pulmonary embolism in computed tomography pulmonary angiography using the deep learning method]. Tuberk Toraks 2023; 71:131-137. [PMID: 37345395 PMCID: PMC10795272 DOI: 10.5578/tt.20239916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
Introduction Pulmonary embolism is a type of thromboembolism seen in the main pulmonary artery and its branches. This study aimed to diagnose acute pulmonary embolism using the deep learning method in computed tomographic pulmonary angiography (CTPA) and perform the segmentation of pulmonary embolism data. Materials and Methods The CTPA images of patients diagnosed with pulmonary embolism who underwent scheduled imaging were retrospectively evaluated. After data collection, the areas that were diagnosed as embolisms in the axial section images were segmented. The dataset was divided into three parts: training, validation, and testing. The results were calculated by selecting 50% as the cut-off value for the intersection over the union. Result Images were obtained from 1.550 patients. The mean age of the patients was 64.23 ± 15.45 years. A total of 2.339 axial computed tomography images obtained from the 1.550 patients were used. The PyTorch U-Net was used to train 400 epochs, and the best model, epoch 178, was recorded. In the testing group, the number of true positives was determined as 471, the number of false positives as 35, and 27 cases were not detected. The sensitivity of CTPA segmentation was 0.95, the precision value was 0.93, and the F1 score value was 0.94. The area under the curve value obtained in the receiver operating characteristic analysis was calculated as 0.88. Conclusions In this study, the deep learning method was successfully employed for the segmentation of acute pulmonary embolism in CTPA, yielding positive outcomes.
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Affiliation(s)
- Nevin Aydın
- Department of Radiology, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Çağatay Cihan
- Department of Radiology, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Özer Çelik
- Department of Mathematics and Computer Science, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Ahmet Faruk Aslan
- Department of Mathematics and Computer Science, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Alper Odabaş
- Department of Mathematics and Computer Science, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Füsun Alataş
- Department of Chest Disease, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Hüseyin Yıldırım
- Department of Chest Disease, Eskişehir Osmangazi University, Eskişehir, Türkiye
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Aprile I, Bramante L, La Russa C, Germanotta M, Barletta VT, Falchini F, Brambilla L, Guglielmelli E, Rossi P. A Multiaxial Rehabilitation Programme for Workers with COVID-19 Sequelae Using a Conventional and Technological-Robotic Approach: The Proposal of INAIL and Fondazione Don Carlo Gnocchi. Healthcare (Basel) 2023; 11:1593. [PMID: 37297733 PMCID: PMC10252900 DOI: 10.3390/healthcare11111593] [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: 03/07/2023] [Revised: 05/11/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 sequelae have been shown to affect respiratory and cardiological functions as well as neuro-psychological functions, and, in some cases, metabolic/nutritional aspects. The Italian National Institute for Insurance against Accidents at Work (Istituto Nazionale Assicurazione Infortuni sul Lavoro, INAIL) recorded that, until December 2022, 315,055 workers were affected by COVID-19; therefore, there is a need to identify an effective approach to treat such patients. Robotic and technological devices could be integrated into the rehabilitation programme of people with long COVID conditions. A review of the literature showed that telerehabilitation may improve functional capacity, dyspnoea, performance, and quality of life in these patients, but no studies were found evaluating the effects of robot-mediated therapy or virtual reality systems. Considering the above, Fondazione Don Carlo Gnocchi and INAIL propose a multi-axial rehabilitation for workers with COVID-19 sequelae. To accomplish this goal, the two institutions merged the epidemiological information gathered by INAIL, the expertise in robotic and technological rehabilitation of Fondazione Don Carlo Gnocchi, and the literature review. Our proposal aims to facilitate a multi-axial rehabilitation approach customized to meet the unique needs of each individual, with a particular emphasis on utilizing advanced technologies to address the current and future challenges of patient care.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lucia Bramante
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Chiara La Russa
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | | | - Francesca Falchini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lorenzo Brambilla
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Eugenio Guglielmelli
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
| | - Patrizio Rossi
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
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20
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Najafi MB, Javanmard SH. Post-COVID-19 Syndrome Mechanisms, Prevention and Management. Int J Prev Med 2023; 14:59. [PMID: 37351054 PMCID: PMC10284243 DOI: 10.4103/ijpvm.ijpvm_508_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/24/2021] [Indexed: 06/24/2023] Open
Abstract
As the population of patients recovering from COVID-19 grows, post COVID-19 challenges are recognizing by ongoing evidences at once. Long COVID is defined as a syndrome with a range of persistent symptoms that remain long after (beyond 12 weeks) the acute SARS-CoV-2 infection. Studies have shown that long COVID can cause multi-organ damages with a wide spectrum of manifestations. Many systems, but not limited to, including respiratory, cardiovascular, nervous, gastrointestinal, and musculoskeletal systems, are involved in long COVID. Fatigue and dyspnea are the most common symptoms of long COVID. Long COVID-19 may be driven by tissue damage caused by virus-specific pathophysiologic changes or secondary to pathological long-lasting inflammatory response because of viral persistence, immune dysregulation, and autoimmune reactions. Some risk factors like sex and age, more than five early symptoms, and specific biomarkers have been revealed as a probable long COVID predicator discussed in this review. It seems that vaccination is the only way for prevention of long COVID and it can also help patients who had already long COVID. Managing long COVID survivors recommended being in a multidisciplinary approach, and a framework for identifying those at high risk for post-acute COVID-19 must be proposed. Possible therapeutic options and useful investigation tools for follow-up are suggested in this review. In sum, as evidence and researches are regularly updated, we provide the current understanding of the epidemiology, clinical manifestation, suspected pathophysiology, associated risk factors, and treatment options of long COVID in this review.
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Affiliation(s)
- Majed B. Najafi
- Applied Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh H. Javanmard
- Applied Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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von Zweck C, Naidoo D, Govender P, Ledgerd R. Current Practice in Occupational Therapy for COVID-19 and Post-COVID-19 Conditions. Occup Ther Int 2023; 2023:5886581. [PMID: 37250066 PMCID: PMC10219768 DOI: 10.1155/2023/5886581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/31/2023] Open
Abstract
The onset of the pandemic highlighted the need for a review of rehabilitation practices to ensure coordinated, effective, and efficient services for people affected by COVID-19. This paper reports on a global survey highlighting the delivery of occupational therapy services to people with COVID-19/post-COVID-19 condition (PCC) and makes recommendations to facilitate quality service delivery for this population. An online cross-sectional descriptive survey was developed and distributed to the global occupational therapy community via member organisations and communication channels of the World Federation of Occupational Therapists to collect information for this study. The survey obtained qualitative and quantitative data from respondents who were occupational therapists or occupational therapy assistants regarding (i) demographic characteristics, (ii) work experience with persons with COVID-19 and PCC, (iii) modes of working, (iv) education and training, (iv) occupational therapy intervention provided to persons with COVID-19 and PCC, and (v) the perceived quality of the occupational therapy services provided. Findings indicate that respondents provided a range of occupational therapy interventions for people affected by COVID-19/PCC aligned with evidence-based practice guidelines. While respondents identified a strong role for occupational therapy and generally rated their services as effective, issues related to the accessibility of their services impacted quality and user satisfaction. The study highlighted the need to advocate for access to occupational therapy to facilitate engagement in desired and needed occupations for COVID-19 survivors. Other recommendations emerging from the findings include the need to develop, disseminate, and use research evidence for guiding services for people with COVID-19/PCC, create quality service standards, and ensure the availability of necessary resources and supports such as referral pathways and screening criteria, availability of staff, training, personal protective equipment, and assistive devices and technology.
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Affiliation(s)
- C. von Zweck
- World Federation of Occupational Therapists, Switzerland
| | - D. Naidoo
- Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu Natal (Westville Campus), South Africa
| | - P. Govender
- Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu Natal (Westville Campus), South Africa
| | - R. Ledgerd
- World Federation of Occupational Therapists, Switzerland
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22
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Krysa JA, Buell M, Pohar Manhas K, Kovacs Burns K, Santana MJ, Horlick S, Russell K, Papathanassoglou E, Ho C. Understanding the Experience of Long COVID Symptoms in Hospitalized and Non-Hospitalized Individuals: A Random, Cross-Sectional Survey Study. Healthcare (Basel) 2023; 11:healthcare11091309. [PMID: 37174851 PMCID: PMC10178853 DOI: 10.3390/healthcare11091309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The relationship between initial COVID-19 infection and the development of long COVID remains unclear. The purpose of this study was to compare the experience of long COVID in previously hospitalized and non-hospitalized adults in a community-based, cross-sectional telephone survey. Participants included persons with positive COVID-19 test results between 21 March 2021 and 21 October 2021 in Alberta, Canada. The survey included 330 respondents (29.1% response rate), which included 165 previously hospitalized and 165 non-hospitalized individuals. Significantly more previously hospitalized respondents self-reported long COVID symptoms (81 (49.1%)) compared to non-hospitalized respondents (42 (25.5%), p < 0.0001). Most respondents in both groups experienced these symptoms for more than 6 months (hospitalized: 66 (81.5%); non-hospitalized: 25 (59.5), p = 0.06). Hospitalized respondents with long COVID symptoms reported greater limitations on everyday activities from their symptoms compared to non-hospitalized respondents (p < 0.0001) and tended to experience a greater impact on returning to work (unable to return to work-hospitalized: 20 (19.1%); non-hospitalized: 6 (4.5%), p < 0.0001). No significant differences in self-reported long COVID symptoms were found between male and female respondents in both groups (p > 0.05). This study provides novel data to further support that individuals who were hospitalized for COVID-19 appear more likely to experience long COVID symptoms.
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Affiliation(s)
- Jacqueline A Krysa
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Mikayla Buell
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Katharina Kovacs Burns
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
- Department of Clinical Quality Metrics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Maria J Santana
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Sidney Horlick
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, University of Alberta, Edmonton AB T6G 1C9, Canada
| | - Kristine Russell
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Elizabeth Papathanassoglou
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, University of Alberta, Edmonton AB T6G 1C9, Canada
| | - Chester Ho
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
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23
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de Facio CA, Guimarães FS, da Cruz AGT, Bomfim RF, Miranda SRAP, Viana DR, Dos Santos Couto Paz CC, Sato TDO, Lorenzo VAPD. Post-COVID-19 functional status scale: Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version. Braz J Phys Ther 2023; 27:100503. [PMID: 37201307 DOI: 10.1016/j.bjpt.2023.100503] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/19/2023] [Accepted: 04/13/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The Post-COVID-19 Functional Status (PCFS) scale was created to assess the functional status of patients after hospital discharge due to COVID-19. OBJECTIVE To perform cross-cultural adaptation of the PCFS Scale and Manual into Brazilian Portuguese and evaluate its measurement properties in patients post-COVID-19. METHODS For the cross-cultural adaptation, independent translations and back-translations were performed. This was followed by a pre-test, with analysis of the Content Validity Index (CVI), and preparation of the final version, after evaluating the measurement properties. Spearman's correlation between the PCFS and the WHO Disability Classification Scheme (WHODAS 2.0) was used for convergent validity. Weighted Kappa (wκ) was used for test-retest and interobserver reliability for PCFS scores and Kappa (κ) for PCFS items. Internal consistency was assessed using Cronbach's alpha. Only patients with post-discharge COVID-19 were evaluated through video-conferencing platforms. RESULTS The CVI was 0.75-0.83 for comprehension and 0.83-0.84 for the language of the self-administered questionnaire and the structured interview version. For measurement properties, 63 patients were evaluated, 68% male, 51.50 (12.60) years, 12.28 (7.62) days of hospitalization. For the convergent validity, a strong correlation was found (r = 0.73; p<0.01). The test-retest (wκ=0.54) and interobserver (wκ=0.43) reliability was moderate and the item-by-item analyzes ranged from fair to substantial (κ=0.25-0.66) and weak to substantial (κ=0.07-0.79). Internal consistency was excellent (0.85). CONCLUSION The final PCFS in Brazilian Portuguese showed adequate content validity, reliability, internal consistency, and convergent validity for the functional assessment of patients after hospital discharge due to COVID-19.
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Affiliation(s)
| | - Fernando Silva Guimarães
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Daiane Roberta Viana
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP Brazil
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24
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Cornejo-Pareja I, Vegas-Aguilar IM, Fernández-Jiménez R, García-García C, Bellido-Guerrero D, Tinahones F, García-Almeida JM. Phase angle and COVID-19: A systematic review with meta-analysis. Rev Endocr Metab Disord 2023; 24:525-542. [PMID: 36959397 PMCID: PMC10036242 DOI: 10.1007/s11154-023-09793-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
Phase angle (PhA) has been identified as a poor prognostic factor in patients with COVID-19. This study aimed to achieve a systematic review, where we discussed the potential role of PhA value as a prognostic marker of adverse clinical outcomes such as mortality and complication in hospitalized with SARS-CoV2 infection and established the strength of recommendations for use. A systematic literature review with meta-analysis was done in the main electronic databases from 2020 to January 2023. The selected articles had to investigate adverse consequences of the COVID-19 population and raw bioimpedance parameters such as PhA and published in peer-reviewed journals. GRADE tools regarded the quality of the methodology. The review protocol was registered in PROSPERO. Only eight studies, 483 studies, were eligible for the analysis. In general, differences in PhA were seen between the comparative study groups. Patients with a low PhA experienced poor outcomes. A low PhA was associated with a significantly increased mortality risk [RR: 2.44; 95% CI (1.20-4.99), p = 0.01; I2 = 79% (p = 0.0008)] and higher complications risk [OR: 3.47, 95% CI (1.16 - 10.37), p = 0.03; I2 = 82% (p = 0.004)] in COVID-19 patients. Our analysis showed four evidence-based recommendations on the prognostic value of PhA with two strong recommendations, one of moderate and another of low-moderate quality, for predicting mortality and complications, respectively. We recommend using PhA as a prognostic marker for mortality and complications in this population. Although the results are promising, future studies must identify the PhA cut-off to guide therapeutic decisions more precisely.Registration code in PROSPERO: CRD42023391044.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Malaga, Spain
- Málaga University, 29010 Málaga, Spain
| | - Isabel M. Vegas-Aguilar
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Rocío Fernández-Jiménez
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | | | - Diego Bellido-Guerrero
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Ferrol, Ferrol, La Coruña Spain
| | - Francisco Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Malaga, Spain
- Málaga University, 29010 Málaga, Spain
| | - Jose Manuel García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010 Malaga, Spain
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Malaga, Spain
- Málaga University, 29010 Málaga, Spain
- Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, 29004 Málaga, Spain
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25
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Zavaroni S, Tristano I, Casamenti V, Colonna V, Cereti M, Mamone M, Prencipe U, Sanzone F, Murgia M, Masala S, Beccacece A, Vetrano M, Vulpiani MC, Bemporad J. Ultrasound-based neuropathy diagnosis in COVID-19 patients in post-intensive care rehabilitation settings. A retrospective observational study. Arch Phys Med Rehabil 2023:S0003-9993(23)00101-6. [PMID: 36854349 PMCID: PMC9968491 DOI: 10.1016/j.apmr.2023.02.002] [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: 08/03/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES using ultrasound scanning to examine the correlation between increase of Common Fibular Nerve's (CFN) Cross Sectional Area (CSA) and functional impairment of foot dorsiflexor muscles as an early sign of peripheral neuropathy. DESIGN retrospective observational study. SETTING in-patient rehabilitation unit between November 2020 and July 2021. PARTICIPANTS 26 inpatients who underwent prolonged hospitilization in ICU'S and were diagnosed with CRYMINE after SARS-COV-2 infection. Physical examination and ultrasound scanning of the CFN and EMG/ENG were carried out on each patient. INTERVENTIONS not applicable MAIN OUTCOME MEASURE(S): CFN's CSA at the peroneal head. RESULTS we verified a significant increase in the CSA of the CFN measured at the peroneal head in more than 90% of the nerves tested. A cut off value of CFN's CSA of 0,20 cm was used to identify pathological nerves. No correlations with other variables (BMI, ICU days) were found. CONCLUSION US scanning of the CFN appears to be an early and specific test in the evaluation of CPN's abnormalities in post COVID-19 patients. US scanning is a reproducible, cost effective, safe and easily administered bedside tool to diagnose a loss of motor function when abnormalities in peripheral nerves are present.
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Affiliation(s)
- Susanna Zavaroni
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Isabella Tristano
- University of Rome "La Sapienza", Policlinico Umberto I, viale Regina Elena 328, Roma, Italy
| | - Vittoria Casamenti
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Vincenzo Colonna
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Margherita Cereti
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Maria Mamone
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Umberto Prencipe
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Fernando Sanzone
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Massimiliano Murgia
- University of Rome "La Sapienza", Policlinico Umberto I, viale Regina Elena 328, Roma, Italy
| | | | - Alessia Beccacece
- National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Via Portuense 292, 00149 Roma, Italy
| | - Mario Vetrano
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Maria Chiara Vulpiani
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Jonathan Bemporad
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy.
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26
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Gurney L, Chung V, MacPhee M, Chan E, Snyman C, Robinson J, Bertoli-Haley S, Baron E. Exploring the Impact of Storytelling for Hospitalized Patients Recovering from COVID-19. Healthcare (Basel) 2023; 11:healthcare11040589. [PMID: 36833123 PMCID: PMC9957174 DOI: 10.3390/healthcare11040589] [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: 01/19/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
There are mental and physical deficits associated with COVID-19 infection, particularly among individuals requiring hospitalization. Storytelling is a relational intervention that has been used to help patients make sense of their illness experiences and to share their experiences with others, including other patients, families and healthcare providers. Relational interventions strive to create positive, healing stories versus negative ones. In one urban acute care hospital, an initiative called the Patient Stories Project (PSP) uses storytelling as a relational intervention to promote patient healing, including the development of healthier relationships among themselves, with families and with healthcare providers. This qualitative study employed a series of interview questions that were collaboratively developed with patient partners and COVID-19 survivors. The questions asked consenting COVID-19 survivors about why they chose to tell their stories and to flesh out more about their recovery process. Thematic analyses of six participant interviews resulted in the identification of key themes along a COVID-19 recovery pathway. Patients' stories revealed how survivors progress from being overwhelmed by their symptoms to making sense of what is happening to them, providing feedback to their care providers, feeling gratitude for care received, becoming aware of a new state of normal, regaining control of their lives, and ultimately discovering meaning and an important lesson behind their illness experience. Our study's findings suggest that the PSP storytelling approach holds potential as a relational intervention to support COVID-19 survivors along a recovery journey. This study also adds knowledge about survivors beyond the first few months of recovery.
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Affiliation(s)
- Lara Gurney
- Vancouver Coastal Health, Vancouver, BC V6T 1Z4, Canada
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Correspondence: (L.G.); (M.M.)
| | - Vincci Chung
- Vancouver Coastal Health, Vancouver, BC V6T 1Z4, Canada
| | - Maura MacPhee
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Correspondence: (L.G.); (M.M.)
| | - Evelyn Chan
- Vancouver Coastal Health, Vancouver, BC V6T 1Z4, Canada
| | - Claire Snyman
- Vancouver Coastal Health, Vancouver, BC V6T 1Z4, Canada
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27
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Poulos RG, Cole AM, Warner KN, Faux SG, Nguyen TA, Kohler F, Un FC, Alexander T, Capell JT, Hilvert DR, O’Connor CMC, Poulos CJ. Developing a model for rehabilitation in the home as hospital substitution for patients requiring reconditioning: a Delphi survey in Australia. BMC Health Serv Res 2023; 23:113. [PMID: 36737750 PMCID: PMC9895972 DOI: 10.1186/s12913-023-09068-5] [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: 07/19/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Reconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning. METHODS A multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses. RESULTS One-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each. CONCLUSIONS Strong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed.
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Affiliation(s)
- Roslyn G Poulos
- HammondCare, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia
| | - Andrew M Cole
- HammondCare, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia
| | - Kerry N Warner
- HammondCare, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia
| | - Steven G Faux
- grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia ,grid.437825.f0000 0000 9119 2677St Vincent’s Hospital, Sydney, Australia
| | - Tuan-Anh Nguyen
- grid.410692.80000 0001 2105 7653South Western Sydney Local Health District, Sydney, Australia
| | - Friedbert Kohler
- HammondCare, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia
| | | | - Tara Alexander
- grid.1007.60000 0004 0486 528XAustralasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia
| | - Jacquelin T Capell
- grid.1007.60000 0004 0486 528XAustralasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia
| | | | - Claire MC O’Connor
- HammondCare, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Population Health, UNSW, Sydney, Australia
| | - Christopher J Poulos
- HammondCare, Sydney, Australia. .,School of Population Health, UNSW, Sydney, Australia.
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Altersberger M, Goliasch G, Khafaga M, Schneider M, Cho Y, Winkler R, Funk G, Binder T, Huber G, Zwick R, Genger M. Echocardiography and Lung Ultrasound in Long COVID and Post-COVID Syndrome, a Review Document of the Austrian Society of Pneumology and the Austrian Society of Ultrasound in Medicine. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:269-277. [PMID: 35906952 PMCID: PMC9353420 DOI: 10.1002/jum.16068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/01/2022] [Accepted: 07/08/2022] [Indexed: 05/08/2023]
Abstract
Lung ultrasound has the potential to enable standardized follow-up without radiation exposure and with lower associated costs in comparison to CT scans. It is a valuable tool to follow up on patients after a COVID-19 infection and evaluate if there is pulmonary fibrosis developing. Echocardiography, including strain imaging, is a proven tool to assess various causes of dyspnea and adds valuable information in the context of long COVID care. Including two-dimensional (2D) strain imaging, a better comprehension of myocardial damage in post-COVID syndrome can be made. Especially 2D strain imaging (left and the right ventricular strain) can provide information about prognosis.
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Affiliation(s)
- Martin Altersberger
- Department of CardiologyNephrology and Intensive Care Medicine, State Hospital SteyrSteyrAustria
| | - Georg Goliasch
- Department of Internal Medicine II, Division of CardiologyMedical University of ViennaViennaAustria
| | - Mounir Khafaga
- Rehabilitation Center Hochegg for Cardiovascular and Respiratory DiseasesGrimmensteinAustria
| | - Matthias Schneider
- Department of Internal Medicine II, Division of CardiologyMedical University of ViennaViennaAustria
| | - Yerin Cho
- Department of CardiologyNephrology and Intensive Care Medicine, State Hospital SteyrSteyrAustria
| | - Roland Winkler
- Rehabilitation Center Hochegg for Cardiovascular and Respiratory DiseasesGrimmensteinAustria
| | - Georg‐Christian Funk
- Department of Internal Medicine II, Division of PulmonologyHospital OttakringViennaAustria
| | - Thomas Binder
- Medical University of Vienna, Teaching CenterViennaAustria
| | | | - Ralf‐Harun Zwick
- Therme Wien Med—Outpatient Pulmonary RehabilitationViennaAustria
| | - Martin Genger
- Department of CardiologyNephrology and Intensive Care Medicine, State Hospital SteyrSteyrAustria
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The Effect of Pulmonary Rehabilitation on Pain, Respiratory Functions and Activities of Daily Living in COVID-19 Patients. JOURNAL OF CONTEMPORARY MEDICINE 2023. [DOI: 10.16899/jcm.1227489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) requires a multidisciplinary approach owing to its multisystem involvement. Pulmonary rehabilitation may be required in patients with COVID-19. In our study, we aimed to examine the effect of the pulmonary rehabilitation program applied after the acute period of back pain in patients with severe pulmonary involvement, dyspnea and health profiles of the patients.
Method: In our retrospectively planned study, 50 patients with advanced pulmonary involvement who were treated for COVID-19 and discharged from the hospital and who were diagnosed with shortness of breath, back pain and difficulties in daily living activities in the 1st month chest diseases polyclinic controls and who were given a pulmonary rehabilitation program for a period of
1 month were included in our study. Before and 1 month after the pulmonary rehabilitation program, back pain was evaluated with the VAS, respiratory functions were evaluated with the Modified Medical Research Council Scale, and activities of daily living were evaluated with the Notthingham scale.
Results: A statistically significant difference was found between the beginning and the end of the pulmonary rehabilitation program in the Modified Medical Research Council Scale scores (p
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Al-Nassan S, Alshallan A, Hawamdeh M. Physiotherapy interventions and profile of practice for COVID-19 patients in Jordan. Work 2023; 74:47-57. [PMID: 36245354 DOI: 10.3233/wor-211460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Physiotherapy plays an essential role in combating the complications of coronavirus disease 2019 (COVID-19). Profiling the experiences and challenges of physiotherapy practice in a country will help in customizing the competencies needed for physiotherapy education and regulations of practice. OBJECTIVE To explore the experiences, knowledge, training, and barriers of practice for Jordanian physiotherapists who worked with COVID-19 cases at different work settings. METHODS An online survey was distributed to physiotherapists working at different Jordanian rehabilitation settings. Physiotherapists who had experience in dealing with COVID-19 cases were eligible to participate in the study. RESULTS The survey showed that only 38% of participants had received specialized training in dealing with COVID-19. Respiratory exercises were mostly used in the intensive care units or isolation wards (60%), and with patients having long-term complications (74%). Inadequate patients' referral to physiotherapy was reported by 88.6% of eligible participants. The majority of participants (68%) reported lack of adequate personal protective equipment (PPE) for physiotherapists. Challenges at the level of treatment skills, techniques, and communication were the most frequently reported by participants (44%), followed by challenges at the level of work policies (32%), then by challenges at the level of knowledge about the disease (28%). CONCLUSION The study showed gaps in knowledge, training, and work-related policies that all created challenges for physiotherapists dealing with COVID-19 cases in Jordan. We hope our data can help in providing a basis for developing educational and training programs, in addition to revising work-related policies, to promote physiotherapy management of COVID-19 in Jordan.
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Affiliation(s)
- Saad Al-Nassan
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Amjad Alshallan
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Mohannad Hawamdeh
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
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KINTRILIS N, KONTAXAKIS A, PAPALAMPIDOU A, MANTHOS P, SIMEONIDOU Z, Stavrianou A, Moumtzi-Nakka E, Galinos I, RAPIDI CA. QUALITY OF LIFE AFTER CORONAVIRUS DISEASE 2019 HOSPITALIZATION AND REHABILITATION NEEDS. JOURNAL OF REHABILITATION MEDICINE. CLINICAL COMMUNICATIONS 2023; 6:5327. [PMID: 36760716 PMCID: PMC9838561 DOI: 10.2340/jrmcc.v6.5327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 01/11/2023]
Abstract
Introduction During the current pandemic, there has been a paucity of Greek data in terms of recording the general long-term functional status of patients after coronavirus disease 2019 (COVID-19) hospitalizations, as well as very little information regarding rehabilitation services nationwide and their utilization. Objective-design This is a prospective cohort study, including 92 adults discharged from the Infectious Disease Unit of a third-level hospital in Greece after hospitalization with COVID-19. Demographics and disease severity data was collected upon admission and symptoms at discharge, 4 months and 1 year. Following rating of 12 common symptoms on a Likert scale, quality-of-life data and accessibility to rehabilitation services were compared among the 3 time points. Results At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. At the 4-month follow-up, only 4.3% of the study participants had visited a rehabilitation facility of any kind, whereas at the 1-year mark the percentage rose to 10.9%. Conclusion A clinically relevant number of participants experienced at least one post-COVID-19 hospitalization symptom. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. With thousands more being infected and needing hospitalization nationwide daily, the need for the inclusion of relevant rehabilitation programmes in the Greek healthcare system appears imminent.
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Affiliation(s)
- Nikolaos KINTRILIS
- Infectious Disease Unit, 401 General Military Hospital of Athens, Athens
| | - Antonis KONTAXAKIS
- Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
| | - Athanasia PAPALAMPIDOU
- Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
| | - Prokopios MANTHOS
- Physical and Rehabilitation Medicine Department, General Hospital of Athens, “Gennimatas”, Athens
| | - Zaira SIMEONIDOU
- Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
| | - Aggeliki Stavrianou
- Physical and Rehabilitation Medicine Center, General Hospital of Florina “Elena Dimitriou”, Florina, Greece
| | - Eleni Moumtzi-Nakka
- Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
| | - Iosif Galinos
- Infectious Disease Unit, 401 General Military Hospital of Athens, Athens
| | - Christina A. RAPIDI
- Physical and Rehabilitation Medicine Department, General Hospital of Athens, “Gennimatas”, Athens
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Voropaeva SV, Segeda AS, Sazonova AD. [Medical rehabilitation features of patients suffered from new coronavirus infection]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2023; 100:64-69. [PMID: 38016058 DOI: 10.17116/kurort202310005164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Despite the development and implementation of preventive measures, new coronavirus infection (COVID-19) cases are still being registered among the population. OBJECTIVE To describe the methods of recovery treatment, used at different rehabilitation stages of patients suffered from COVID-19. MATERIAL AND METHODS An analytical review of rehabilitation methods of patients after COVID-19 was conducted. The literature reviews and original researches from Scopus, Web of Science, PubMed, CyberLeninka and eLibrary electronic databases were studied. RESULTS AND CONCLUSION Lungs, heart and vessels, gastrointestinal tract and central nervous system are most commonly affected by COVID-19. Due to this, the article considers key aspect of rehabilitation of patients with revealed disorders. Multidisciplinary approach is the main treatment type of patient with COVID-19. The effective result of comprehensive and multidisciplinary approach can be achieved only by the work of a team of specialists from different disciplines. The early onset, consistency and continuity of rehabilitation activities are important factors in the recovery of patients with post-COVID syndrome.
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Affiliation(s)
- S V Voropaeva
- G.R. Derzhavin Tambov State University, Tambov, Russia
| | - A S Segeda
- G.R. Derzhavin Tambov State University, Tambov, Russia
| | - A D Sazonova
- G.R. Derzhavin Tambov State University, Tambov, Russia
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Natural Course of Muscular Strength, Physical Performance, and Musculoskeletal Symptoms in Hospitalized Patients With COVID-19. Arch Phys Med Rehabil 2023; 104:18-26. [PMID: 36103903 PMCID: PMC9464470 DOI: 10.1016/j.apmr.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/16/2022] [Accepted: 09/03/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the course of muscle strength, musculoskeletal symptoms and physical performance over time in hospitalized COVID-19 patients, and their relation with disease severity at admission. DESIGN Prospective cohort study. SETTING Pandemic clinic of Gazi University Hospital, Ankara, Turkey. PARTICIPANTS 76 adult COVID-19 patients (aged >18 years) were enrolled in the study between March 2021 and May 2021 (N=76). The participants were grouped as "mild," "moderate," and "severe" according to clinical and radiological findings. MAIN OUTCOME MEASURES The fraction of inspired oxygen (FiO2), oxygen saturation (SpO2), hand grip strength (HGS), 5-times sit and stand test (5XSTS), modified Borg scale at rest (mBorg-rest), modified Borg scale during activities of daily living (mBorg-ADL), Barthel index, and visual analog scale for myalgia (myalgia-VAS) values were recorded on the first day of hospitalization and in the first, third, and 12th weeks. Outcome measures were compared between disease severity groups. In addition, the changes in these outcome measures over time were also examined. RESULTS There were 15 (19.7%) participants in the mild, 20 (26.3%) in the moderate, and 41 (53.9%) in the severe groups. At the baseline evaluation, SpO2 (P<.001), FiO2 (P<.001), 5XSTS (P=.002), mBorg-rest (P=.016), and mBorg-ADL (P<.001) were different in 3 groups, but there were no differences for HGS, Barthel index, and myalgia-VAS score. HGS, 5XSTS, myalgia-VAS, and mBorg-ADL scores improved significantly over time in all the groups (P<.001, P≤.001, and P<.001, respectively). At the end of 12 weeks, only 5XSTS was different between the groups. 5XSTS was significantly longer in the severe group (P=.010). CONCLUSION Although significant improvement was observed in the muscle strength, physical performance, and musculoskeletal symptoms of patients with COVID-19 over time, the physical performance of these patients did not reach normal standards. We conclude that post-COVID-19 rehabilitation programs are needed to optimize the physical performance of the patients.
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Altersberger M, Grafeneder A, Cho Y, Winkler R, Zwick RH, Mathis G, Genger M. One-Year Follow-Up Lung Ultrasound of Post-COVID Syndrome-A Pilot Study. Diagnostics (Basel) 2022; 13:70. [PMID: 36611362 PMCID: PMC9818489 DOI: 10.3390/diagnostics13010070] [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: 10/08/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Millions of people worldwide were infected with COVID-19. After the acute phase of the disease, many suffer from prolonged symptoms, the post-COVID syndrome, especially the phenotype with lung residuals. Many open questions regarding lung ultrasound (LUS) have to be answered. One essential question is the means for optimal following-up of patients with post-COVID-19 residuals with LUS; (2) Methods: A retrospective data analysis of patients after acute COVID-19 infection diagnosed with post-COVID syndrome in the state hospital of Steyr and the rehabilitation center of Hochegg was performed. LUS examinations following a 12-zone scanning protocol were performed, and the LUS score quantified comet tail artifacts. A total of 16 patients were evaluated twice with LUS from May 2020 until June 2021. (3) Results: All patients’ reverberation artifacts were reduced over time. The initial LUS score of 17.75 (SD 4.84) points was decreased over the duration of the second rehabilitation to 8,2 (SD 5.94). The difference in the Wilcoxon test was significant (p < 0.001); (4) Conclusions: Lung ultrasound was a valuable tool in the follow-up of post-COVID-syndrome with lung residuals in the first wave of COVID-19. A reduction in reverberation artifacts was demonstrated. Further studies about the clinical significance have to follow.
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Affiliation(s)
- Martin Altersberger
- Department of Cardiology, Nephrology and Intensive Care Medicine, State Hospital Steyr, 4400 Steyr, Austria
| | - Anna Grafeneder
- Department of Cardiology, Nephrology and Intensive Care Medicine, State Hospital Steyr, 4400 Steyr, Austria
| | - Yerin Cho
- Department of Cardiology, Nephrology and Intensive Care Medicine, State Hospital Steyr, 4400 Steyr, Austria
| | - Roland Winkler
- Rehabilitation Center Hochegg for Cardiovascular and Respiratory Diseases, 2840 Grimmenstein, Austria
| | | | | | - Martin Genger
- Department of Cardiology, Nephrology and Intensive Care Medicine, State Hospital Steyr, 4400 Steyr, Austria
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Rutkowski S, Bogacz K, Czech O, Rutkowska A, Szczegielniak J. Effectiveness of an Inpatient Virtual Reality-Based Pulmonary Rehabilitation Program among COVID-19 Patients on Symptoms of Anxiety, Depression and Quality of Life: Preliminary Results from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416980. [PMID: 36554860 PMCID: PMC9779397 DOI: 10.3390/ijerph192416980] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 06/01/2023]
Abstract
Forms of rehabilitation for patients after COVID-19 are gaining interest. The purpose of this study was to investigate and compare an innovative in-hospital pulmonary rehabilitation programs augmented with training elements performed in virtual reality. This randomized controlled study included 32 patients enrolled in post-COVID-19 rehabilitation at a Public Hospital in Poland. The rehabilitation models included exercise capacity training on a cycle ergometer, breathing and general fitness workout, resistance training, and relaxation. The forms of training and relaxation differed between the groups: the experimental group employed virtual reality, and the control group used a traditional form of therapy. Exercise tolerance was assessed using a 6 min walk test (6 MWT), while psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). The analysis of the post-rehabilitation results showed a statistically significant improvement in both groups regarding depression (VR: 6.9 (3.9) vs. 4.7 (3.5), p = 0.008; CG: 7.64 (4.5) vs. 6.6 (4.8), p = 0.017) and anxiety (VR: 8.6 (4.6) vs. 5.6 (3.3), p < 0.001; CG: 9.57 (6.0) vs. 8 (4.8), p = 0.003). No statistically significant improvements in quality of life were noted in both groups. Moreover, the analysis showed a statistically significant improvement in the exercise capacity in both groups after completion of the rehabilitation program, expressed as a distance in the 6 MWT, as well as a statistically significant improvement in dyspnea in the VR group. To conclude, the analysis of the preliminary data revealed that a 3-week hospital-based pulmonary rehabilitation program for COVID-19 patients led to an improvement in exercise tolerance as well as a reduction in the symptoms of anxiety and depression. The virtual reality-based form of training delivery, despite its attractiveness, did not significantly affect patients' performance.
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Affiliation(s)
- Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
| | - Katarzyna Bogacz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
- Specialist Hospital of the Ministry of the Interior and Administration in Głuchołazy, 48-340 Głuchołazy, Poland
| | - Oliver Czech
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Anna Rutkowska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
| | - Jan Szczegielniak
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
- Specialist Hospital of the Ministry of the Interior and Administration in Głuchołazy, 48-340 Głuchołazy, Poland
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Hegde S, Sreeram S, Bhat KR, Satish V, Shekar S, Babu M. Evaluation of post-COVID health status using the EuroQol-5D-5L scale. Pathog Glob Health 2022; 116:498-508. [PMID: 35129097 PMCID: PMC9639560 DOI: 10.1080/20477724.2022.2035623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
SARS-CoV-2 has had a lasting effect on the overall health of recovered patients, called 'long COVID'. Currently, there is a lack of a validated standard questionnaire to assess post-COVID health status. A retrospective observational study involving the recovered COVID patients admitted to a secondary care hospital in India between June to December 2020 (n = 123), was conducted using the EuroQol-5D-5L scale at discharge, 4 weeks and 8 weeks post-discharge. A significant difference in anxiety/depression scores was found (χ2 = 65.6, p < 0.000) among the 3 categories of time (discharge, 4 weeks and 8 weeks). The anxiety/depression dimension scores showed a significant change (p < 0.0001) between discharge and 8 weeks, using paired t-test. Age had a significant relationship with the anxiety/depression dimension at 4 weeks (OR = 5.617, 95% CI = 1.0320-30.5746, p < 0.05). A significant difference was found using Kruskal-Wallis rank-sum test on mean index scores (χ2 = 60.0, p < 0.000) among the three categories of time (discharge, 4 weeks and 8 weeks). There was a statistically significant difference of time on EQ Index scores as determined by one-way repeated measures ANOVA (F(2,375) = 18.941, p = <0.00001). Our study found time to have a statistically significant impact on the mean index scores, level sum scores and dimension scores. Smoking was found to be significantly associated with usual activity scores at 4 weeks. The most remarkable changes occurred in the anxiety/depression dimension. Overall, there was a general trend of health improvement.
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Affiliation(s)
| | | | | | - Vaishnavi Satish
- Department of Community Medicine, Kasturba Medical College and Hospital, Mangalore, India
| | | | - Mahesh Babu
- Department of Ophthalmology, KVG Medical College and Hospital, Sullia, India
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Barbieri V, Scarabel L, Bertella L, Scarpina F, Schiavone N, Perucca L, Rossi P. Evaluation of the predictive factors of the short-term effects of a multidisciplinary rehabilitation in COVID-19 survivors. J Int Med Res 2022; 50:3000605221138843. [PMID: 36448484 PMCID: PMC9716619 DOI: 10.1177/03000605221138843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Functional impairments after coronavirus disease 2019 (COVID-19) constitute a major concern in rehabilitative settings; however, evidence assessing the efficacy of rehabilitation programs is lacking. The aim of this study was to verify the clinical characteristics that may represent useful predictors of the short-term effectiveness of multidisciplinary rehabilitation. METHODS In this real-practice retrospective pre-post intervention cohort study, the short-term effectiveness of a multidisciplinary patient-tailored rehabilitation program was assessed through normalized variations in the Functional Independence Measure in post-acute care patients who had overcome severe COVID-19. Biochemical markers, motor and nutritional characteristics, and the level of comorbidity were evaluated as predictors of functional outcome. Length of stay in the rehabilitation ward was also considered. RESULTS Following rehabilitation, all participants (n = 53) reported a significant decrease in the level of disability in both motor and cognitive functioning. However, neither motor and nutritional characteristics nor comorbidities played a significant role in predicting the overall positive change registered after rehabilitation. CONCLUSIONS The results support the existing sparse evidence addressing the importance of an early rehabilitation program for patients who received intensive care and post-acute care due to severe COVID-19.
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Affiliation(s)
- Valentina Barbieri
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland,IRCCS Istituto Auxologico Italiano, U.O. di Riabilitazione Neuromotoria Auxologico ‘Capitanio’, Milan, Italy,Valentina Barbieri, Clinica Hildebrand, Centro di Riabilitazione Brissago, Via Crodolo 18, 6614 Brissago, Switzerland.
| | - Luca Scarabel
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland,Cliniche di Riabilitazione Ente Ospedaliero Cantonale (CREOC), Novaggio and Faido, Switzerland
| | - Laura Bertella
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland
| | - Federica Scarpina
- ‘Rita Levi Montalcini’ Department of Neurosciences, University of Turin, , Turin, Italy,IRCCS Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Nicola Schiavone
- Cliniche di Riabilitazione Ente Ospedaliero Cantonale (CREOC), Novaggio and Faido, Switzerland
| | - Laura Perucca
- IRCCS Istituto Auxologico Italiano, U.O. di Riabilitazione Neuromotoria Auxologico ‘Capitanio’, Milan, Italy,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Paolo Rossi
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland
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Cevei M, Onofrei RR, Gherle A, Gug C, Stoicanescu D. Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215350. [PMID: 36430069 PMCID: PMC9691035 DOI: 10.3390/ijerph192215350] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/17/2022] [Indexed: 06/01/2023]
Abstract
The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients' reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients' musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.
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Affiliation(s)
- Mariana Cevei
- Psychoneuro Sciences and Rehabilitation Department, Faculty of Medicine & Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Roxana Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, Research Center for Assessment of Human Motion, Functionality and Disability, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Anamaria Gherle
- Psychoneuro Sciences and Rehabilitation Department, Faculty of Medicine & Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Cristina Gug
- Microscopic Morphology Department, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Dorina Stoicanescu
- Microscopic Morphology Department, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
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Bloomquist K, Tang LH, Kjelsbak S, Hansen LL, Christensen J. National mapping of municipality-based rehabilitation services for patients recovering from COVID-19 in Denmark: a cross-sectional study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background/aims A lack of knowledge exists as to how municipalities are meeting the rehabilitation needs of patients recovering from COVID-19. This poses a potential barrier when referring patients for rehabilitation. The aim of this study was to map and describe municipality-based rehabilitation services for patients recovering from COVID-19 in Denmark. Methods This was a cross-sectional, nation-wide survey. Key staff members from all 98 municipalities in Denmark were invited to participate. Participants had insight into the organisation and professional content of municipal rehabilitation. Structured telephone interviews were conducted by three interviewers between October and November 2020. The interview guide consisted of items that asked about the availability, content and organisation of municipality-based rehabilitation services. Results A total of 91 municipalities (93% response rate) participated in the study. Rehabilitation could be provided within pre-existing services in 98% of municipalities and 93% systematically assessed individual rehabilitation needs using a variety of measurement methods. All municipalities reported that they had services in place to provide functional rehabilitation (eg gait training) and over 90% provided physical, cognitive and lifestyle-related rehabilitation. In contrast, 70% could provide COVID-19 education and 64% psychological therapy. Overall, 32% of municipalities had not received referrals for COVID-19 rehabilitation. Of the 62 municipalities that had COVID-19 rehabilitation experience, 73% rated the degree to which they could deliver coherent and coordinated rehabilitation for patients with complex rehabilitation needs as high or very high. Conclusions Overall, Danish municipalities reported that pre-existing services are in place to provide relevant, individualised rehabilitation for patients recovering from COVID-19. Nonetheless, future efforts should ensure that patient education is established, in step with health care providers accumulating knowledge, as well as integrated referral pathways between sectors, to deliver rehabilitation to patients with complex needs. Further, implementation of a national data collection strategy would strengthen and inform future development of relevant services both nationally and internationally.
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Affiliation(s)
- Kira Bloomquist
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars H Tang
- Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sissel Kjelsbak
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Linea L Hansen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Muacevic A, Adler JR, Papavdi M, Manousopoulou G, Karamani T, Avgoustou H, Kotsi E, Niakas D, Vassilopoulos D. Long-Term Effect on Health-Related Quality of Life in Patients With COVID-19 Requiring Hospitalization Compared to Non-hospitalized COVID-19 Patients and Healthy Controls. Cureus 2022; 14:e31342. [PMID: 36514618 PMCID: PMC9741546 DOI: 10.7759/cureus.31342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/12/2022] Open
Abstract
Background In this study, we aimed to evaluate the health-related quality of life (HRQL) in patients with severe coronavirus disease 2019 (COVID-19) six months after their hospitalization and compare it to that of non-hospitalized patients with mild COVID-19 and healthy controls. Methodology Participants were enrolled between September 2021 and April 2022 and included hospitalized COVID-19 patients at General Hospital of Athens "Hippocration" who had been discharged at least six months prior to enrollment, non-hospitalized patients with COVID-19, and healthy controls. Collected data included demographics, disease severity, medication history, and comorbidities. Participants completed a EuroQol 5 Dimensions 5Levels (EQ5D5L), a Short Form 36 version 2 (SF36v2), a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and a Post-COVID-19 Functional Status Scale (PCFSS) regarding HRQL before and six months after infection with severe acute respiratory syndrome coronavirus 2. In the case of healthy controls, two sets of questionnaires were completed at least six months apart. Statistical analysis was performed using the SPSS version 25 software (IBM Corp., Armonk, NY, USA). Results A total of 151 participants were enrolled. Hospitalized patients with COVID-19 demonstrated a statistically significant deterioration in most parameters of SF36v2 as well as both parameters of the EQ5D5L and FACIT-F questionnaires. Hospitalized patients exhibited worse results in SF36v2 and EQ5D5L when compared to both healthy controls as well as those with mild COVID-19 (p < 0.05). Hospitalized women, in particular, were shown to fare worse than other women in parameters associated with both mental/psychological and physical health (p < 0.05). Hospitalized patients between 41 and 60 years old demonstrated a statistically significant drop in the scores of all three main questionnaires compared to their previous health status (p < 0.05). Hospitalized patients between 61 and 80 years old exhibited a similar trend, but statistical significance was achieved in fewer parameters. HRQL decline was greater in both age groups compared to that of healthy and milder disease counterparts. There was a significant correlation between the results from the three main questionnaires. Similarly, PCFS scale values were shown to correlate with disease severity (hospitalization or not) and age. Conclusions HRQL remained noticeably impacted six months after hospitalization due to COVID-19. The physical and mental/psychological stress of severe COVID-19 translated into lasting health deterioration, especially for women and those aged 41-60 years old. The use of questionnaires, such as those implemented in this study, might help in the early detection of patients who could benefit from rehabilitation programs. Psychological, as well as physical and social, support is crucial to alleviate the burden of post-COVID-19 symptomatology and expedite the recovery of this group of patients.
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BENZARTI W, TOULGUI E, GHRAM A, RAHMANI C, AISSA S, GHANNOUCHI I, GARGOURI I, SAYHI A, KNAZ A, OUANES W, JEMNI S, BEN SAAD H. Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study. F1000Res 2022; 11:1226. [PMID: 37547787 PMCID: PMC10403745 DOI: 10.12688/f1000research.126301.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background In addition to the cardiorespiratory, muscular, and neurological manifestations, coronavirus disease 2019 (COVID-19) alters patients' health-related quality of life (HRQoL), induces a large variety of psychiatric manifestations, and reduces mobility and motor activity. Several studies have raised the impact of a pulmonary rehabilitation program (PRP) on social disadvantage ( e.g., HRQoL, anxiety, depression) and physical activity of COVID-19 patients, but very few have been performed in low-income countries. This study aimed to investigate the impact of a PRP on post-COVID-19 HRQoL, hospital anxiety and depression (HAD), and physical activity in Tunisian post-COVID19-patients. Methods This was a cross-sectional study in an outpatient care setting. Patients with post-COVID-19 were included. They completed an interview (including three questionnaires) before and after a PRP (three sessions/week for four weeks, each session was 70 minutes in duration, PRP items: aerobic cycle endurance, strength training, and education). The VQ11 questionnaire assessed functional dimension, psychological dimension, relational dimension, and total score; HAD appraised depression and anxiety; and Voorrips physical activity assessed daily activity, physical activity, leisure activity, and total scores. Data were expressed as mean±standard deviation in PRP change (PRP change=after-PRP values - before-PRP values). Results In total, 14 moderate to severe post-COVID-19 patients (61±4 years) were included. The PRP significantly improved the i) functional, psychological, and relational dimensions, and the VQ11 total score by 1.79±1.58 (p=0.0033), 2.00±2.15 (p=0.0108), 1.57±1.50 (p=0.0077), and 5.36±3.97 (p=0.0015), respectively; ii) HAD anxiety and depression scores by 2.07±2.40 (p=0.0076), and 2.57±3.08 (p=0.0058); and iii) physical activity and total scores by 1.75±2.44 (p=0.0251), and 1.78±2.65 (p=0.0341), respectively. Conclusion The PRP improved HRQoL, HAD, and physical activity of Tunisian post-COVID-19 patients.
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Affiliation(s)
- Wafa BENZARTI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna TOULGUI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Amine GHRAM
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
| | - Chiraz RAHMANI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sana AISSA
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines GHANNOUCHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Imene GARGOURI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani SAYHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma KNAZ
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Walid OUANES
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sonia JEMNI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Helmi BEN SAAD
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Seid AA, Aychiluhm SB, Mohammed AA. Effectiveness and feasibility of telerehabilitation in patients with COVID-19: a systematic review and meta-analysis. BMJ Open 2022; 12:e063961. [PMID: 36198459 PMCID: PMC9534777 DOI: 10.1136/bmjopen-2022-063961] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the pooled effectiveness and feasibility of telerehabilitation in patients with COVID-19. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES PubMed, CINAHL, Science Direct, PEDro, Google Scholar and Cochrane Library databases were systematically searched to the end of March 2022. ELIGIBILITY CRITERIA AND OUTCOMES RCTs investigating the effects of telerehabilitation in the management of patients with COVID-19 were included. The outcomes of interest were functional capacity, cardiopulmonary exercise tests, quality of life and other variables where data are available. DATA EXTRACTION AND SYNTHESIS Two reviewers screened, extracted data and performed methodological quality assessment independently. The revised Cochrane Risk of Bias tool was used to assess the risk of bias. Review Manager V.5.4 and Stata V.14.0 software were used for statistical analysis. Mean difference (MD) with 95% CI and the corresponding p value were used to determine the treatment effect between groups. A fixed-effect model was used for all variables as no significant heterogeneity was observed. RESULTS Four studies with 334 patients with COVID-19 were included. The pooled result of telerehabilitation showed statistically significant improvement on 6-minute walking test (MD 75.50; 95% CI 54.69 to 96.30; p=0.48), 30-second sit-to-stand test (MD 1.76; 95% CI 1.47 to 2.04; p=0.30), Borg Scale (MD 2.49; 95% CI 2.16 to 2.83; p=0.28) and level of dyspnoea (MD 6.26; 95% CI 5.42 to 7.10; p=0.66). The overall treatment completion rate was 88.46%, and the most common reason for withdrawal after randomisation was lost to follow-up or uncooperativeness. CONCLUSIONS The findings showed that telerehabilitation interventions could improve functional capacity and exercise perception among patients affected by COVID-19 and can be implemented with a high completion rate and minimal adverse events. However, more studies are required to investigate the effects on cardiopulmonary function, quality of life, anxiety, depression and other variables. PROSPERO REGISTRATION NUMBER CRD42021287975.
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Affiliation(s)
- Abubeker Alebachew Seid
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Afar, Ethiopia
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Al-Husinat L, Nusir M, Al-Gharaibeh H, Alomari AA, Smadi MM, Battaglini D, Pelosi P. Post-COVID-19 syndrome symptoms after mild and moderate SARS-CoV-2 infection. Front Med (Lausanne) 2022; 9:1017257. [PMID: 36262270 PMCID: PMC9573938 DOI: 10.3389/fmed.2022.1017257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background Post-COVID-19 Syndrome (PCS) is characterized by residual symptoms following the initial recovery from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The prevalence of PCS is known to be the highest among severe and critical forms of the disease. However, the occurrence and risk factors for PCS after mild or moderate SARS-CoV-2 infection has not been extensively investigated. Methods Online and offline via both paper or mailed questionnaires distributed among Jordan collected between 1st and 21st August 2021, including a total number of 800 respondents, of whom 495 had previous mild to moderate COVID-19 infection. The Newcastle post-COVID syndrome Follow-up Screening Questionnaire was modified, translated, and used as a standard instrument for data collection regarding psychological, medical, and socio-economic symptoms post-infection. The primary outcome was the prevalence of PCS after mild to moderate COVID-19 in Jordan. Secondary outcome was the identification of PCS risk factors. Results The most common PCS symptom was mood disturbance followed by fatigue, anxiety, and myalgia. Female gender significantly increased the risk for multiple PCS symptoms. Age < 30 years was found to be an independent risk factor for myalgia (p = 0.001). Conclusion PCS is highly prevalent among COVID-19 survivors in Jordan, especially in females and patients with comorbidities. Planning physical and mental rehabilitation services is recommended for those patients with PCS symptoms after mild to moderate COVID-19 infection.
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Affiliation(s)
- Lou'i Al-Husinat
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mokeem Nusir
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Haitham Al-Gharaibeh
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Amer A Alomari
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Mahmoud M Smadi
- Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan
| | - Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy
| | - Paolo Pelosi
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
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Rico Hernansanz G, Supervía M, López Sánchez A, Peña Peña D, Arroyo Riaño MO. [Satisfaction and utility of rehabilitative treatment through educational material in patients with COVID-19]. Rehabilitacion (Madr) 2022; 56:320-327. [PMID: 35654626 PMCID: PMC8486673 DOI: 10.1016/j.rh.2021.09.006] [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: 06/28/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors. MATERIAL AND METHOD We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge. RESULTS 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were "very satisfied" with the educational material and considered it easy to perform in 100% (n=100) of cases. CONCLUSION The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff.
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Affiliation(s)
- G Rico Hernansanz
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España.
| | - M Supervía
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España; Division of Preventive Cardiology, Department of Cardiovascular Medicine. Mayo Clinic, Minnesota, USA
| | - A López Sánchez
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
| | - D Peña Peña
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
| | - M O Arroyo Riaño
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
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Saha S, Sharma K. Modification of Lifestyle to Recover from Post-COVID Symptoms: A Short Review. J Lifestyle Med 2022; 12:113-118. [PMID: 36628181 PMCID: PMC9798880 DOI: 10.15280/jlm.2022.12.3.113] [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: 04/23/2022] [Accepted: 09/04/2022] [Indexed: 12/24/2022] Open
Abstract
Poor lifestyle is associated with a high risk of developing the symptoms of post-COVID. It does not only have the negative effect on physical health, but also psychological health. This also creates a challenge on health care system. One of the cost-effective and easy ways to deal this situation is medication of lifestyle. The review study aimed to understand the importance of lifestyle modification in managing symptoms of post-COVID.
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Affiliation(s)
- Shilpasree Saha
- Department of Physiotherapy, Nopany Institute of Healthcare Studies, Kolkata, India,Corresponding author: Shilpasree Saha Department of Physiotherapy, Nopany Institute of Healthcare Studies, Kolkata 700006, India Tel: 91-9856802334, Fax: 91-9856802334 E-mail:
| | - Kritika Sharma
- Department of Physiotherapy, Sikkim Professional College of Physiotherapy, Sikkim, India
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Toulgui E, Benzarti W, Rahmani C, Aissa S, Ghannouchi I, Knaz A, Sayhi A, Sellami S, Mahmoudi K, Jemni S, Gargouri I, Hayouni A, Ouanes W, Ammar A, Ben saad H. Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study. Front Physiol 2022; 13:1029766. [PMID: 36246110 PMCID: PMC9555273 DOI: 10.3389/fphys.2022.1029766] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/12/2022] [Indexed: 12/12/2022] Open
Abstract
Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.
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Affiliation(s)
- Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Chiraz Rahmani
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Sana Aissa
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines Ghannouchi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma Knaz
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani Sayhi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sana Sellami
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Khaoula Mahmoudi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sonia Jemni
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Imene Gargouri
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | | | - Walid Ouanes
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, Paris Nanterre University, UFR STAPS, Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- *Correspondence: Achraf Ammar,
| | - Helmi Ben saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
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Maglakelidze M, Kurua I, Maglakelidze N, Maglakelidze T, Chkhaidze I, Gogvadze K, Chkhaidze N, Beadle H, Redden-Rowley K, Adab P, Adams R, Chi C, Cheng KK, Cooper B, Correia-de-Sousa J, Dickens AP, Enocson A, Farley A, Gale NK, Jowett S, Martins S, Rai K, Sitch AJ, Stavrikj K, Stelmach R, Turner AM, Williams S, Jordan RE, Jolly K. Feasibility of a pulmonary rehabilitation programme for patients with symptomatic chronic obstructive pulmonary disease in Georgia: a single-site, randomised controlled trial from the Breathe Well Group. BMJ Open 2022; 12:e056902. [PMID: 36153030 PMCID: PMC9511586 DOI: 10.1136/bmjopen-2021-056902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess the feasibility of delivering a culturally tailored pulmonary rehabilitation (PR) programme and conducting a definitive randomised controlled trial (RCT). DESIGN A two-arm, randomised feasibility trial with a mixed-methods process evaluation. SETTING Secondary care setting in Georgia, Europe. PARTICIPANTS People with symptomatic spirometry-confirmed chronic obstructive pulmonary disease recruited from primary and secondary care. INTERVENTIONS Participants were randomised in a 1:1 ratio to a control group or intervention comprising 16 twice-weekly group PR sessions tailored to the Georgian setting. PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility of the intervention and RCT were assessed according to: study recruitment, consent and follow-up, intervention fidelity, adherence and acceptability, using questionnaires and measurements at baseline, programme end and 6 months, and through qualitative interviews. RESULTS The study recruited 60 participants (as planned): 54 (90%) were male, 10 (17%) had a forced expiratory volume in 1 second of ≤50% predicted. The mean MRC Dyspnoea Score was 3.3 (SD 0.5), and mean St George's Respiratory Questionnaire (SGRQ) 50.9 (SD 17.6). The rehabilitation specialists delivered the PR with fidelity. Thirteen (43.0%) participants attended at least 75% of the 16 planned sessions. Participants and rehabilitation specialists in the qualitative interviews reported that the programme was acceptable, but dropout rates were high in participants who lived outside Tbilisi and had to travel large distances. Outcome data were collected on 63.3% participants at 8 weeks and 88.0% participants at 6 months. Mean change in SGRQ total was -24.9 (95% CI -40.3 to -9.6) at programme end and -4.4 (95% CI -12.3 to 3.4) at 6 months follow-up for the intervention group and -0.5 (95% CI -8.1 to 7.0) and -8.1 (95% CI -16.5 to 0.3) for the usual care group at programme end and 6 months, respectively. CONCLUSIONS It was feasible to deliver the tailored PR intervention. Approaches to improve uptake and adherence warrant further research. TRIAL REGISTRATION NUMBER ISRCTN16184185.
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Affiliation(s)
- Mariam Maglakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Ia Kurua
- Georgian Respiratory Association, Tbilisi, Georgia
| | | | - Tamaz Maglakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Ivane Javakhishvili Tbilisi State University Faculty of Medicine, Tbilisi, Georgia
| | - Ivane Chkhaidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Tbilisi State Medical University Faculty of Medicine, Tbilisi, Georgia
| | | | | | - Helen Beadle
- Department of Physiotherapy, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kelly Redden-Rowley
- iCares Directorate, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Rachel Adams
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Chunhua Chi
- Department of General Practice, Peking University First Hospital, Beijing, 100034, China
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Brendan Cooper
- Lung Function & Sleep, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jaime Correia-de-Sousa
- Life and Health Sciences Research Institute, University of Minho, Braga, Portugal
- International Primary Care Respiratory Group, Edinburgh, Scotland
| | - Andrew P Dickens
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Observational and Pragmatic Research Institute, Singapore
| | - Alexandra Enocson
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Amanda Farley
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Nicola K Gale
- Health Services Management Centre, University of Birmingham College of Arts and Law, Birmingham, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Sonia Martins
- Family Medicine, ABC Medical School, São Paulo, Brazil
| | - Kiran Rai
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Alice J Sitch
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Katarina Stavrikj
- Centre for Family Medicine, Medical Faculty, Skopje, North Macedonia
| | - Rafael Stelmach
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alice M Turner
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Sian Williams
- International Primary Care Respiratory Group, Edinburgh, Scotland
| | - Rachel E Jordan
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
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Haunhorst S, Bloch W, Wagner H, Ellert C, Krüger K, Vilser DC, Finke K, Reuken P, Pletz MW, Stallmach A, Puta C. Long COVID: a narrative review of the clinical aftermaths of COVID-19 with a focus on the putative pathophysiology and aspects of physical activity. OXFORD OPEN IMMUNOLOGY 2022; 3:iqac006. [PMID: 36846561 PMCID: PMC9494493 DOI: 10.1093/oxfimm/iqac006] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 11/14/2022] Open
Abstract
The pandemic coronavirus disease 2019 (COVID-19) can cause multi-systemic symptoms that can persist beyond the acute symptomatic phase. The post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, describe the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms and are estimated to affect at least 20% of the individuals infected with SARS-CoV-2 regardless of their acute disease severity. The multi-faceted clinical picture of long COVID encompasses a plethora of undulating clinical manifestations impacting various body systems such as fatigue, headache, attention disorder, hair loss and exercise intolerance. The physiological response to exercise testing is characterized by a reduced aerobic capacity, cardiocirculatory limitations, dysfunctional breathing patterns and an impaired ability to extract and use oxygen. Still, to this day, the causative pathophysiological mechanisms of long COVID remain to be elucidated, with long-term organ damage, immune system dysregulation and endotheliopathy being among the hypotheses discussed. Likewise, there is still a paucity of treatment options and evidence-based strategies for the management of the symptoms. In sum, this review explores different aspects of long COVID and maps the literature on what is known about its clinical manifestations, potential pathophysiological mechanisms, and treatment options.
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Affiliation(s)
- Simon Haunhorst
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena 07749, Germany,Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne 50933, Germany
| | - Heiko Wagner
- Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Claudia Ellert
- Department for Vascular Surgery, Lahn-Dill Clinics Wetzlar, Wetzlar 35578, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen 35394, Germany
| | - Daniel C Vilser
- Hospital for Pediatrics and Adolescent Medicine, Jena University Hospital, Jena 07747, Germany
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena 07747, Germany
| | - Philipp Reuken
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena 07747, Germany
| | - Andreas Stallmach
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Christian Puta
- Correspondence address. Department for Sports Medicine and Health Promotion, Friedrich-Schiller-Universität Jena, Wöllnitzer Straße 42, Jena 07749, Germany. Tel: +49 3641 9-45607; Fax: +49 3641 9-45652; E-mail:
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49
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Toulgui E, Benzarti W, Saad HB. Comments about the “Systematic Review: Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae”. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
I read with great interest the systematic review of Prabawa et al. “Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review”. The rational of this systematic review is very interesting, since it discusses the rehabilitation therapy for long coronavirus disease 2019 (COVID-19) syndrome with respiratory sequelae. In COVID-19, physical rehabilitation is a new management axis, and studies related to its impacts on COVID-19 patients’ data are scarce. In their paper, Prabawa et al. have included one Tunisian study (Benzarti W, et al. General practitioners should provide the cardiorespiratory rehabilitation’ ‘minimum advice’ for long COVID-19 patients. Lib J Med. 2022;17(1):2009101) published by the authors of this correspondence. However, three remarks related to the following points were noted: i) Citation of a wrong country of Benzarti et al., ii) Publishing a figure belonging to Benzarti et al. without obtaining the authors’ permission, and iii) Omission to develop a chapter for nutrition rehabilitation. The present Letter to Editor is an appeal for a more rigor when reporting data from previous publications (eg; avoid mistakes related to the country of the first author), and is a remain that permission is needed if some authors want to use a figure created by somebody else.
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COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art. Turk J Phys Med Rehabil 2022; 68:317-335. [DOI: 10.5606/tftrd.2022.11435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient’s prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is “a state of complete physical, mental and social well-being”, individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients.
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