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León-Herrera S, Samper-Pardo M, Oliván-Blázquez B, Sánchez-Recio R, Magallón-Botaya R, Sánchez-Arizcuren R. Loss of socioemotional and occupational roles in individuals with Long COVID according to sociodemographic and clinical factors: Secondary data from a randomized clinical trial. PLoS One 2024; 19:e0296041. [PMID: 38386633 PMCID: PMC10883534 DOI: 10.1371/journal.pone.0296041] [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: 06/05/2023] [Accepted: 11/20/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Long COVID syndrome can have a major impact on life organization. Its persistent symptoms may cause a potentially disabling condition that affects the quality of life of those suffering from it. The resulting loss of functional independence hinders the ability to return to normal life. Many research studies carried out on this novel syndrome have focused on describing its extensive symptomatology. Studies on later repercussions, however, such as disability or loss of significant roles, remain scarce. This study examines the loss of socioemotional and occupational roles experienced by individuals suffering from Long COVID, as a result of the disease. A secondary objective is to analyze the sociodemographic and clinical factors associated with this loss of roles. PATIENTS AND METHODS A cross-sectional study was conducted with the participation of 100 patients diagnosed with Long COVID, over the age of 18, and attended by Primary Health Care in the Autonomous Community of Aragon. The main study variable was the loss of significant socioemotional and occupational roles by the participants. Sociodemographic and clinical data were also collected through a structured interview. Subsequently, a descriptive, correlational, and regression-based statistical analysis was performed using the SPSS Statistics program. RESULTS Based on the 100 study participants, the median number of roles lost was 3 (IQR 2) and the median number of valuable roles lost was 2 (IQR 2). More cognitive impairment and not having an active work role were predictors of a greater loss of valuables roles. CONCLUSION Long COVID symptoms hinder the development of socioemotional and occupational roles. Healthcare professionals should consider this when intervening to ensure that their patients may recover their life as it was before the disease.
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Affiliation(s)
- Sandra León-Herrera
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | | | - Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, University of Zaragoza, Zaragoza, Spain
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2
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Myklebust-Hansen HJ, Hasvik E, Solyga VM, Ghanima W. The feasibility of self-performing measurements of peripheral oxygen saturation and respiratory exercises in home-isolated COVID-19 patients-a single-arm prospective trial. Pilot Feasibility Stud 2023; 9:195. [PMID: 38042811 PMCID: PMC10693052 DOI: 10.1186/s40814-023-01415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/25/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND COVID-19 is a highly contagious disease where isolation of infected individuals is deemed warranted. If possible, home isolation is preferred over hospitalization. This implies a need for methods of observation that can ensure the safety of these patients. Preventive treatment methods that can both decrease the probability for development of critical disease and hopefully decrease the need for hospitalization would be an added benefit. This was a single-arm prospective pilot study performed to assess the feasibility of performing self-measurements of SpO2 and respiratory exercises in at-home isolated COVID-19 patients. METHOD A total of 40 ambulant SARS-CoV-2-positive individuals in home isolation were followed up for a period of 14 days. At baseline, they were equipped with a pulse oximeter, PEF meter, a project diary to note all measurements, and simple instructions on how to perform respiratory exercises. No other contact was made, but participants were instructed to contact the hospital based on given criteria for blood oxygenation levels and dyspnea severity and to return study equipment and the project diary at the end of study. RESULTS During the follow-up period, 35 participants (87.5%) recorded daily SpO2 measurements, and 12 (30%) adhered to daily respiratory exercises as instructed. Four participants (10%) were admitted to hospital during the follow-up period. Five participants terminated follow-up prematurely. CONCLUSIONS Performing self-measurements of SpO2 during home isolation due to COVID-19 infection is feasible. The feasibility of performing respiratory exercises in ambulant patients is questionable and may require more motivational interventions to increase adherence. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04647747.
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Affiliation(s)
| | - Eivind Hasvik
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway
| | - Volker M Solyga
- Department of Acute Medicine, Østfold Hospital Trust, 1714, Grålum, Norway
| | - Waleed Ghanima
- Department of Acute Medicine, Østfold Hospital Trust, 1714, Grålum, Norway
- Department of Hematology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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3
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Awatade NT, Wark PAB, Chan ASL, Mamun SMAA, Mohd Esa NY, Matsunaga K, Rhee CK, Hansbro PM, Sohal SS. The Complex Association between COPD and COVID-19. J Clin Med 2023; 12:jcm12113791. [PMID: 37297985 DOI: 10.3390/jcm12113791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is significant cause of morbidity and mortality worldwide. There is mounting evidence suggesting that COPD patients are at increased risk of severe COVID-19 outcomes; however, it remains unclear whether they are more susceptible to acquiring SARS-CoV-2 infection. In this comprehensive review, we aim to provide an up-to-date perspective of the intricate relationship between COPD and COVID-19. We conducted a thorough review of the literature to examine the evidence regarding the susceptibility of COPD patients to COVID-19 infection and the severity of their disease outcomes. While most studies have found that pre-existing COPD is associated with worse COVID-19 outcomes, some have yielded conflicting results. We also discuss confounding factors such as cigarette smoking, inhaled corticosteroids, and socioeconomic and genetic factors that may influence this association. Furthermore, we review acute COVID-19 management, treatment, rehabilitation, and recovery in COPD patients and how public health measures impact their care. In conclusion, while the association between COPD and COVID-19 is complex and requires further investigation, this review highlights the need for careful management of COPD patients during the pandemic to minimize the risk of severe COVID-19 outcomes.
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Affiliation(s)
- Nikhil T Awatade
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
| | - Peter A B Wark
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle 2305, Australia
| | - Andrew S L Chan
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St. Leonards 2065, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - S M Abdullah Al Mamun
- Department of Respiratory Medicine & Sleep Medicine, Evercare Hospitals Dhaka, Dhaka 1229, Bangladesh
| | | | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube 755-8505, Japan
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Philip M Hansbro
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
- Centre for Inflammation, Faculty of Science, School of Life Sciences, Centenary Institute and University of Technology Sydney, Sydney 2050, Australia
| | - Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston 7248, Australia
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Hajibashi A, Sarrafzadeh J, Amiri A, Salehi R, Vasaghi-Gharamaleki B. Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial. Complement Ther Clin Pract 2023; 51:101730. [PMID: 36731284 PMCID: PMC9877153 DOI: 10.1016/j.ctcp.2023.101730] [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: 02/10/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND and purpose: Most patients with coronavirus disease 2019 (COVID-19) experience persistent physical and psychological symptoms. This study aimed to investigate the effects of pulmonary telerehabilitation (PTR) combined with progressive muscle relaxation (PMR) on the physical and psychological outcomes of discharged patients with COVID-19. MATERIALS AND METHODS This randomised, assessor-blinded, parallel-group study was conducted in hospitals affiliated with Qom University of Medical Sciences between May and October 2021. Discharged COVID-19 patients aged 18-65 years were randomly assigned to two groups of 26 patients each. The experimental group underwent PTR and PMR for six weeks, while the comparison group received PTR alone. Primary (functional capacity) and secondary (dyspnoea, anxiety, depression, fatigue, sleep quality, and quality of life) outcomes were evaluated at baseline and after six weeks. RESULTS The experimental group showed significantly higher sleep quality (P = 0.001, 95% confidence interval [CI]: 1.20-4.09) and significantly lower fatigue (P = 0.041, 95% CI: 4.79-5.25) and anxiety (P = 0.001, 95% CI: 1.21-4.47) than the comparison group. No between-group differences were observed in terms of other outcomes (P > 0.05). CONCLUSION PTR coupled with PMR was more effective for promoting sleep quality and alleviating anxiety and fatigue than PTR alone.
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Affiliation(s)
- Arghavan Hajibashi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Sarrafzadeh
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Amiri
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Geriatric Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnoosh Vasaghi-Gharamaleki
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Postolache PA, Nechifor A, Buculei I, Soare I, Mocanu H, Petrariu FD. Clinical Features and Paraclinical Findings in Patients with SARS CoV-2 Pneumonia and the Impact of Pulmonary Rehabilitation on the Instrumental Activities of Daily Living in POST-COVID-19 Patients. J Pers Med 2023; 13:jpm13020182. [PMID: 36836416 PMCID: PMC9964772 DOI: 10.3390/jpm13020182] [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: 12/06/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
The functional sequelae grouped under the name "long COVID" most often bring the patient in front of a team of specialists in pulmonary rehabilitation. The aim of this study was to evaluate clinical features and paraclinical findings in patients with SARS CoV-2 (Severe Acute Respiratory Syndrome-Corona Virus-2) pneumonia and to also evaluate the impact of rehabilitation in this category of patients. This study included 106 patients diagnosed with SARS CoV-2. The division of the patients into two groups was performed based on the presence of SAR-CoV-2 pneumonia. Clinical symptoms, biochemical parameters, and pulmonary functional and radiological examinations were recorded and analyzed. The Lawton Instrumental Activities of Daily Living (IADL) scale was applied to all patients. Patients in group I were included in the pulmonary rehabilitation program. Among demographic characteristics, age over 50 years (50.9%; p = 0.027) and the female sex (66%; p = 0.042) were risk factors for pneumonia in patients with SARS CoV-2. Over 90% of the 26 patients included in the rehabilitation program were less able to feed, bathe, dress, and walk. After 2 weeks, approximately 50% of patients were able to eat, wash, and dress. It is important to provide longer rehabilitation programs in cases of moderate, severe, and very severe COVID-19 patients, in order to significantly improve patients' participation in daily activities and their quality of life.
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Affiliation(s)
- Paraschiva A. Postolache
- Internal Medicine Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800008 Galati, Romania
- Correspondence: (A.N.); (I.B.)
| | - Ioana Buculei
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, “Grigore T. Popa” University of Medicine and Pharmacy, 700454 Iasi, Romania
- Doctoral School of the Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Correspondence: (A.N.); (I.B.)
| | - Ioana Soare
- Insurance Medicine Department, Faculty of Medicine, “Titu Maiorescu” University, 040441 Bucharest, Romania
| | - Horia Mocanu
- Department of Ear, Nose and Throat and Head and Neck, Faculty of Medicine, “Titu Maiorescu” University, 040441 Bucharest, Romania
| | - Florin Dumitru Petrariu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Carvalho AC, Moreira J, Cubelo P, Cantista P, Aguiar Branco C, Guimarães B. Multidisciplinary rehabilitation in intensive care for COVID-19: randomised controlled trial. ERJ Open Res 2023; 9:00350-2022. [PMID: 36628269 PMCID: PMC9571162 DOI: 10.1183/23120541.00350-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/20/2022] [Indexed: 01/13/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has led to an increasing number of patients in intensive care units (ICUs). The size of this post-ICU cohort will be unprecedented, with many patients vulnerable to post-intensive care syndrome. We analysed the respiratory and functional effects of a multidisciplinary rehabilitation programme on functional performance, in patients hospitalised in the ICU due to COVID-19. We conducted a randomised controlled clinical trial. 96 patients who fulfilled the eligibility criteria were randomised into control or intervention group. The control group received standard of care in the ICU, and the intervention group received a functional and respiratory rehabilitation protocol that included medical, nursing, physiotherapy and occupational therapy interventions. At discharge, the intervention group showed significantly better muscular strength and respiratory capacity, and significantly fewer days of hospitalisation (12.90±5.8 versus 15.60±6.7 days, p=0.037). At the 4- and 12-week follow-up, we applied our main outcome measure, the 6-min walk test (6MWT). The intervention group had significantly better results than the control group on the 6MWT at the 4-week follow-up (604±67 versus 571±57 m, p=0.018) and at the 12-week follow-up (639±53 versus 611±67 m, p=0.025). These results support the role of a multidisciplinary rehabilitation programme in COVID-19 patients hospitalised in the ICU and adds evidence that the implementation of rehabilitation programmes in ICUs could result in beneficial outcomes for critically ill patients.
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Affiliation(s)
- Ana Cristina Carvalho
- Public Health Unit – Porto Oriental, ACeS Grande Porto VI, Porto, Portugal,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal,Corresponding author: Ana Cristina Carvalho ()
| | - Jorge Moreira
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Pedro Cubelo
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Pedro Cantista
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal,Department of Physical and Rehabilitation Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Catarina Aguiar Branco
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal,Department of PRM/Integrated Clinic, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Bruno Guimarães
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal,Cardiovascular Research Center, Faculty of Medicine, University of Porto, Porto, Portugal
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Samper-Pardo M, León-Herrera S, Oliván-Blázquez B, Benedé-Azagra B, Magallón-Botaya R, Gómez-Soria I, Calatayud E, Aguilar-Latorre A, Méndez-López F, Pérez-Palomares S, Cobos-Rincón A, Valero-Errazu D, Sagarra-Romero L, Sánchez-Recio R. Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010462. [PMID: 36612782 PMCID: PMC9819090 DOI: 10.3390/ijerph20010462] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. METHODS The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. DISCUSSION Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR).
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Affiliation(s)
| | | | - Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Belén Benedé-Azagra
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Department of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Isabel Gómez-Soria
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Estela Calatayud
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Fátima Méndez-López
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Sara Pérez-Palomares
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, University of La Rioja, 26004 Logroño, Spain
| | - Diana Valero-Errazu
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Lucia Sagarra-Romero
- GAIAS Research Group, Faculty of Health Sciences, University San Jorge, 50830 Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain
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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: 13] [Impact Index Per Article: 6.5] [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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Carpallo-Porcar B, Romo-Calvo L, Pérez-Palomares S, Jiménez-Sánchez C, Herrero P, Brandín-de la Cruz N, Calvo S. Efficacy of an asynchronous telerehabilitation program in post-COVID-19 patients: A protocol for a pilot randomized controlled trial. PLoS One 2022; 17:e0270766. [PMID: 35853037 PMCID: PMC9295945 DOI: 10.1371/journal.pone.0270766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background
About 40% of patients who have had COVID-19 still have symptoms three months later whereas a 10% may experience physical and/or psychological consequences two years later. Therefore, it is necessary to perform preventive interventions when patients are discharged from the hospital to decrease the aforementioned sequelae. The purpose of this pilot-controlled trial will be to determine the efficacy of a rehabilitation program on functional status and psychosocial factors for post-COVID-19 patients when it is delivered through a tele-care platform versus a booklet-based rehabilitation.
Methods
The estimated sample size will be of 50 participants who have been discharged after COVID-19 and have a level of fatigue equal or greater than 4 on the Fatigue Severity Scale. The primary outcome will be the severity of fatigue. Participants will be randomly allocated to an “asynchronous telerehabilitation group” or to a “booklet-based rehabilitation group”. Treatment in both groups will be the same and will consist of a combination of therapeutic exercise and an educative program. Treatment outcomes will be evaluated the last day of the intervention and at three- and six-months follow-up.
Discussion
The telerehabilitation intervention appears to be a viable and efficacy option in decreasing severe fatigue and other fitness variables such as strength and aerobic capacity, similar to other traditional rehabilitation formats such as through an explanatory booklet.
Clinical trial registration
This trial has been prospectively registered at clinialtrials.gov identifier: NCT04794036.
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Affiliation(s)
- Beatriz Carpallo-Porcar
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Laura Romo-Calvo
- Hospital Real y Provincial Nuestra Señora de Gracia, Zaragoza, Spain
| | - Sara Pérez-Palomares
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | - Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
- * E-mail:
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | - Natalia Brandín-de la Cruz
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
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Espin A, García-García J, Latorre Erezuma U, Aiestaran M, Irazusta J, Rodriguez-Larrad A. Videoconference-Based Physical Performance Tests: Reliability and Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127109. [PMID: 35742358 PMCID: PMC9223237 DOI: 10.3390/ijerph19127109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Validated tools to evaluate physical performance remotely with real-time supervision are lacking. We assessed test−retest and inter-rater reliability, as well as the feasibility of carrying out the five-repetition sit-to-stand (5RSTS), kneeling push-up (KPU) and Shirado−Ito trunk flexor endurance (SIF) tests by 1:1 real-time videoconference. We also evaluated the correlation of these tests with measures of self-reported physical fitness, physical activity, health state and pain. A total of 96 healthy adults participated in the study (18−65 years). Relative and absolute reliabilities were assessed with the intraclass correlation coefficient (ICC) and standard error of measurement (SEM), respectively. Feasibility outcomes included testing duration, participant acceptability (1−5 Likert scale) and presence of adverse events. Self-reported measures were obtained with validated online questionnaires, and correlations were analyzed with Pearson’s partial correlation coefficients controlling for age. ICCs were excellent (>0.9), and SEMs were generally low (2.43−16.21%). The mean duration of all tests was <5 min, mean acceptability was ≥4.5, and adverse events were few. The KPU showed statistically significant correlations with various self-reported measures (p < 0.05). In conclusion, the 5RSTS, KPU and SIF were reliable and feasible when conducted by 1:1 real-time videoconference. This study provides a tool that could be logistically and economically advantageous.
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Affiliation(s)
- Ander Espin
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Julia García-García
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
| | - Unai Latorre Erezuma
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Maialen Aiestaran
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
| | - Jon Irazusta
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Correspondence:
| | - Ana Rodriguez-Larrad
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain; (A.E.); (J.G.-G.); (U.L.E.); (M.A.); (A.R.-L.)
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
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11
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Seid AA, Aychiluhm SB, Mohammed AA. Effectiveness and feasibility of telerehabilitation in patients with COVID-19: a protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e058932. [PMID: 34992124 PMCID: PMC8739537 DOI: 10.1136/bmjopen-2021-058932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Respiratory rehabilitation is the use of exercise, education, and behavioural interventions to alleviate symptoms and improve quality of life. Recent studies highlight that respiratory rehabilitation is effective and safe for patients with COVID-19. We aim to evaluate the effectiveness and feasibility of respiratory telerehabilitation on patients infected with COVID-19 by conducting a systematic review and meta-analysis. METHODS AND ANALYSIS PubMed, Web of Science, Science Direct, Physiotherapy Evidence Database, Google Scholar and Cochrane Library databases will be searched from inception to the end of November 2021. Randomised controlled trials investigating the effectiveness of telerehabilitation in the management of COVID-19 will be included. The primary outcomes will be functional capacity, cardiopulmonary exercise tests and quality of life. Secondary outcomes will include anxiety/depression level, sleep quality, mortality rate, completion rate, reason for withdrawal, adverse events, service satisfaction, cost-effectiveness and other potential factors. Two reviewers will independently screen and extract data and perform quality assessment of included studies. The Cochrane risk of bias tool will be used to assess risk of bias. Review Manager V.5.4 (Cochrane Collaboration) software will be used for statistical analysis. Heterogeneity will be analysed using I² statistics. Mean difference or standardised mean difference with 95% CI and p value will be used to calculate treatment effect for outcome variables. ETHICS AND DISSEMINATION Ethical approval is not required because this systematic review and meta-analysis is based on previously published data. Final result will be published in peer-reviewed journal and presented at relevant conferences and events. 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, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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12
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Perenc L, Perenc A, Bartosik-Psujek H. Selected factors determining the failure to undertake physical activity in patients with multiple sclerosis in Poland. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:2. [PMID: 35342441 PMCID: PMC8943561 DOI: 10.4103/jrms.jrms_170_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/03/2020] [Accepted: 07/28/2021] [Indexed: 11/04/2022]
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13
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Rodríguez-Blanco C, Bernal-Utrera C, Anarte-Lazo E, Saavedra-Hernandez M, De-La-Barrera-Aranda E, Serrera-Figallo MA, Gonzalez-Martin M, Gonzalez-Gerez JJ. Breathing exercises versus strength exercises through telerehabilitation in coronavirus disease 2019 patients in the acute phase: A randomized controlled trial. Clin Rehabil 2021; 36:486-497. [PMID: 34783270 DOI: 10.1177/02692155211061221] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare the effectiveness of two different exercise-based programs through telerehabilitation in patients with coronavirus disease 2019. DESIGN Randomized, controlled, parallel, double-blinded, three-arm clinical trial. SETTING Patients' homes through telerehabilitation devices. SUBJECTS Subjects with coronavirus disease 2019 in the acute phase. INTERVENTIONS Subjects were divided into three groups: breathing exercises group, strength exercises group or no treatment/control group. MAIN MEASURES We analysed visual analogue scale for fatigue, 6-minute walking test, 30-seconds sit-to-stand test, multidimensional dyspnoea-12 questionnaire and Borg scale at baseline and 14 days later. RESULTS From 93 subjects recruited, 88 were enrolled, and 77 patients (mean [SD] age 39.40 [11.71]) completed the 14-days intervention and were included in the analysis: 26 in strength exercises group, 29 in breathing exercises group and 22 in control group. The intergroup analysis shows significant differences between the study groups and control group in all variables (p < 0.05); Borg scale, multidimensional dyspnoea-12 questionnaire (pre-post intervention score: strength exercises group: 7.85 [6.82] - 4.54[4.82], breathing exercises group: 11.04 [6.49] - 5.32 [3.63], control group: 10.27 [6.49] - 10.59[6.58]), visual analogue scale for fatigue, 6-minute walking test and 30-seconds sit-to-stand test (pre-post intervention score: strength exercises group: 12.19 [4.42] - 13.58 [5.37], breathing exercises group: 11.18 [3.42] - 12.79 [4.00], control group: 10.45 [2.15] - 9.86[1.88]). The greatest effect sizes were found in the variables Borg Scale (R2 = 0.548) and multidimensional dyspnoea-12 questionnaire (R2 = 0.475). CONCLUSIONS Strength exercises group and breathing exercises group obtained significant improvements in fatigue, dyspnoea, perceived effort, and physical state, compared to control group, although the greatest benefits were found for dyspnoea and aerobic capacity in breathing exercises group.
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Affiliation(s)
- Cleofas Rodríguez-Blanco
- Fisiosur I + D Research Institute, Garrucha, Spain.,Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, 16778University of Seville, Spain
| | - Carlos Bernal-Utrera
- Fisiosur I + D Research Institute, Garrucha, Spain.,Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, 16778University of Seville, Spain
| | | | - Manuel Saavedra-Hernandez
- Fisiosur I + D Research Institute, Garrucha, Spain.,Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, 16721University of Almeria, Spain
| | | | | | | | - Juan Jose Gonzalez-Gerez
- Fisiosur I + D Research Institute, Garrucha, Spain.,Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, 16721University of Almeria, Spain
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14
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Perspectives and Attitudes of Patients with COVID-19 toward a Telerehabilitation Programme: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157845. [PMID: 34360138 PMCID: PMC8345417 DOI: 10.3390/ijerph18157845] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 01/07/2023]
Abstract
The total isolation of patients with coronavirus disease 2019 (COVID-19) requires non-face-to-face medical assistance. There is evidence of the efficacy of home treatments with exercises in patients with respiratory disorders which could become the therapeutic method of choice for the treatment and supervision of patients isolated due to infection during home confinement. This study’s objective was to analyse the experience and opinions of isolated patients with COVID-19 included in a programme of telerehabilitation exercises for 14 days and it is intended to reflect, from a qualitative point of view, the viability and usefulness of telerehabilitation tools in the management of these patients. Twenty-five participants of a telerehabilitation programme were interviewed by telephone through semi-structured interviews, following a positivist and objective model. The data were categorised and analysed through NVIVO qualitative analysis software. The information obtained was classified into four main topics (telerehabilitation programme, perception of clinical benefit, psychological aspects and level of health care) and six subtopics (technical aspects, communication, improvement aspects, exercise plan, motivation and applicability to public health systems). The telerehabilitation programme established in patients confined by COVID-19 is very well received, without considerable technical difficulties and generates physical and psychological improvements. Patients highlight the importance of applying this type of programme in public health systems.
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15
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Lei J, Yang L, Wen G, Qumu S, Ren X, Yang T. Pulmonary telerehabilitation and efficacy among discharged COVID-19 patients: Rational and design of a prospective real-world study. CLINICAL RESPIRATORY JOURNAL 2021; 15:1158-1167. [PMID: 34260823 DOI: 10.1111/crj.13422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/26/2021] [Accepted: 07/11/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The novel coronavirus disease 2019 (COVID-19) could cause physical and psychological dysfunction in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients. Pulmonary telerehabilitation is strongly recommended due to the contagious nature of the disease, but its efficacy and benefit need to be comprehensively evaluated. METHODS An 8-week pulmonary telerehabilitation programme is designed in a real-world and prospective manner, aiming to assess the efficacy of remote rehabilitation among discharged patients with COVID-19 from three designated hospitals in the epicenter of China (Wuhan City). The telerehabilitation programme includes physicians and physiotherapists remotely guided training (online) for 2 weeks, and patient self-managed rehabilitation (offline) for 6 weeks with assistance of information technology and digital device. The main rehabilitation intervention includes breathing exercise, respiratory muscle training, aerobic exercise, and resistance training. The primary outcome is 6-min walk distance, and secondly pulmonary function, respiratory muscle strength, physical activity, symptom, psychological status and quality of life, etc. will also be assessed. Patients will be followed up periodically at week two, four, eight after enrolment and at month one, three, six and 12 after the rehabilitation accomplished, respectively. Current study has been approved by the ethics committee of China-Japan Friendship Hospital and three participating centers in Wuhan City. DISCUSSION We anticipate that the health status of discharged patients with COVID-19 could be improved through this systemic pulmonary telerehabilitation programme. The interdisciplinary remote mode of rehabilitation could be an optimal way in management of emerging respiratory tract infectious disease. TRIAL REGISTRATION ClinicalTrials.gov, NCT04368793.
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Affiliation(s)
- Jieping Lei
- Data and Project Management Unit, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.,Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Lulu Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Geyi Wen
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province, Kunming City, China
| | - Shiwei Qumu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Xiaoxia Ren
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Disease, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
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16
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Wittmer VL, Paro FM, Duarte H, Capellini VK, Barbalho-Moulim MC. Early mobilization and physical exercise in patients with COVID-19: A narrative literature review. Complement Ther Clin Pract 2021; 43:101364. [PMID: 33743391 PMCID: PMC7955568 DOI: 10.1016/j.ctcp.2021.101364] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 02/13/2021] [Accepted: 03/10/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Currently, little is known about early mobilization and exercise in individuals with COVID-19. OBJECTIVE To describe the indication and safety of early mobilization and exercises in mild to severe COVID-19 patients and to investigate the use of telerehabilitation to deliver exercise programs to these patients. METHODS This narrative literature review was conducted performing a comprehensive search of databases. RESULTS 32 articles met the established criteria and the main findings were summarized and described, including indication, contraindication and recommendation for early rehabilitation and exercises prescription. CONCLUSIONS The literature suggests that early mobilization and physical exercise are beneficial for individuals with COVID-19. However, much of what has been published is based on expert opinion due to a lack of randomized trials, which are needed.
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Affiliation(s)
- Veronica Lourenço Wittmer
- Department of Integrated Education on Health, Center of Health Science, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
| | - Flavia Marini Paro
- Department of Integrated Education on Health, Center of Health Science, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
| | - Halina Duarte
- Department of Integrated Education on Health, Center of Health Science, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
| | - Verena Kise Capellini
- Department of Biosciences, Institute of Health and Society, Campus Baixada Santista, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil.
| | - Marcela Cangussu Barbalho-Moulim
- Department of Integrated Education on Health, Center of Health Science, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
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17
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Silva RN, Goulart CDL, Oliveira MR, Tacao GY, Back GD, Severin R, Faghy MA, Arena R, Borghi-Silva A. Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation. Expert Rev Respir Med 2021; 15:1107-1120. [PMID: 33606567 DOI: 10.1080/17476348.2021.1893169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION It has become increasingly evident that COVID-19 contributes to multiorgan pathophysiology. The systemic inflammatory response increases both pro-inflammatory cytokine and chemokine levels, leading to immune dysregulation and increasing the likelihood of incurring cardiac and pulmonary injuries. AREAS COVERED Longer periods of hospitalization (~20 days) increase susceptibility to ICU-acquired muscle weakness and deconditioning, which decreases muscle function and functional capacity. These conditions affect the quality of life in the post-COVID-19 period and require multi-disciplinary approaches to rehabilitate the cardiopulmonary and musculoskeletal systems of these patients. In this context, this narrative review, which included articles published in the Embase, PEDro and PubMed databases up to December 2020, is focused on discussing the essential role of exercise and rehabilitation health professionals in the COVID-19 recovery process, from hospitalization to hospital discharge, addressing strategies for professionals to mitigate the cardiac and pulmonary impairments associated with hospitalization to home or ambulatory rehabilitation, purposing ways to conduct rehabilitation programs to restore their functional status and quality of life after the infection. EXPERT OPINION In the current environment, these findings further point to the vital role of rehabilitation health professionals in the coming years and the urgent need to develop strategies to assist COVID-19 survivors.
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Affiliation(s)
- Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Guilherme Yassuyuki Tacao
- Department of Physiotherapy, Postgraduate Program in Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Zip-code: Presidente Prudente, SP, Brazil
| | - Guilherme Dionir Back
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Richard Severin
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA.,Department of Physical Therapy, Robbins College of Applied Health Sciences, Baylor University, Waco, TX, USA
| | - Mark A Faghy
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department School of Human Sciences, Human Science Research Centre, University of Derby, Derby, UK
| | - Ross Arena
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil.,Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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18
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Tsutsui M, Gerayeli F, Sin DD. Pulmonary Rehabilitation in a Post-COVID-19 World: Telerehabilitation as a New Standard in Patients with COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:379-391. [PMID: 33642858 PMCID: PMC7903963 DOI: 10.2147/copd.s263031] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/07/2021] [Indexed: 12/15/2022] Open
Abstract
Pulmonary rehabilitation (PR) is effective in reducing symptoms and improving health status, and exercise tolerance of patients with chronic obstructive pulmonary disease (COPD). The coronavirus disease 19 (COVID-19) pandemic has greatly impacted PR programs and their delivery to patients. Owing to fears of viral transmission and resultant outbreaks of COVID-19, institution-based PR programs have been forced to significantly reduce enrolment or in some cases completely shut down during the pandemic. As a majority of COPD patients are elderly and have multiple co-morbidities including cardiovascular disease and diabetes, they are notably susceptible to severe complications of COVID-19. As such, patients have been advised to stay at home and avoid social contact to the maximum extent possible. This has increased patients’ vulnerability to physical deconditioning, depression, and social isolation. To address this major gap in care, some traditional hospital or clinic-centered PR programs have converted some or all of their learning contents to home-based telerehabilitation during the pandemic. There are, however, some significant barriers to this approach that have impeded its implementation in the community. These include variable access and use of technology (by patients), a lack of standardization of methods and tools for evaluation of the program, and inadequate training and resources for health professionals in optimally delivering telerehabilitation to patients. There is a pressing need for high-quality studies on these modalities of PR to enable the successful implementation of PR at home and via teleconferencing technologies. Here, we highlight the importance of telerehabilitation of patients with COPD in the post-COVID world and discuss various strategies for clinical implementation.
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Affiliation(s)
- Mai Tsutsui
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Firoozeh Gerayeli
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
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19
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Fiani B, Siddiqi I, Lee SC, Dhillon L. Telerehabilitation: Development, Application, and Need for Increased Usage in the COVID-19 Era for Patients with Spinal Pathology. Cureus 2020; 12:e10563. [PMID: 33101809 PMCID: PMC7577310 DOI: 10.7759/cureus.10563] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has triggered governments worldwide to implement severe restrictions on physical therapy protocols in order to better control the spread of the virus. One of the mechanisms of providing physical therapy patient care during this era is via telemedicine. Telerehabilitation or telerehab is a technological visual-audio system that serves patients, including those with a spine injury, ailment, or postoperatively, with neurological deficits. In this scoping review, we discuss the development of telerehab, the technological advances in the field, and the usage of telerehab specifically pertaining to spine patients, and comment on the advancement of telerehab in the time of COVID-19. There is preliminary evidence that suggests that the adoption of telerehab in lieu of face-to-face interventions is beneficial for reducing pain and improving physical function in patients afflicted with chronic nonmalignant musculoskeletal pain from low back pain, lumbar stenosis, neck pain, and osteoarthritis. Availability is important, as the necessary technology should be accessible to all participants. Safety and security should be addressed, as the passage of patient data over the Internet requires secure confidentiality. Ease-of-use is crucial to promote practicality, user-friendly operation, and adherence to therapy. The combination of evidence-based methodologies with cost-effective services will serve as a basis for the further expansion of vital telerehab services and increases reimbursement by health insurance providers.
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Affiliation(s)
- Brian Fiani
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Imran Siddiqi
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, USA
| | - Sharon C Lee
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, USA
| | - Lovepreet Dhillon
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, USA
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