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Agnihotri S, Srivastava A, Gupta D, Naeem F. Rehabilitation of a Chronic Guillain-Barré Syndrome Patient With Vibratory Motor Stimulation of Dorsiflexors: A Case Report. Cureus 2024; 16:e53936. [PMID: 38469017 PMCID: PMC10925777 DOI: 10.7759/cureus.53936] [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] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
There are various reports describing physiotherapy rehabilitation in Guillain-Barré syndrome (GBS) but the use of current to rehabilitate GBS patients has remained an untouched topic. To elaborate on this work, we describe a case report focusing on the intervention plan for the rehabilitation of a chronic GBS case by the use of vibratory motor stimulation (VMS) current. The study aimed to describe the therapeutic application of VMS current in improving muscle power of dorsiflexors and overall outcome measures in a case of GBS presenting in a tertiary care hospital in North India. A 29-year-old male patient came to Teerthanker Mahaveer University Hospital and consulted in the Department of Physiotherapy after 1.4 years of being diagnosed with acute motor axonal neuropathy-type GBS. Rehabilitation of this case included strengthening exercises of the upper and lower limbs along with balance exercises. Specifically, in this case, we gave VMS current after assessing the muscle power of the dorsiflexors, which was found to be grade-0 over the bilateral dorsiflexors, combined with passive dorsiflexion. Different outcome measures were used for assessment, including manual muscle testing, functional independence measurement, and the Berg Balance Scale. Improvement in the patient's condition was observed in his outcome measures after two months of treatment. There was an overall improvement in the muscle power of our patient's dorsiflexors, where muscle power was upgraded from grade-0 to grade-I and grade-I+ in the bilateral lower limbs by the use of VMS current. This study marks a novel application of VMS to the dorsiflexors of a GBS patient, yielding positive outcomes in upgrading muscle power grades from grade-0 to grade-I and grade-I+. Further research is needed to confirm VMS efficacy as an early intervention in GBS patient rehabilitation.
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Affiliation(s)
- Saurabh Agnihotri
- Department of Physiotherapy, College of Paramedical Sciences, Teerthanker Mahaveer University, Moradabad, IND
| | - Ankita Srivastava
- Department of Physiotherapy, Teerthanker Mahaveer Hospital, Moradabad, IND
| | - Deepali Gupta
- Department of Physiotherapy, Teerthanker Mahaveer University, Moradabad, IND
| | - Fareha Naeem
- Department of Physiotherapy, Teerthanker Mahaveer University, Moradabad, IND
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Monteiro IP, Appelt PA, Sisconetto AT, Minaré Baldo Sucupira KS, Bazan R, Luvizutto GJ, Pascucci Sande de Souza LA. Post-coronavirus disease 2019 functional impairments, limitations, and restrictions: A prospective cohort study based on the international classification of functioning, disability, and health. J Cent Nerv Syst Dis 2023; 15:11795735231195759. [PMID: 38025402 PMCID: PMC10655659 DOI: 10.1177/11795735231195759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Current knowledge regarding coronavirus disease 2019 (COVID-19) is constantly evolving, and the long-term functional impairments, limitations, and restrictions have not yet been well established. Objective to evaluate the impact of post-COVID condition on the human functioning through the International Classification of Functioning, Disability and Health (ICF) classification. Methods This is a prospective cohort study with 53 individuals with post-COVID condition at 3 time points: 0 to 3 (baseline), 3 to 6, and 6-12 months (follow-up). Outcomes were organized in dichotomous variable: No impairment (0); presence of impairment (≥1) in body function, structure, activities, and participation domains according to the ICF checklist. Chi-square test was used to determine the differences of 3 time points, and association with persistent symptoms. Results A statistically significant difference was observed between the periods, with greater disabilities at 6-12 than at 0-3 months in mental, sensory, pain, and movement-related functions; cardiovascular, immunological, and respiratory systems. In terms of activity and participation, a greater limitation at 6-12 months was observed than at 0-3 months in learning and applying knowledge, general tasks, and mobility. In the domain of interpersonal interactions and relationships, there was a statistically significant difference between the 6-12 and 3-6 months groups. Associations between COVID-19 symptoms and ICF components at the first follow-up were: anosmia and dysgeusia with weight maintenance, fatigue and irritability with pain, brain fog with watching and listening, walking difficulty with pain, and headache with pain, watching, and listening. At the second follow-up were: anosmia and dysgeusia with energy and drive functions, attention, memory, and emotional functions; dizziness with watching and listening; fatigue with emotional function, pain, undertaking multiple tasks, lifting and carrying objects, and driving; irritability with energy and drive, emotional function, undertaking multiple tasks, lifting and carrying objects, and walking; walking difficulty with energy and driving, emotional function, respiration, muscle power, cardiovascular system, undertaking multiple tasks, lifting and carrying objects, and walking; and headache with emotional function, watching, and listening. Conclusions Individuals with COVID-19 persistent symptoms showed impairments in structure and function, activity limitations, and participation restrictions during the 1-year follow-up period.
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Affiliation(s)
- Isabella Polo Monteiro
- Departamento de Fisioterapia Aplicada, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Brasil
| | - Pablo Andrei Appelt
- Departamento de Fisioterapia Aplicada, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Brasil
| | | | | | - Rodrigo Bazan
- Departamento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP), Botucatu, Brasil
| | - Gustavo José Luvizutto
- Departamento de Fisioterapia Aplicada, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Brasil
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Ostolin TLVDP, Miranda RADR, Abdala CVM. [Evidence map on post-acute COVID-19 sequelae and rehabilitation: Update as of July 2022Mapa de evidencia sobre las secuelas y la rehabilitación tras la COVID-19 aguda: versión actualizada en julio del 2022]. Rev Panam Salud Publica 2023; 47:e30. [PMID: 36788961 PMCID: PMC9910559 DOI: 10.26633/rpsp.2023.30] [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: 02/14/2022] [Accepted: 08/17/2022] [Indexed: 02/11/2023] Open
Abstract
Objective To update the evidence map on the effects of interventions for post-acute COVID-19 rehabilitation. Method The search scope was defined according to the population (patients with symptomatic COVID-19 and post-acute COVID sequelae), the context (interventions for rehabilitation), and the type of study (systematic reviews, rapid reviews, scoping reviews or overviews of reviews). Following a search in PubMed and the Virtual Health Library, two independent authors selected the articles for review. The map was updated on July 27, 2022, using the same procedures employed in the initial review. Results The initial evidence map included 22 studies (four systematic reviews, four rapid reviews, four reviews of case reports, one scoping review, and nine systematic review protocols). In the present update, an additional 10 studies were included. The analysis revealed four groups of interventions (multimodal, therapeutic, complementary, and pharmacological) and seven groups of outcomes (pathological conditions, diseases/respiratory disorders, pain, physiological and metabolic markers, mental health/quality of life, sensory function, and mortality), totaling 166 associations between interventions and outcomes. The highest number of associations was observed for complementary therapies (n = 94). Among the outcomes, the highest number of associations was observed for physiological and metabolic markers, pathological conditions, and mental health/quality of life (44, 41, and 35 associations respectively). Conclusions The map update involved the analysis of 69 associations, most notably exercise (isolated, multicomponent, or multimodal intervention), with 23 positive and four potentially positive effects) and pharmacologic and complementary therapies for sensorial functions (15 associations). The high number of systematic review protocols indicates that the literature is still incipient.
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Affiliation(s)
- Thatiane Lopes Valentim Di Paschoale Ostolin
- Universidade Federal de São Paulo (UNIFESP)Departamento de Ciências do Movimento HumanoLaboratório de Epidemiologia e Movimento Humano (EPIMOV)São Paulo (SP)BrasilUniversidade Federal de São Paulo (UNIFESP), Departamento de Ciências do Movimento Humano, Laboratório de Epidemiologia e Movimento Humano (EPIMOV), São Paulo (SP), Brasil.,
| | - Rafael Abe da Rocha Miranda
- Universidade de Brasília (UNB)Departamento de FarmáciaBrasília (DF)BrasilUniversidade de Brasília (UNB), Departamento de Farmácia, Brasília (DF), Brasil.
| | - Carmen Verônica Mendes Abdala
- Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME/OPAS/OMS)São Paulo (SP)BrasilCentro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME/OPAS/OMS), São Paulo (SP), Brasil.
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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] [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,CONTACT Mahesh Babu Department of Ophthalmology, Kvg Medical College and Hospital, Sullia, D.K., Karnataka, India
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AL-Mhanna SB, Mohamed M, Noor NM, Afolabi HA, Irekeola AA, Bello KE, Aldhahi MI, Wan Ghazali WS. Effectiveness of Pulmonary Rehabilitation among COVID-19 Patients: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10112130. [PMID: 36360471 PMCID: PMC9691193 DOI: 10.3390/healthcare10112130] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many COVID-19 patients presented with detrimental features, such as impaired respiratory function, physical capacity, and overall poor quality of life. The present study evaluates the effectiveness of pulmonary rehabilitation on COVID-19 patients. Methods: We searched PubMed, Scopus, ScienceDirect, and Google Scholar from 2019 to 2021. The protocol was registered in PROSPERO with the registration number CRD42021273618. We performed statistical analyses via random effects and expressed the outcomes as standardized mean difference (SMD) for continuous variables, with 95% confidence intervals (CI). Results: We included six trials involving 432 patients. The primary outcome showed a significant improvement in physical function (SMD 0.83, 95% CI −0.58 to 1.09; p < 0.001; four trials, 266 participants; high-quality evidence). There was significant difference in anxiety (SMD −0.80, 95% CI −1.23 to −0.37; p = 0.003), physical activity intensity levels (SMD −1.27, 95% CI −2.23 to −0.32; p = 0.009), sleep quality (MD −0.05, 95% CI −0.83 to −0.16; p = 0.004), peripheral muscle performance of lower limbs (SMD 0.90, 95% CI −0.60 to 1.20; p < 0.001), and dyspnoea outcomes (SMD −0.55, 95% CI −0.87 to −0.23; p = 0.007). Conclusions: Pulmonary rehabilitation is an effective adjuvant therapy that minimizes COVID-19 severity in the intervention group compared to the conventional treatment. The findings of this study will need to be considered in the framework of the clinical outcome as observed in the intervention outcome. Additionally, safer data on guideline rehabilitation would be needed to examine whether pulmonary rehabilitation would be a fruitful intervention to reduce COVID-19 severity.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Kubang Kerian 16150, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Hospital University Sains Malaysia HUSM, University Sains Malaysia USM, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa 4412, Nigeria
| | - Kizito Eneye Bello
- Department of Microbiology, Kogi State University (Prince Abubakar Audu University), Anyigba 272102, Nigeria
- Department of Medical Microbiology and Parasitology, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence:
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Anghelescu A, Saglam AO, Stoica SI, Onose G. Rehabilitation of severe neurological complications post SARS-CoV-2 infection. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Medical rehabilitation is a multi-professional / interdisciplinary process aimed at enhancing and restoring functional ability (activity and participation) and quality of life to people with im-pairments or disabilities. Rehabilitation is applied throughout the continuum of care. COVID-19 patients may develop a myriad of acute medical problems (linked to the virus per se, or as con-sequences of the invasive procedures), which can cause acute, post-acute and long-term conse-quences requiring rehabilitation. Information about short and long-term sequelae of COVID-19 indicate an increasing need for rehabilitation. The paper is focused on two main aspects: rehabil-itation of the severe neurological disabilities that occurred during the acute phase and continu-ing in the chronic phase (i.e., different neurological sensory-motor and cognitive deficits sec-ondary to stroke, encephalitis, seizures, encephalopathies). The other main issue is generated by the disruption of regular rehabilitation in people with neurological disabilities and chronic dis-eases (people living with sequels after stroke, Parkinson's disease, multiple sclerosis) due to quarantine, social isolation, movement restriction, and other healthcare systems ’disruptions. Methods Internet literature search (Lit Covid and PubMed) using the following keywords (Covid-19, Coronavirus, neurological complications, rehabilitation). During 2020-2021 were published 88 papers (in 2020 = 54, and in 2021= 54), with 21 reviewes (2020 = 15; 2021 = 8), and 2 systematic reviews, refearing neuroreabilitation in Covid-19 subacutre and long-term cas-es. Discussion REH-COVER Cochrane Rehabilitation WHO initiative (“Rapid Living Systematic Reviews Second Edition, called 2020”), contains the main cornerstones for a tailored rehabilita-tion programme, the best (current) available rehabilitation evidence on recovery interventions, for the patients living with sequelae of COVID-19. Conclusions More than two years since the outbreak of the COVID-19 pandemic, it is obvious that rehabilitation services play a crucial role in post-COVID recovery trajectories. A further achievement of research and evidence focussed on the clinical management, comprehensive treatments, and efficacy need to be targeted on short and long-term (neuro)-rehabilitation service models of care, for COVID-19 survivors.
Keywords: Covid-19, rehabilitation, neurological disabilities, SARS-CoV-2
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Affiliation(s)
- Aurelian Anghelescu
- 1 „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2 Teaching Emergency Hospital „Bagdasar Arseni” (THEBA) Bucharest, Romania
| | - Ali-Osman Saglam
- „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Simona Isabelle Stoica
- 1 „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2 Teaching Emergency Hospital „Bagdasar Arseni” (THEBA) Bucharest, Romania
| | - Gelu Onose
- 1 „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2 Teaching Emergency Hospital „Bagdasar Arseni” (THEBA) Bucharest, Romania
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Piotrowicz K, Gąsowski J, Michel JP, Veronese N. Post-COVID-19 acute sarcopenia: physiopathology and management. Aging Clin Exp Res 2021; 33:2887-2898. [PMID: 34328636 PMCID: PMC8323089 DOI: 10.1007/s40520-021-01942-8] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022]
Abstract
In this review, we discuss the pathophysiologic and management aspects of acute sarcopenia in relation to SARS-CoV-2 infection. COVID-19 is as a multi-organ infectious disease characterized by a severe inflammatory and highly catabolic status, influencing the deep changes in the body build, especially the amount, structure, and function of skeletal muscles which would amount to acutely developed sarcopenia. Acute sarcopenia may largely impact patients’ in-hospital prognosis as well as the vulnerability to the post-COVID-19 functional and physical deterioration. The individual outcome of the COVID-19 and the degree of muscle mass and functional loss may be influenced by multiple factors, including the patient’s general pre-infection medical and functional condition, especially in older adults. This paper gathers the information about how the SARS-CoV-2 hyper-inflammatory involvement exacerbates the immunosenescence process, enhances the endothelial damage, and due to mitochondrial dysfunction and autophagy, induces myofibrillar breakdown and muscle degradation. The aftermath of these acute and complex immunological SARS-CoV-2-related phenomena, augmented by anosmia, ageusia and altered microbiota may lead to decreased food intake and exacerbated catabolism. Moreover, the imposed physical inactivity, lock-down, quarantine or acute hospitalization with bedrest would intensify the acute sarcopenia process. All these deleterious mechanisms must be swiftly put to a check by a multidisciplinary approach including nutritional support, early physical as well cardio-pulmonary rehabilitation, and psychological support and cognitive training. The proposed holistic and early management of COVID-19 patients appears essential to minimize the disastrous functional outcomes of this disease and allow avoiding the long COVID-19 syndrome.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland.
| | | | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
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Arienti C, Kiekens C, Bettinsoli R, Engkasan JP, Frischknecht R, Gimigliano F, Grubisic F, Howe T, Iannicelli V, Ilieva E, Lazzarini SG, Levack WM, Meyer T, Oral A, Patrini M, Pollini E, Rathore FA, Negrini S. Cochrane Rehabilitation: 2020 annual report. Eur J Phys Rehabil Med 2021; 57:303-308. [PMID: 33971699 DOI: 10.23736/s1973-9087.21.06877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During its fourth year of existence, Cochrane Rehabilitation went on to promote evidence-informed health decision-making in rehabilitation. In 2020, the outbreak of the COVID-19 pandemic has made it necessary to alter priorities. In these challenging times, Cochrane Rehabilitation has firstly changed its internal organisation and established a new relevant project in line with pandemic needs: the REH-COVER (Rehabilitation - COVID-19 evidence-based response) action. The aim was to focus on the timely collection, review and dissemination of summarised and synthesised evidence relating to COVID-19 and rehabilitation. Cochrane Rehabilitation REH-COVER action has included in 2020 five main initiatives: 1) rapid living systematic reviews on rehabilitation and COVID-19; 2) interactive living evidence map on rehabilitation and COVID-19; 3) definition of the research topics on "rehabilitation and COVID-19" in collaboration with the World Health Organization (WHO) rehabilitation programme; 4) Cochrane Library special collection on Coronavirus (COVID-19) rehabilitation; and 5) collaboration with COVID-END for the topics "rehabilitation" and "disability." Furthermore, we are still carrying on five different special projects: Be4rehab; RCTRACK; definition of rehabilitation for research purposes; ebook project; and a prioritization exercise for Cochrane Reviews production. The Review Working Area continued to identify and "tag" the rehabilitation-relevant reviews published in the Cochrane library; the Publication Working Area went on to publish Cochrane Corners, working more closely with the Cochrane Review Groups (CRGs) and Cochrane Networks, particularly with Cochrane Musculoskeletal, Oral, Skin and Sensory Network; the Education Working Area, the most damaged in 2020, tried to continue performing educational activities such as workshops in different online meetings; the Methodology Working Area organized the third and fourth Cochrane Rehabilitation Methodological (CRM) meetings respectively in Milan and Orlando; the Communication Working Area spread rehabilitation evidences through different channels and translated the contents in different languages.
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Affiliation(s)
| | - Carlotte Kiekens
- Montecatone Rehabilitation Institute SpA, Imola, Bologna, Italy.,University Hospitals Leuven - KU Leuven, Leuven, Belgium
| | | | - Julia P Engkasan
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rolf Frischknecht
- Honorary Consultant in Physical Medicine and Rehabilitation Center of Physical Medicine and Rehabilitation Lausanne University Hospital, Lausanne, Switzerland
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Frane Grubisic
- Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | | | | | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | | - Thorsten Meyer
- School of Public Health, University of Bielefeld, Bielefeld, Germany
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | - Farooq A Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi, Pakistan.,Bahria University Medical and Dental College, Karachi, Pakistan.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan "La Statale", Milan, Italy
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Negrini S, Ceravolo MG, Ferriero G. One year of COVID-19 pandemics and its effect on rehabilitation: the search for the best available evidence. Eur J Phys Rehabil Med 2021; 57:175-180. [PMID: 33826279 DOI: 10.23736/s1973-9087.21.06992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | - Giorgio Ferriero
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy - .,Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
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10
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de Sire A, Andrenelli E, Negrini F, Patrini M, Lazzarini SG, Ceravolo MG. Rehabilitation and COVID-19: a rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020. Eur J Phys Rehabil Med 2021; 57:181-188. [PMID: 33599442 DOI: 10.23736/s1973-9087.21.06870-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION COVID-19 infection significantly increased mortality risk and the burden of disability in most survivors, regardless of symptom severity at onset. The rehabilitation needs of people infected are receiving growing attention, as evidenced by the increasing number of publications, including those addressing the chronic consequences of infection. This rapid living systematic review reports the evidence published in November and December 2020 and summarises the entire body of literature on rehabilitation in COVID-19 patients published in 2020. EVIDENCE ACQUISITION This update was performed using the methodology reported by the second edition conducted by Cochrane Rehabilitation REH-COVER Action. We searched PubMed, Embase, CINAHL, Scopus, Web of Science, and Pedro databases. Papers related to COVID-19 and rehabilitation were retrieved and summarised descriptively. EVIDENCE SYNTHESIS The search retrieved 4441 studies. After the removal of duplicates and the screening for title and abstract, we retained 105 studies. Of these, we included 54 in the qualitative synthesis of this update. According to OCEBM 2011 levels of evidence table, most studies (64.8%) fall within the category of level 4 evidence. Up to 40.7% of papers included COVID-19 patients in the postacute phase. In 2020, our rapid living systematic review included 230 studies; most of these (73.9%) were level 4 studies, 25.7% were level 3, and only one study was level 2. The evidence level improved over time. While most studies (44.8%) included patients with acute COVID-19, we observed a gradual increase in the number of reports about chronic symptoms and the long-term consequences of the infection. CONCLUSIONS The update of the rapid living systematic review by Cochrane Rehabilitation Field demonstrates an increase in the level of evidence of studies addressing the rehabilitation needs associated with COVID-19 infection. Although most studies are still case reports/series, there is a trend towards conducting prospective investigations of the early natural history of the disease (first months post onset). High-quality-level studies on the efficacy of rehabilitation, and long-term monitoring of the disease and its sequelae are yet to emerge.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | | | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
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Baricich A, Borg MB, Cuneo D, Cadario E, Azzolina D, Balbo PE, Bellan M, Zeppegno P, Pirisi M, Cisari C. Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study. Eur J Phys Rehabil Med 2021; 57:199-207. [PMID: 33565741 DOI: 10.23736/s1973-9087.21.06699-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND COVID-19 has been mainly investigated concerning the acute and subacute phase implications and management. Meanwhile, few studies focused on the midterm sequelae, which still remain largely unknown. AIM To assess the physical performance of COVID-19 survivors at 3 to 6 months from Hospital discharge. DESIGN A cross-sectional study focused on mid-term functional outcomes evaluation in COVID-19 survivors. SETTING Outpatients who had been previously hospitalized due to COVID-19 from March to May 2020 at the University Hospital of Novara, Italy. POPULATION We enrolled 204 patients, of which 60% were men, with the mean age of 57.9 years. METHODS Patients firstly underwent the short physical performance battery test (SPPB), which is composed of a series of physical tests assessing the lower limb function and the functional status of the subjects. Subsequently, based on SPPB results, patients' cardiorespiratory fitness performance was further investigated. Patients with normal SPPB score (SPPB>10) underwent the 2-minute walking test (2MWT) whereas, in order to safely test the cardiorespiratory function, in patients with abnormal SPPB score (SPPB≤10) the 1-minute sit-to-stand test (1MSTST) was performed. It should be noted that the 1MSTST can be safely performed even by subjects with compromised walking ability. RESULTS Overall, 66 patients (32% of our sample) showed an impaired physical performance at 3 to 6 months after hospital discharge. In particular, 29 patients presented an SPPB score ≤10, and the 1MSTST confirmed this status in the whole group (100%) compared to the reference values for age and sex. Besides, among patients with a normal SPPB score, 37 showed a lower sex- and age-matched 2MWT score. Finally, a significant association between Intensive Care Unit hospitalization or mechanical ventilation and physical impairment was observed together with a significant association between the walking ability (measured with SPPB and 2MWT) and the number of comorbidities. CONCLUSIONS A residual physical and functional impairment was observed in COVID-19 survivors at mid-term evaluation after hospitalization. CLINICAL REHABILITATION IMPACT Considering the current COVID-19 epidemiology, we might expect a tremendous burden of disability in the next future. Thus, an appropriate clinical rehabilitation pathway must be implemented.
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Affiliation(s)
- Alessio Baricich
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy - .,Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy -
| | - Margherita B Borg
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy
| | - Daria Cuneo
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy
| | - Emanuela Cadario
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Danila Azzolina
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Piero E Balbo
- Department of Pneumology, Maggiore della Carità University Hospital, Novara, Italy
| | - Mattia Bellan
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy
| | - Carlo Cisari
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy
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12
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Bertolucci F, Sagliocco L, Tolaini M, Posteraro F. Comprehensive rehabilitation treatment for sub-acute COVID-19 patients: an observational study. Eur J Phys Rehabil Med 2021; 57:208-215. [PMID: 33541042 DOI: 10.23736/s1973-9087.21.06674-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND COVID-19 is a respiratory infection, but it should be considered as a systemic illness with increasing interest on the survivors' sequelae and their management. Considering multi-organ disabilities, a comprehensive rehabilitation provided in sub-acute phase could be considered a suitable setting for these patients. AIM The aim of this article was to report the features and rehabilitative outcomes of patients requiring rehabilitation due to disabilities related to severe COVID-19 infection. DESIGN Longitudinal Observational Study. SETTING Department of Rehabilitation in General Hospital. POPULATION Patients showing multiple disabilities due to severe COVID-19 infection. METHODS Thirty-nine consecutive patients were admitted to a rehabilitation ward transferred from ICU or Medical wards. Barthel Index (BI) and Functional Ambulation Categories (FAC) were scored as disabilities measures. Data regarding comorbidity, rehabilitation course, swabs, procedures in acute phase, non-respiratory manifestations, dysphagia, mental confusion, PaO2/FiO2, oxygen supplementation have been collected to admission and discharge. For all patients a comprehensive rehabilitation treatment have been provided. RESULTS Functional outcome is good with a statistically significant improvement in BI and FAC scores. Thirty-eight patients were discharged at their home. Mean lenght of stay (LOS) in acute wards was 46 days. Mean LOS in rehabilitation was 20 day. Eleven patients still had tracheostomy at admission, none at discharge and all dysphagic patients recovered a normal oral feeding. The change in PaO2/FiO2 and the reduction of the oxygen supplementation testify a good recovery of pulmonary function. CONCLUSIONS Our results showed a consistent recovery with little caregiver burden at discharge. Fast relocation from ICU makes beds available which are very valuable during pandemic. Comprehensive rehabilitation treatment provided in sub-acute phase for patients still positive for SARS-CoV-2, would be desirable as it seems to be an effective setting. In this setting a strong medical assistance must be ensured. CLINICAL REHABILITATION IMPACT The activation of comprehensive rehabilitation settings able to assist sub-acute patients still positive would be desirable as it could be a very efficient Healthcare Systems answer to the catastrophic pandemic, decompressing acute hospital as well. Furthermore, contagious patients with swabs positivity affected by other kind of disabilities (i.e. Stroke, Femur Fracture) can be treated avoiding to lose the early rehabilitation.
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Affiliation(s)
- Federica Bertolucci
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
| | - Laura Sagliocco
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
| | - Martina Tolaini
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy -
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Frota AX, Vieira MC, Soares CCS, da Silva PS, da Silva GMS, Mendes FDSNS, Mazzoli-Rocha F, Veloso HH, da Costa AD, Lamas CDC, Valete-Rosalino CM, Gonçalves TR, Costa HS, Rodrigues LF, Mediano MFF. Functional capacity and rehabilitation strategies in Covid-19 patients: current knowledge and challenges. Rev Soc Bras Med Trop 2021; 54:e07892020. [PMID: 33533821 PMCID: PMC7849325 DOI: 10.1590/0037-8682-0789-2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.
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Affiliation(s)
- Aline Xavier Frota
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Marcelo Carvalho Vieira
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Paula Simplício da Silva
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | | | - Flavia Mazzoli-Rocha
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Henrique Horta Veloso
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Ananda Dutra da Costa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Cristiane da Cruz Lamas
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
| | - Claudia Maria Valete-Rosalino
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de Janeiro, Departamento de Otorrinolaringologia e Oftalmologia, Rio de Janeiro, RJ, Brasil
- Conselho Nacional de Desenvolvimento Científico e Tecnológico, Programa de Produtividade em Pesquisa, Brasília, DF, Brasil
| | - Tatiana Rehder Gonçalves
- Universidade Federal do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil
| | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Luiz Fernando Rodrigues
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Estado do Rio de Janeiro, Departamento de Ciências Fisiológicas, Rio de Janeiro, RJ, Brasil
| | - Mauro Felippe Felix Mediano
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
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14
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Elanwar R, Hussein M, Magdy R, Eid RA, Yassien A, Abdelsattar AS, Alsharaway LA, Fathy W, Hassan A, Kamal YS. Physical and Mental Fatigue in Subjects Recovered from COVID-19 Infection: A Case-Control Study. Neuropsychiatr Dis Treat 2021; 17:2063-2071. [PMID: 34188476 PMCID: PMC8235935 DOI: 10.2147/ndt.s317027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Much effort has been directed toward studying COVID-19 symptoms; however, the post-COVID-19 phase remains mysterious. The aim of this work was to conduct a clinical and neurophysiological evaluation of physical and mental fatigue in COVID-19 long-haulers and to study whether markers of COVID-19 severity are able to predict the likelihood of developing postinfectious fatigue syndrome (PIFS) in such patients. PATIENTS AND METHODS This case-control study was conducted on 46 COVID-19 long-haulers who met the criteria for PIFS and 46 recovered COVID-19 subjects without any residuals. Clinical assessment of fatigue was done using a fatigue questionnaire. Repetitive nerve stimulation and single-fiber electromyography were done after excluding neuropathy and myopathy. RESULTS The median value for physical fatigue was 4 (IQR 2-7), while that for mental fatigue was 2 (IQR 0-3). Each day's increase in the period of COVID-19 illness increased the odds of PIFS in COVID-19 long-haulers 1.104-fold, and each unit increase in ferritin increased the odds of PIFS 1.006-fold. A significant decrement in at least one muscle was observed in 50% of patients. Patients with PIFS had significantly higher mean consecutive difference (MCD) in the extensor digitorum communis than the control group. There were statistically significant positive correlations between MCD values and physical, mental, and total fatigue scores. CONCLUSION Higher ferritin levels and prolonged COVID-19 infection were independent predictors of PIFS in COVID-19 long-haulers. There was electrophysiological evidence of abnormalities in the peripheral portion of the motor unit in COVID-19 long-haulers with PIFS.
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Affiliation(s)
- Rehab Elanwar
- Clinical Neurophysiology, Neurodiagnostic Research Center, Beni-Suef University, Beni-Suef, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
| | - Rehab Magdy
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Ragaey A Eid
- Department of Tropical Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ahmed Yassien
- Department of Critical Care Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | | | - Wael Fathy
- Department of Anaesthesia, Surgical ICU and Pain Management, Beni-SuefUniversity, Beni-Suef, Egypt
| | - Amr Hassan
- Department of Neurology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmine S Kamal
- Department of Neurology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.,Department of Neurology, Rashid Hospital, Dubai, United Arab Emirates
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Negrini F, de Sire A, Andrenelli E, Lazzarini SG, Patrini M, Ceravolo MG. Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field. Update as of October 31st, 2020. Eur J Phys Rehabil Med 2020; 57:166-170. [PMID: 33263249 DOI: 10.23736/s1973-9087.20.06723-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This living systematic review presents the monthly update of the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER Action Steering Committee. The aim of this study was to update the monthly COVID-19 and rehabilitation literature research up to October 31st, 2020. EVIDENCE ACQUISITION Methodology described in the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER action was applied. PubMed, Embase, CINAHL, Scopus, Web of Science, and PEDro databases were searched, and papers related to COVID-19 and rehabilitation were retrieved and summarized descriptively. EVIDENCE SYNTHESIS The database search retrieved 2704 publications. Duplicates were removed, and 1185 unique records were screened for inclusion. After screening titles, abstracts and full-texts, 22 papers were included in the present review. According to OCEBM 2011 Levels of Evidence table, 17 studies (77%) fall within the level of evidence 4 category, while the remainder (23%) are categorized as level of evidence 3. Most studies (N.=19; 86%) provided epidemiological data about the disease natural history/determining factor or the clinical presentation of COVID-19 infection, while only two studies focused on health service organization and intervention efficacy. CONCLUSIONS The most recent published COVID-19 research relevant to rehabilitation primarily provides data on the clinical course and the clinical presentation of the pathology, rather than on rehabilitation interventions or service delivery. Studies with high levels of evidence regarding the efficacy of interventions, long-term monitoring, or new health service organization models are lacking.
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Affiliation(s)
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy -
| | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
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