Department of Physical Medicine and Rehabilitation, Koc University School of Medicine, Istanbul, Turkey -
Department of Physical Medicine and Rehabilitation, Koc University School of Medicine, Istanbul, Turkey.
Eur J Phys Rehabil Med. 2021 Jun;57(3):434-442. doi: 10.23736/S1973-9087.21.06551-5. Epub 2021 Jan 15.
The risk of muscle weakness is high in the survivors of acute respiratory distress syndrome with COVID-19 following discharge from intensive care unit.
To evaluate the effects of early rehabilitation program in intensive care unit in patients with acute respiratory distress syndrome secondary to COVID-19.
The design of the study is observational.
The setting of the study is inpatient.
Thirty-five patients with acute respiratory distress syndrome secondary to COVID-19 were enrolled.
This study was performed in an intensive care unit of a university hospital. Early rehabilitation program consisting of passive or active range of motion exercises and neuromuscular electrical stimulation in addition to standard intensive care (N.=18) compared to standard intensive care (N.=17). Primary outcome was hand grip strength following discharge.
Rehab group had higher prevalence of chronic pulmonary diseases and neurologic diseases. There was no difference in hand grip or manual muscle strength following discharge between rehab and non-rehab groups. No adverse event was noted.
The results did not support the beneficial effects of early rehabilitation in intensive care unit on improving muscle strength. More patients with pulmonary and neurologic diseases in rehab group might impede the impact of rehabilitation on outcomes. On the other hand, these comorbidities underline the role and need of rehabilitation. It is safe both for the patients and the health care workers when necessary precautions are taken.
This study guide how to rehabilitate patients with acute respiratory distress syndrome with COVID-19 during intensive care unit in a safe way.
COVID-19 急性呼吸窘迫综合征患者从重症监护病房出院后，肌肉无力的风险很高。
评估 COVID-19 继发急性呼吸窘迫综合征患者在重症监护病房中早期康复方案的效果。
研究设计为观察性。
研究地点为住院部。
共纳入 35 例 COVID-19 继发急性呼吸窘迫综合征患者。
本研究在一所大学医院的重症监护病房进行。早期康复方案包括被动或主动关节活动度练习和神经肌肉电刺激，与标准重症监护（n=17）相比。主要结局为出院后手握力。
康复组慢性肺部疾病和神经系统疾病的患病率较高。出院后康复组和非康复组之间的手握力或手动肌力无差异。未观察到不良事件。
结果不支持重症监护室早期康复对改善肌肉力量的有益作用。康复组中更多的肺部和神经系统疾病患者可能会阻碍康复对结局的影响。另一方面，这些合并症强调了康复的作用和需求。在采取必要的预防措施时，对患者和医护人员都是安全的。
本研究为 COVID-19 急性呼吸窘迫综合征患者在重症监护病房中以安全的方式进行康复提供了指导。
