Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú 9251521, Chile.
Escuela de Kinesiología, Universidad de Santiago de Chile, Santiago 9170022, Chile.
Int J Environ Res Public Health. 2021 Oct 3;18(19):10434. doi: 10.3390/ijerph181910434.
COVID-19 has caused a certain proportion of patients to be hospitalized in intensive care units (ICU) and may cause musculoskeletal and neurological deficits following intubation and mechanical ventilation. The aim of this study was to quantify and describe the presence of shoulder pain in patients released from hospitals after suffering COVID-19. Patients with positive Apley tests were sent to a physiatrist for a clinical evaluation, ultrasound and electromyography (EMG). This evaluation was completed with a pain scale, joint range and shoulder muscle strength evaluations. Of the one-hundred-sixteen patients, seventy eight entered the respiratory rehabilitation program. Twenty patients were sent to the multidisciplinary shoulder team for positive Apley scratch tests. Of these twenty patients, one had only an EMG, ten had only ultrasounds, seven had an EMG and ultrasound and two did not need complementary tests. The twenty patients were sent to the physical therapist, with all presenting pain and diminished joint range and muscle strength in the affected shoulder. In this context, shoulder pain could be associated with the prone position in the ICU. We suggest time control and position change for patients on mechanical ventilation in a prone position with COVID-19.
COVID-19 导致一定比例的患者住院接受重症监护病房(ICU)治疗,并且在插管和机械通气后可能导致肌肉骨骼和神经系统缺陷。本研究的目的是量化和描述 COVID-19 出院患者的肩部疼痛的存在情况。对 Apley 试验阳性的患者进行物理治疗师的临床评估、超声和肌电图(EMG)检查。该评估完成后,会使用疼痛量表、关节活动范围和肩部肌肉力量评估来进行评估。在 116 名患者中,78 名进入呼吸康复计划。20 名患者因 Apley 划痕试验阳性被送往多学科肩部治疗团队。在这 20 名患者中,1 人仅进行了肌电图检查,10 人仅进行了超声检查,7 人进行了肌电图和超声检查,2 人不需要进行补充检查。这 20 名患者被转介给物理治疗师,所有患者均在受影响的肩部出现疼痛、关节活动范围减小和肌肉力量减弱的情况。在这种情况下,肩部疼痛可能与 ICU 中的俯卧位有关。我们建议对 COVID-19 患者进行机械通气时,控制时间并改变俯卧位的姿势。