Rodrigues Margarida, Costa Ana João, Santos Rui, Diogo Pedro, Gonçalves Eugénio, Barroso Denise, Almeida Miguel P, Vaz Inês Machado, Lima Ana
Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal.
Hospital Central do Funchal, Funchal, Portugal.
Disabil Rehabil. 2023 Jan;45(2):266-276. doi: 10.1080/09638288.2022.2032408. Epub 2022 Feb 8.
To evaluate the impact of an inpatient multimodal and intensive rehabilitation program on neuromuscular, respiratory, and functional impairments of post-ICU COVID-19 patients.
Prospective study including post-ICU COVID-19 survivors consecutively admitted to a rehabilitation centre. Rehabilitation was conducted by an interdisciplinary team. Medical Research Council (MRC) score, maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), peak cough flow (PCF), Functional Oral Intake Scale (FOIS), Brief Balance Evaluation Systems Test (Brief-BESTest), Timed Up and Go (TUG) test, 1 min Sit to Stand Test (1' STST), 6 min Walking Test (6MWT), Fatigue Assessment Scale (FAS), Functional Independence Measure (FIM) were assessed at admission (T0) and discharge (T1).
A total of 42 patients were included. After 32.00;26.00 days of inpatient rehabilitation, there was a significant improvement in limb and respiratory muscle strength, cough effectiveness, fatigue, balance, exercise capacity, and in the ability to perform activities of daily living. Advanced age, longer acute care hospitalization, depressive symptoms, and cognitive deficits were associated with poorer functional outcomes.
Post-ICU COVID-19 patients present multiple sequelae with detrimental functional impact. An adapted interdisciplinary rehabilitation program is essential for a thorough evaluation of these patients and results in significant functional gains.IMPLICATIONS FOR REHABILITATIONPost-ICU COVID-19 survivors present multiple sequelae and disabilities.An intensive and interdisciplinary inpatient rehabilitation results in significant improvement in limb and respiratory muscle strength, cough effectiveness, fatigue, balance, exercise capacity, and ability to perform activities of daily living.Timely referral from the acute care setting to rehabilitation services is crucial to minimize the functional impact of severe multisystemic disease and prolonged hospitalization.
评估住院多模式强化康复计划对新冠病毒疾病重症监护病房(ICU)后患者神经肌肉、呼吸和功能障碍的影响。
前瞻性研究,纳入连续入住康复中心的新冠病毒疾病ICU后幸存者。康复由多学科团队进行。在入院时(T0)和出院时(T1)评估医学研究委员会(MRC)评分、最大呼气压力(MEP)、最大吸气压力(MIP)、峰值咳嗽流量(PCF)、功能性经口摄食量表(FOIS)、简短平衡评估系统测试(Brief-BESTest)、计时起立行走测试(TUG)、1分钟坐立测试(1'STST)、6分钟步行测试(6MWT)、疲劳评估量表(FAS)、功能独立性测量(FIM)。
共纳入42例患者。经过32.00;26.00天的住院康复,肢体和呼吸肌力量、咳嗽有效性、疲劳、平衡、运动能力以及日常生活活动能力有显著改善。高龄、急性护理住院时间较长、抑郁症状和认知缺陷与较差的功能结局相关。
新冠病毒疾病ICU后患者存在多种后遗症,对功能有不利影响。适应性多学科康复计划对于全面评估这些患者至关重要,并能带来显著的功能改善。康复启示新冠病毒疾病ICU后幸存者存在多种后遗症和残疾。强化多学科住院康复可显著改善肢体和呼吸肌力量、咳嗽有效性、疲劳、平衡、运动能力以及日常生活活动能力。从急性护理环境及时转诊至康复服务对于将严重多系统疾病和长期住院的功能影响降至最低至关重要。