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新冠后住院康复的初步结果。

First results from post-COVID inpatient rehabilitation.

作者信息

Kupferschmitt Alexa, Langheim Eike, Tüter Haris, Etzrodt Franziska, Loew Thomas H, Köllner Volker

机构信息

Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany.

Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité - Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Front Rehabil Sci. 2023 Jan 23;3:1093871. doi: 10.3389/fresc.2022.1093871. eCollection 2022.

Abstract

BACKGROUND

COVID-19 is associated with various symptoms and psychological involvement in the long term. In view of the multifactorial triggering and maintenance of the post-COVID syndrome, a multimodal therapy with somatomedical and psychotherapeutic content is expedient. This paper compares the psychological stress of post-COVID patients and their course in rehabilitation to psychosomatic and psychocardiological patients.

METHOD

Observational study with control-groups and clinical, standardized examination: psychological testing (BDI-II, HELATH-49), 6-MWT as somatic parameter, two measurement points (admission, discharge). Sample characteristics, including work related parameters, the general symptom-load and the course of symptoms during rehabilitation are evaluated.

RESULTS

At admission in all measures post-COVID patients were significantly affected, but less pronounced than psychosomatic or psychocardiological patients (BDI-II post-COVID = 19.29 ± 9.03, BDI-II psychosomatic = 28.93 ± 12.66, BDI-II psychocardiology = 24.47 ± 10.02). During rehabilitation, in all complaint domains and sub-groups, symptom severity was significantly reduced (effect sizes ranging from  = .34 to  = 1.22). Medium positive effects were seen on self-efficacy ( = .69) and large effects on activity and participation ( = 1.06) in post-COVID patients. In the 6-MWT, the walking distance improved by an average of 76.43 ± 63.58 meters ( = 1.22). Not a single patient deteriorated in walking distance, which would have been a possible sign of post exercise malaise (PEM).

CONCLUSION

Post-COVID patients have a slighter psychological burden as psychocardiological or psychosomatic patients. Although rehabilitation is not curative, post-COVID patients benefit significantly from the interventions and there were no signs of PEM.

摘要

背景

新型冠状病毒肺炎(COVID-19)长期伴有各种症状及心理问题。鉴于新冠后综合征的多因素触发和维持机制,采用包含躯体医学和心理治疗内容的多模式疗法是适宜的。本文比较了新冠后患者的心理压力及其康复过程与心身疾病和心理心脏病学患者的情况。

方法

采用对照组观察性研究及临床标准化检查:心理测试(贝克抑郁量表第二版[BDI-II]、健康量表HELATH-49),6分钟步行试验(6-MWT)作为躯体参数,两个测量点(入院时、出院时)。评估样本特征,包括工作相关参数、总体症状负荷及康复期间症状的变化过程。

结果

入院时,在所有测量指标上,新冠后患者均受到显著影响,但程度低于心身疾病或心理心脏病学患者(BDI-II:新冠后患者=19.29±9.03,心身疾病患者=28.93±12.66,心理心脏病学患者=24.47±10.02)。在康复过程中,在所有主诉领域和亚组中,症状严重程度均显著降低(效应量范围为0.34至1.22)。新冠后患者在自我效能方面有中等程度的积极影响(效应量=0.69),在活动和参与方面有较大影响(效应量=1.06)。在6-MWT中,步行距离平均改善了76.43±63.58米(效应量=1.22)。没有一例患者步行距离恶化,而步行距离恶化本可能是运动后不适(PEM)的迹象。

结论

新冠后患者的心理负担比心理心脏病学或心身疾病患者更轻。虽然康复不能治愈疾病,但新冠后患者从干预措施中显著获益,且没有PEM的迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8af/9899863/c3708a5264b7/fresc-03-1093871-g001.jpg

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