Department of rehabilitation, Ryozenkai Hikari Hospital, Otsu, Japan.
Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan.
Nagoya J Med Sci. 2023 Feb;85(1):93-102. doi: 10.18999/nagjms.85.1.93.
Previous studies have reported on associations between immobility syndrome and the COVID-19 pandemic. However, little is known about the aggravation of this syndrome in older patients negative for COVID-19 infection amidst behavior restriction due to a clustered COVID-19 infection. Patients hospitalized one month before a clustered COVID-19 infection occurred in our hospital were recruited. Rehabilitation therapy was suspended for 25 days during behavior restriction. The ability of daily living of the patients was evaluated with the functional independence measure and Barthel index. Chronological changes in the functional independence measure and Barthel index scores were evaluated monthly, beginning one month before the clustered COVID-19 infection to one month after re-initiation of rehabilitation therapy. Patients with minimum scores in the functional independence measure (18) and Barthel index (0) prior to the clustered COVID-19 infection were excluded. Functional independence measure scores of 73 older patients and the Barthel index scores of 48 patients were analyzed. The mean total functional independence measure score amidst the behavior restriction significantly changed from 36.3 to 35.1 ( = 0.019), while statistical significance was not detected in the mean motor subtotal (from 21.6 to 20.9 with = 0.247) or cognitive subtotal functional independence measure scores (from 14.6 to 14.2 with = 0.478). During the behavior restriction, the mean Barthel index scores declined from 25.8 to 23.2 without statistical significance ( = 0.059). Behavior restriction due to a clustered COVID-19 infection may aggravate immobility syndrome in older patients who are negative for COVID-19.
先前的研究报告了活动受限综合征与 COVID-19 大流行之间的关联。然而,对于在由于 COVID-19 聚集性感染而实施行为限制的情况下,COVID-19 感染阴性的老年患者中,这种综合征的恶化情况,人们知之甚少。
我们招募了在我院发生 COVID-19 聚集性感染前一个月住院的患者。在行为限制期间,暂停了康复治疗。使用功能独立性测量和巴氏量表评估患者的日常生活能力。从 COVID-19 聚集性感染发生前一个月开始,每月评估功能独立性测量和巴氏量表评分的时间变化,直到重新开始康复治疗一个月后。排除了在 COVID-19 聚集性感染前功能独立性测量(18 分)和巴氏量表(0 分)评分最低的患者。分析了 73 名老年患者的功能独立性测量总评分和 48 名患者的巴氏量表评分。在行为限制期间,功能独立性测量的总分平均值从 36.3 显著变化为 35.1(=0.019),而运动总分(从 21.6 变为 20.9,=0.247)或认知总分功能独立性测量评分(从 14.6 变为 14.2,=0.478)没有统计学意义。在行为限制期间,巴氏量表评分的平均值从 25.8 下降到 23.2,但无统计学意义(=0.059)。由于 COVID-19 聚集性感染而实施的行为限制可能会使 COVID-19 阴性的老年患者的活动受限综合征恶化。