Institute for Rehabilitation, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute for Rehabilitation, Belgrade, Serbia.
Eur J Phys Rehabil Med. 2023 Jun;59(3):425-435. doi: 10.23736/S1973-9087.23.07806-1. Epub 2023 Mar 31.
In the published literature there is scarce data on the importance of acute rehabilitation in patients suffering from COVID-19 disease.
Evaluation of the feasibility of respiratory and neuromuscular rehabilitation treatment in stable acute COVID-19 inpatients.
The study was designed as an observational prospective investigation of two cohorts respectively identified as Mild/Moderate and Stable Severe COVID-19 disease. All patients received a rehabilitation treatment consisting of breathing exercises, range of motion exercises and strengthening exercises, with the main difference in intensity and progression of treatment, depending on individual capacity of patient.
Inpatients with diagnosed mild to moderate, or stable severe COVID-19 infection were included in the study.
Acute COVID-19 inpatients.
Patients were divided into two groups depending on the severity of disease: "mild to moderate group" (MMG) and "stable severe group" (SSG). Functional outcomes included the Barthel Index (BI), Six Minute Walk Test (6MWT), Borg Scale for dyspnea, "Time Up and Go" Test (TUG), "Sit To Stand" test (STS), "One Leg Stance Test" (OLST) and Beck Depression Inventory (BDI) were evaluated at baseline and after rehabilitative treatment, on discharge.
We included 147 acute COVID-19 inpatients (75 male and 72 female), mean aged 63.90±13.76 years. There were noticeable statistically significant improvements in all observed measurements in both groups. Comparison between groups showed significant difference in MMG compared to SSG in all functional outcomes: TUG (P<0.001), STS (P<0.001), OLST (P<0.001), BDI (P=0.008), BI (P<0.001), and Borg scale for dyspnea (P<0.001). Despite the significant improvements of BI in SSG, the obtained values showed that the patients were still not functionally independent.
Acute respiratory and neuromuscular rehabilitation program is a feasibile, but also effective and safe method for improving functional status in patients with COVID-19 infection.
Results of the present study implicate that a supervised early rehabilitation program, implemented in the treatment of patients with COVID-19 disease in the acute phasis a feasible way for significant improvement of patient's functional outcomes. Early rehabilitation should be included into clinical protocols for the treatment of patients with COVID-19.
在已发表的文献中，关于 COVID-19 患者急性康复的重要性的数据很少。
评估稳定的急性 COVID-19 住院患者进行呼吸和神经肌肉康复治疗的可行性。
该研究设计为对分别确定为轻度/中度和稳定严重 COVID-19 疾病的两个队列进行观察性前瞻性研究。所有患者均接受呼吸锻炼、运动范围锻炼和强化锻炼的康复治疗，主要区别在于治疗的强度和进展，取决于患者的个体能力。
患有确诊的轻度至中度或稳定严重 COVID-19 感染的住院患者被纳入研究。
急性 COVID-19 住院患者。
根据疾病严重程度将患者分为两组：“轻度至中度组”（MMG）和“稳定严重组”（SSG）。功能结果包括巴氏指数（BI）、六分钟步行试验（6MWT）、呼吸困难 Borg 量表、“起身行走试验”（TUG）、“坐站起试验”（STS）、“单腿站立试验”（OLST）和贝克抑郁量表（BDI），在基线和康复治疗后、出院时进行评估。
我们纳入了 147 例急性 COVID-19 住院患者（75 名男性和 72 名女性），平均年龄 63.90±13.76 岁。两组患者所有观察指标均有明显的统计学显著改善。组间比较显示，在 TUG（P<0.001）、STS（P<0.001）、OLST（P<0.001）、BDI（P=0.008）、BI（P<0.001）和呼吸困难 Borg 量表（P<0.001）方面，MMG 与 SSG 之间存在显著差异。尽管 SSG 的 BI 有显著改善，但获得的数值表明患者仍未达到功能独立性。
急性呼吸和神经肌肉康复方案是一种可行、有效且安全的方法，可改善 COVID-19 感染患者的功能状态。
本研究结果表明，在 COVID-19 疾病的急性期实施监督下的早期康复方案是一种可行的方法，可以显著改善患者的功能结果。早期康复应纳入 COVID-19 患者的临床治疗方案。
