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新型冠状病毒肺炎感染后患者康复的临床及功能效应

Clinical and Functional Effects of Rehabilitation of Patients after COVID-19 Infection.

作者信息

Dzięcioł-Anikiej Zofia, Kuryliszyn-Moskal Anna, Pociene Monika, Dzięcioł Janusz, Dakowicz Agnieszka, Kostro Amanda

机构信息

Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland.

Department of Physiotherapy and Beauty Therapy, Klaipedos Valstybine Kolegija, 91274 Klaipeda, Lithuania.

出版信息

J Clin Med. 2024 May 31;13(11):3257. doi: 10.3390/jcm13113257.

Abstract

The most common post-acute consequences of SARS-CoV-2 include lung dysfunction, the impairment of cognitive functions and mental health, as well as the impairment of the musculoskeletal system in the form of fatigue and muscle weakness. Post-COVID-19 patients often experience impaired balance and reduced physical capacity. It is important to implement a rehabilitation program that eliminates the side effects of COVID-19 and allows for significant improvement in the patient's functionality. The aim of our study was to assess patient functionality after a 6-week rehabilitation program on balance, foot pressure distribution, and physical capacity in post-COVID-19 patients. The clinical study group consisted of 53 people 3 months after COVID-19 infection, confirmed by a positive PCR test. Exclusion from the study included people with comorbidities that impaired balance and gait. The patients underwent a posturographic assessment-Romberg test, a baropodometric assessment-static and dynamic, and a performance assessment-a 6 min walk test determining shortness of breath on the mMRC scale, blood pressure, heart rate, and saturation. Patients participated in rehabilitation until the sixth week, after which they were assessed again. Comparisons were made using IBM SPSS Statistics 27.0 software using the Wilcoxon pairwise order test, at a significance level of < 0.05. The result of the postural control assessment showed an improvement in the ability to maintain the centre of gravity in terms of the foot support area-statistical decreases were observed in the ellipse area, from 745.28 mm to 453.52 mm ( = 0.009), as well as maximum (from 3133.5 gr/cm to 2994.2 gr/cm; = 0.065) and average load on the left foot (from 1010.1 gr/cm to 969.38 gr/cm; = 0.028). In the 6 min walk test before and after exercise, the heart rate decreased after the therapy (shortness of breath on the mMRC scale also decreased from 79.12 to 74.95). This means that patients achieved better physical fitness and efficiency. Rehabilitation significantly improved balance, as measured by a decrease in ellipse area during the Romberg test

摘要

新型冠状病毒2(SARS-CoV-2)感染最常见的急性后期后果包括肺功能障碍、认知功能和心理健康受损,以及以疲劳和肌肉无力形式出现的肌肉骨骼系统损伤。新冠康复患者常出现平衡能力受损和身体机能下降。实施一项消除新冠后遗症并能显著改善患者功能的康复计划很重要。我们研究的目的是评估新冠康复患者在进行为期6周的平衡、足部压力分布和身体机能康复计划后的功能状况。临床研究组由53名在新冠感染3个月后经聚合酶链反应(PCR)检测呈阳性确诊的患者组成。排除标准包括患有影响平衡和步态的合并症的患者。患者接受了姿势描记评估——罗姆伯格试验、足压计评估——静态和动态评估,以及运动能力评估——6分钟步行试验,以确定改良英国医学研究委员会(mMRC)量表上的呼吸急促情况、血压、心率和血氧饱和度。患者参加康复训练直至第6周,之后再次进行评估。使用IBM SPSS Statistics 27.0软件,采用威尔科克森配对秩和检验进行比较,显著性水平<0.05。姿势控制评估结果显示,就足部支撑面积而言,维持重心的能力有所改善——椭圆面积出现统计学下降,从745.28平方毫米降至453.52平方毫米(P = 0.009),左脚的最大负荷(从3133.5克/平方厘米降至2994.2克/平方厘米;P = 0.065)和平均负荷(从1010.1克/平方厘米降至969.38克/平方厘米;P = 0.028)也有所下降。在运动前后的6分钟步行试验中,治疗后心率下降(mMRC量表上的呼吸急促情况也从79.12降至74.95)。这意味着患者的身体素质和运动能力得到了改善。通过罗姆伯格试验中椭圆面积的减小来衡量,康复显著改善了平衡能力

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9154/11173142/290e64ba67a6/jcm-13-03257-g001.jpg

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