Značaj rehabilitacije kod dekondicioniranog bolesnika nakon hospitalno lečene COVID-19 infekcije - Prikaz slučaja
Abstract
Introduction: The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to significant public health problems, severe complications, and functional impairment in persons who have recovered from this disease.
Case report: A 60-years-old male deconditioned patient was transferred from Corona 4 Center to the Center for Physical Medicine and Rehabilitation of the University Clinical Center in Kragujevac for a post-COVID rehabilitation due to a pronounced muscle weakness and inability to walk. After functional testing, an individual rehabilitation plan was created, and a kinesitherapy program was adjusted daily based on the patient's respiratory status. After the kinesitherapy program, Respivol was used - a volumetric medical device for breathing exercises in patients with respiratory difficulties. At the time of admission, the patient could not move independently, was not performing the transfer from lying to sitting position on his own, was not maintaing balance in a sitting position. Hypotrophy caused by prolonged inactivity of the muscles of the whole body dominated the clinical picture. The six-week rehabilitation treatment performed on the patient showed a significant improvement in functionality (FIM test), muscle strength (manual muscle test), daily life activity (Barthel index), as well as a reduction of anxiety (GAD-7 scale).
Conclusion: The goal of the rehabilitation program is to return the patient to a state of functionality before the COVID-19 treatment, so that he can perform his regular professional activities, and achieve a complete independence in activities of daily living (ADL).
References
1. Pandey P, Agarwal S, Rajkumar. Lung Pathology in COVID-19: A Systematic Review. Int J Appl Basic Med Res. 2020;10(4):226-233.
2. Polastri M, Nava S, Clini E, Vitacca M, Gosselink R. COVID-19 and pulmonary rehabilitation: preparing for phase three. European Respiratory Journal. 2020; 55 (6): 2001822.
3. Vitacca M, Nava S, Santus P, Harari S. Early consensus management for non-ICU acute respiratory failure SARS-CoV-2 emergency in Italy: from ward to trenches. European Respiratory Journal. 2020; 55 (5): 2000632.
4. Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger C et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. Journal of Physiotherapy. 2020; 66 (2): 73-82.
5. Kress J, Hall J. ICU-Acquired Weakness and Recovery from Critical Illness. New England Journal of Medicine. 2014; 370 (17): 1626-1635.
6. Silva RN, Goulart CDL, Oliveira MR, Tacao GY, Back GD, Severin R, Faghy MA, Arena R, Borghi-Silva A. Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation. Expert Rev Respir Med. 2021;15(9):1107-1120.
7.British Thoracic Society. Delivering rehabilitation to individuals surviving COVID-19 using an adapted pulmonary rehabilitation approach - BTS guidance. www.brit-thoracic.org.uk [cited 4 June 2021]. Available from: http://www.brit-thoracic.org.uk/
8. Battaglia E, Fulgenzi A, Bernucci S, Giardini M, Ferrero M. Home respiratory muscle training in patients with chronic obstructive pulmonary disease. Respirology. 2006; 11 (6): 799-804.
9. Linacre JM, Heinemann AW, Wright BD, Granger CV, Hamilton BB. The structure and stability of the Functional Independence Measure. Arch Phys Med Rehabil. 1994; 75 (2): 127-132.
10. Mahoney FI, Barthel DW. Functional evaluation: The Barthel Index. Md State Med J. 1965; 14: 61-65.
11. Swinson R. The GAD-7 scale was accurate for diagnosing generalized anxiety disorder. Evidence-Based Medicine. 2006; 11 (6): 184-184.
12. Kumar A, Arora A, Sharma P, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14(4):535-545.
13. Spruit M, Holland A, Singh S, Tonia T, Wilson K, Troosters T. COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force. European Respiratory Journal. 2020; 56 (6): 2002197.
14. Vinícius Santana A, Daiane Fontana A, Pitta F. Pulmonary rehabilitation after COVID-19. Journal of Brazilian Pneumology. 2021; 47 (1): e20210034-e20210034.
15. Udina C, Ars J, Morandi A, Vilaró J, Cáceres C, Inzitari M. Rehabilitation in adult post-COVID-19 patients in post-acute care with Therapeutic Exercise. The Journal of Frailty & Aging. 2021; 1-4.
16. Daynes E, Gerlis C, Chaplin E, Gardiner N, Singh S. Early experiences of rehabilitation for post-COVID individuals to improve fatigue, breathlessness exercise capacity and cognition - A cohort study. Chronic Respiratory Disease. 2021; 18: 147997312110156.
17. Grbovic V, Markovic N, Bogojevic P, Nikolic J, Milosevic J, Simovic S, Cekerevac I, Jurišić-Škevin A, Zdravkovic N, Mijailovic S, Zdravkovic N. The effects of respiratory exercises on partial pressures of gases and anxiety in the acute phase of COVID-19 infection. Physiother Theory Pract. 2021:1-9.