ABSTRACT
The issue of physical rehabilitation of post-COVID patients stays relevant up to this day. Most publications discuss inpatient rehabilitation and only few publications describe outpatient physical rehabilitation of such patients. The aim. Our study was performed to investigate efficacy of outpatient physical rehabilitation of post-COVID patients with lung injury. Methods. This was a prospective non-randomized open controlled study. All patients with COVID-19-associated lung injury were referred to supervised outpatient rehabilitation program. We analyzed 6-minute walk test (6-MWT) results, evaluation of dyspnea using Borg scale and assessment of oxygen saturation (SpO2) using pulse oxymeter before and after walking. Results. The rehabilitation group included 24 patients and the control group included 6 patients. The baseline and demographic findings did not differ significantly between the groups. The 6-minute distance (6-MWD) (p = 0.000018), heat rate at rest (p = 0.017) and after walking (p = 0.017), dyspnea after walking (p = 0.017), oxygen saturation at rest (p = 0.030) and after walking (p = 0.0021) improved significantly in the rehabilitation group and did not change significantly in the control group. At the end of the study, 6-MWD increased by 63.2 +/- 36.3 m in the rehabilitation group compared to 14.0 +/- 28.8 m in the control group (p = 0,01) and exertional dyspnea score increased by 0 (0 - 1) compared to 1 (1 - 2) in the control group (p = 0.033). Conclusion. Supervised outpatient physical rehabilitation in outpatient settings can accelerate physical recovery in post-COVID patients with lung injury. Copyright © 2022 Medical Education. All rights reserved.
ABSTRACT
In recent decades, attention to lung diseases associated with bronchiectasis has increased significantly. Despite the availability of modern effective therapy methods, primarily inhalation therapy, the problems of improving mucociliary clearance, reducing hypersecretion in pathologically deformed bronchi do not lose relevance. In patients with bronchiectasis, cystic fibrosis, COPD with bronchiectasis, methods of kinesitherapy to improve lung drainage function come to the fore. One of modern effective methods of kinesitherapy is the use of simulators with positive expiratory pressure. This includes the PARI O-PEP and the PARI PEP S system. These simulators are effective and easy to use. The PARI PEP S system is attached to a nebulizer and the patient can perform basic mucolytic therapy with exhaled resistance, which is more effective in influencing lung drainage function. The use of expiratory simulators is even more effective if included in a pulmonary rehabilitation course, conducted in conjunction with the improvement of breathing pattern (breathing pattern) through the use of aspiratory simulators, with training of the upper and lower muscle groups that are affected by chronic infectious process. The use of hardware methods to improve lung drainage function, such as vibration and compression therapy, is important to manage exacerbations of bronchiectasis. Due to the pandemic of new coronavirus infection (COVID-19), it is necessary to prevent worsening of the course or exacerbation of lung diseases associated with bronchiectasis, so the daily use of physical training, aspiration training and expiratory exercise machines is essential. © 2022, Remedium Group Ltd. All rights reserved.
ABSTRACT
The expert consensus of the Russian communities discusses the issues of comprehensive medical rehabilitation of patients with coronavirus disease 2019 (COVID-19). COVID-19 is a contagious infectious disease that can cause pulmonary, cardiac, motor, metabolic, neurocognitive and mental disorders, that is, multiple organ dysfunction. COVID-19 survivors, especially after a severe clinical course, face serious psychological and physical problems, posttraumatic stress, cognitive dysfunction, nutritional deficiencies and exacerbation of concomitant chronic diseases. Some patients, regardless of the COVID-19 severity, have a long clinical course of the disease (“chronic-COVID”, “long COVID”). There is evidence of post-acute COVID-19 syndrome. In this regard, patients after COVID-19 will need rehabilitation measures. The expert consensus of the Russian communities presents general principles, stages and aspects of medical rehabilitation after COVID-19, indications and contraindications for rehabilitation interventions. The paper includes recommendations on comprehensive cardiac and pulmonary rehabilitation, as well as specifics of rehabilitation care for different COVID-19 courses within the national three-stage rehabilitation system.
ABSTRACT
At the end of 2019, an outbreak of a new coronavirus infection was identified in the People's Republic of China centerd in the city of Wuhan. The official name COVID-19 (COronaVIrus Disease 2019) was assigned to the infection caused by the novel coronavirus by the World Health Organization on February 11, 2020. The International Committee on Taxonomy of Viruses assigned the name to the causative agent of the infection - SARS-CoV-2 on February 11, 2020. The bilateral pneumonia is currently known to be the most common clinical manifestation of the variant of coronavirus infection. The development of acute respiratory distress syndrome was found in 3 - 4% of patients. As a result of pneumonia, patients develop ventilation and perfusion disorders, weakness of skeletal muscles. To recover patients after viral pneumonia, methods of pulmonary rehabilitation should be applied. This article represents the methods of pulmonary rehabilitation aimed to improve the blood circulation in the lungs, the ventilation-perfusion ratios, and to the restoration of the skeletal muscles. © 2020 Medical Education. All rights reserved.