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Introduction: To our knowledge, there are no published studies on the implementation and results of Pulmonary telerehabilitation (PTR) in Argentina. Our objective was to describe PTR strategies used during the COVID-19 pandemic, the results of the different PTR modalities and the patient satisfaction. Method(s): A prospective study was carried out between April and August 2020. Patients who switched to different PTR modalities participated: synchronous (SPTR) or asynchronous (APTR). The level of satisfaction, quality of life with the St. George's Respiratory Questionnaire (SGRQ) and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) at baseline, 6 and 12 weeks were evaluated. Result(s): 20 centers participated. 299 patients were included (55.9% female), with a median (P25-75) age of 68 (62- 72) years, 184/249 (73.9%) diagnosed with COPD, 37 (14.9%) interstitial lung diseases, 12 (4.8%) asthma and 16 (6.4%) other CRD. 110 (36.8%) patients underwent SPTR and 189 (63.2%) with APTR. No differences were observed in the SGRQ and HADS except in the activities subscale of the SGRQ that increased significantly (p<0.05) in both groups, the impact subscale and the total that increased significantly in the SPTR group at 12 weeks (p<0.01). Both groups reported being satisfied with the PTR, 5.9 (5.4-6.3) in SPTR and 5 (4.6-5.4) in APTR, being significantly higher in SPTR (p=0.004) Conclusion(s): We observed significant satisfaction with PRT during the pandemic. No improvements were seen in quality of life, anxiety, or depression.
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Introduction: The Post COVID Functional Status Scale (PCFS) was designed to measure functional changes in patients after SARS-COV2 infection. Objective(s): To compare the status of fatigue, dyspnea, and mental health of patients with COVID-19 according to the PCFS score. Method(s): Cross-sectional study that included patients hospitalized for at least 10 days. Were grouped according to the PCFS score. In addition, the Fatigue Assessment Scale (FAS), Hospital Anxiety and Depression Scale (HADS), and the modified Medical Research Council (mMRC) were applied. The study was approved by the ethics committee of Clinica de Occidente in Cali-Colombia. Result(s): Between February and August 2021, 72 participants (age 57.4 +/- 15.3 years, 47,2% women) were included;patients with a score of 3 and 4 in PCFS presented worse levels in the result of FAS, HADS, and mMRC (p < 0.001) compared to the other groups;participants with a score of 0 had better results in the clinical variables (Table 1). Conclusion(s): Patients with COVID19 with greater functional limitations also have more impact on fatigue, dyspnea, anxiety, and depression;this result stimulates the referral of patients to rehabilitation programs. .
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Introduction: The impact caused by the Coronavirus disease (COVID-19) has considerably altered the provision of outpatient rehabilitation services, especially pulmonary rehabilitation (PR). Objective(s): To describe the situation of PR services in Latin America 18 months after the beginning of the COVID-19 pandemic. Method(s): Cross-sectional study in which a survey was sent to professionals from PR centers in Latin America. An online questionnaire was applied from May to September 2021. The following data were included: demographic data of the programs, evaluation strategies, program structure, RP intervention in post-COVID-19 patients, and perception of therapeutic strategies for the care of post-COVID patients. COVID-19. The questionnaire was distributed in Spanish and Portuguese languages. This study was approved by the ethics committee. Result(s): Responses were received from 196 centers from 14 countries;Most of the surveys were answered by physiotherapists/kinesiologists in 65.7%. In the evaluation of exercise tolerance, the 6-minute walk test is the most used. Less than 50% of the institutions evaluate the quality of life, symptoms, and lung function. In the prescription of exercise intensity, there is reduced use of CPET and it is prescribed mainly with subjective scales of symptoms (Borg Scale) (78.1%), and response to exercise with vital signs (71.4%). The programs have, practically, for the most part, physical therapists (90.8%), as well as pulmonologists (60%), psychologists (35%), among other professionals. Conclusion(s): The application of these programs in Latin America is heterogeneous, both in the evaluations and the interventions carried out.
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The long-term impact of COVID-19 is still unknown. This study aimed to explore post COVID-19 effects on patients chest computed tomography (CT), lung function, respiratory symptoms, fatigue, functional capacity, health-related quality of life (HRQoL), and the ability to return to work beyond 3 months post infection. Method(s): A systematic search was performed on PubMed, Web of Science, and Ovid MEDLINE on 22 May 2021, to identify studies that reported persistent effects of COVID-19 beyond 3 months. Data on the proportion of patients who had the outcome were collected and analyzed using a one-group meta-analysis. Result(s): Data were extracted from 24 articles that presented information on a total of 5323 adults, post-infection, between 3 to 6 months after symptom onset or hospital discharge. The pooled prevalence of CT abnormalities was 59% (95% CI 44-73, I2 = 96%), abnormal lung function was 39% (95% CI 24-55, I2 = 94%), fatigue was 38% (95% CI 27-49, I2 = 98%), dyspnea was 32% (95% CI 24-40, I2 = 98%), chest paint/tightness was 16% (95% CI 12-21, I2 = 94%), and cough was 13%, (95% CI 9-17, I2 = 94%). Decreased functional capacity and HRQoL were found in 36% (95% CI 22-49, I2 = 97%) and 52% (95% CI 33-71, I2 = 94%), respectively. On average, 8 out of 10 of the patients had returned to work or reported no work impairment. Conclusion(s): Post-COVID-19 patients may experience persistent respiratory symptoms, fatigue, decreased functional capacity and decreased quality of life up to 6 months after infection. Further studies are needed to establish the extent to which post-COVID-19 effects continue beyond 6 months, how they interact with each other, and to clarify their causes and effective management.
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BACKGROUND: In coronavirus disease (COVID-19), physical capacity is one of the most impaired sequelae. Due to their simplicity and low cost, field tests such as the six-minute walk test (6MWT) are widely used However, in many places it is difficult to perform them and alternatives can be used such as the 1 min sit-to-stand test (1min-STST) or the Chester step test (CST). Therefore, our objective was to compare the 6MWT, 1min-STST and the CST in post-COVID-19 patients. METHODS: We conducted a cross-sectional analysis in post-COVID-19 patients, compared with matched controls (CG). Demographic characteristics and comorbidities were collected. We analysed oxygen saturation (SpO2), heart rate (HR), and the modified Borg scale in the 6MWT, 1min-STST, and CST. Additionally, the correlations between tests were analysed. RESULTS: We recruited 27 post-COVID-19 patients and 27 matched controls. The median age was 48 (IQR 43-59) years old (44% female). The median distance walked in 6MWT was 461 (IQR 415-506) m in post-COVID-patients and 517 (IQR 461-560) m in CG (p = 0.001). In 1min-STST, the repetitions were 21.9 ± 6.7 and 28.3 ± 7.1 in the post-COVID-19 group and CG, respectively (p = 0.001). In the CST, the post-COVID-19 group performed 150 (86-204) steps vs the CG with 250 (250-250) steps (p < 0.001). We found correlations between the 6MWT with the 1min-STST in COVID-19 patients (r = 0.681, p < 0.001) and CG (r = 0.668, p < 0.001), and between the 6MWT and the CST in COVID-19 patients (r = 0.692, p < 0.001). CONCLUSION: The 1min-STST and the CST correlated significantly with the 6MWT in patients post-COVID-19 being alternatives if the 6MWT cannot be performed.
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This study's objective is to describe the effects of a telerehabilitation program on functionality and user satisfaction of COVID-19 survivors in a public hospital. It is an observational, longitudinal and retrospective study. The background was compiled from medical twenty adult user from a public hospital with limited resources, whom had entered a telerehabilitation program supervised by physiotherapists between June and October 2020. The functional capacity variables of functional capacity and lower extremity strength with Sit-to-Stand test, the functional status evaluated with the Fatigue assessment scale and the independence doing daily life activities (AVDs) evaluated with the Barthel Index. The user satisfaction surveys were answered after the intervention had ended. After telerehabilitation, patients improved functional capacity and lower limb strength, functional status, AVDs (p<0.01;effect size range=-0.18;-0.40) and expressed good user satisfaction. There were no differences in fatigue perception (p=0.33;effect size=0.08) after the intervention. We concluded that a structured telerehabilitation program for COVID-19 survivors, proved to be effective for functionality and user satisfaction of this population. © Federación Española de Asociaciones de Docentes de Educación Física (FEADEF)
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Background: Facing a severe life-threatening disease has physical and emotional consequences for patients. Aim: To evaluate the physical and emotional sequelae in patients who survived COVID-19 pneumonia. Material and Methods: This cross-sectional study collected data from post-COVID-19 pneumonia patients admitted to an outpatient follow-up program in a public hospital in Chile. One month after hospital discharge, the evaluation of physical capacity was carried out through the 1-minute sit-to-stand test (1STST). In addition, the Clinical Frailty Scale (CFS) and the Hospital Anxiety and Depression scale were applied Results: We included 70 patients aged 63 +or- 13 years (54% women). Eighty-five percent of the patients were able to execute the 1STST with an average of 20.6 +or- 4.8 repetitions. Forty-eight percent of the patients had a performance below the 2.5th percentile according to the reference values and 28% of patients had exertional desaturation. The CFS classified as mildly vulnerable or with some degree of frailty to 33% of patients. Twenty-five percent of the patients presented symptoms of depression and 33% of anxiety. Conclusions: Patients who survived COVID-19 have a decrease in physical capacity and a significant proportion of depression and anxiety one month after hospital discharge.
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INTRODUCTION: To evaluate functional state, it is fundamental to have simple instruments that allow for monitoring the course of symptoms and the commitment of the functional status that adult COVID-19 survivors may present. This study aims to evaluate the psychometric properties of the Post COVID-19 Functional Status (PCFS) scale. MATERIAL AND METHODS: A cross-sectional scale validation study was performed. In the content validation 22-health professionals, whom through expert judgment evaluated the scale in the sufficiency, clarity, coherence and relevance categories. In addition, two professionals performed the retest with 20 people who had been infected with COVID-19. In addition, their observations and comments are revealed. The degree of agreement amongst the experts was determined with the Kendall coefficient. For the retest test, the Spearman coefficient was utilized. In all the analyzes, a P value of <.05 was considered. RESULTS: In regards to the content validity, there was agreement between raters only for the relevance category (P=.032). A strong agreement was obtained between two evaluators (Spearman's Rho=.929 for the score). Some of the content terms were adjusted without affecting the general structure of the scale. Of the original 16 items that make up the PCFS scale, none was eliminated. CONCLUSIONS: The Spanish version of the PCFS (Chile) was adapted to the cultural context of the country, shows good psychometric characteristics in terms of reliability.
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COVID-19 , Adult , Cross-Sectional Studies , Functional Status , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires , SurvivorsABSTRACT
BACKGROUND: Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID-19). The literature on previous coronavirus infections reports that patients may experience persistent impairment in respiratory function after being discharged. Our objective was to determine the prevalence of restrictive pattern, obstructive pattern and altered diffusion in patients post-COVID-19 infection and to describe the different evaluations of respiratory function used with these patients. METHODS: A systematic review was conducted in five databases. Studies that used lung function testing to assess post-infection COVID-19 patients were included for review. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. RESULTS: Of the 1973 reports returned by the initial search, seven articles reporting on 380 patients were included in the data synthesis. In the sensitivity analysis, we found a prevalence of 0.39 (CI 0.24-0.56, pâ¯<â¯0.01, I2â¯=â¯86%), 0.15 (CI 0.09-0.22, pâ¯=â¯0.03, I2â¯=â¯59%), and 0.07 (CI 0.04-0.11, pâ¯=â¯0.31, I2â¯=â¯16%) for altered diffusion capacity of the lungs for carbon monoxide (DLCO), restrictive pattern and obstructive pattern, respectively. CONCLUSION: Post-infection COVID-19 patients showed impaired lung function; the most important of the pulmonary function tests affected was the diffusion capacity.