Effect of twist and raise walking technique on icu-acquired weakness in COVID-19 patients: a pre-post experimental study

Background: Recent studies presenting first recommendations on respiratory rehabilitation management have failed to advocate a specific protocol as there is still missing data about the current specific needs due to COVID-19. This necessitates the extensive research to be carried out for investigating the efficacy of various physiotherapeutic interventional methods on these associated symptoms which often go unnoticed. In the same interest, an attempt was made to address the complications of prolonged immobilization by facilitating early ambulation along with incorporation of upper limb, lower limb as well as trunk movements. The aim was to facilitate chest expansion along with initiation of early ambulation in order to reduce the possible complications of ICU acquired weakness. Materials and Methods: 32 COVID-19 positive subjects were given the twist and raise walking technique as a rehabilitative intervention for a period of 7 days. Post intervention data for various outcome measures like inspiratory hold capacity and forced expiration were recorded. Results: Clinically significant results were seen in post-test scores of all the subjects in terms of Inspiratory Hold Capacity (p<0.0001) as well as Forced Expiration Volume (p<0.0001). Conclusion: Twist and Raise Walking Technique was proven significant in reducing the intensity of ICU-acquired weakness by improving both the inspiratory hold capacity as well as the forced expiration. This technique can be advocated as a effective rehabilitation intervention especially in COVID-19 patients to minimize the possible complications of ICU-acquired weakness.

Effectiveness of structured exercise protocol on functional performance in subjects with COVID-19

It is a well-established fact that patients of Covid 19 have musculoskeletal dysfunctions in addition to cardiorespiratory and psychosocial problems. Muscu-loskeletal system is amongst the most common systems found to be affected in patients admitted in ICU for prolonged periods and some patients of Covid 19 do have to spend a reasonably long period in ICU’s. Prolonged hospital stay may be needed in Covid 19 patients having ARDS or pneumonia and symptoms of fever, cold and cough to monitor their recovery. This may result in musculoskeletal dysfunctions as demonstrated in some studies. Thus, treat-ing the musculoskeletal system becomes a vital part of the regimen to be followed during the patients stay in the ICU which needs to be followed up even after the patient is shifted from the ICU by keeping a track of Physical Functional performance of the subjects after discharge. This experimental study was done on 150 Covid-19 positive subjects to see the long term effectiveness of a structured exercise protocol on the Physical Functional performance of Covid 19 patients. The results of the study were analysed statistically and both the outcome measures FIMS and POMA showed significant changes with p value <0.05 and <0.05 respectively. The study thus shows that the structured exercise protocol helped in maintaining the Physical Functional performance of the subjects through-out the hospital stay and also after discharge during follow up.