ABSTRACT
The number of patients who have had pneumonia caused by COVID-19 is increasing every month. However, despite the ongoing treatment, the consequences of this disease are possible, which may appear in the short term or after a while. Pneumonia associated by the new coronavirus infection COVID-19 is characterized by the presence of such complications as cough, shortness of breath, fatigue, sleep disturbances, appetite disorders, etc. Often, pneumonia leads to dysfunctions of the respiratory system, higher mental functions, functions of the cardiovascular system and, unfortunately, possible disability. The search and implementation of new methods of physical rehabilitation is an urgent task of modern medicine. Low-frequency magnetotherapy is one of the safest and most commonly recommended treatments for pneumonia. The development of new methods of medical rehabilitation for patients with pneumonia associated with COVID-19, using physical factors such as low-frequency magnetotherapy, laser therapy is one of the leading fields. Magnetotherapy is included in the recommendations of the Ministry of Health of the Russian Federation for the purpose of anti-inflammatory, decongestant, reparative-regenerative action; improvement of microcirculation, acceleration of the resorption of infiltrative changes (Temporary methodological recommendations «Medical rehabilitation for a new coronavirus infection (COVID-19)¼, version 2 of 31.07.2020). International rehabilitation practice of using the International Classification of Functioning, Disability and Health (ICF) advises to use it as a tool that allows you to objectively determine the state of health of patients, determine the prognosis of impaired functions and evaluate the effectiveness of ongoing rehabilitation measures. OBJECTIVE: To assess the effectiveness of the use of low-frequency magnetotherapy in the complex medical rehabilitation of patients who have had pneumonia in the phase of convalescence according to the International Classification of Functioning, Disability and Health. MATERIAL AND METHODS: The study included 200 patients who had suffered from pneumonia associating by COVID-19 and whose average age was 54.3±5.8 years. 1st (main) group (n=100), against the background of standard therapy on the 16th day after discharge from the hospital, received low-frequency magnetotherapy on the ALMAG-02 apparatus («Elamed¼, Russia) daily for 10-20 minutes, a course of 15 procedures. The 2nd group(control) included 100 patients who underwent low-frequency placebo-magnetotherapy on the ALMAG-02 apparatus («Elamed¼, Russia). In order to assess the dynamics of clinical and laboratory data and the effectiveness of treatment, control methods were used in this study in accordance with the Temporary Clinical Recommendations of the Ministry of Health of the Russian Federation. Each patient was evaluated for the severity of the initial manifestations of respiratory failure using the mMRC scale (Degree of Shortness of breath) and the Borg scale, and the quality of life of patients was assessed on the EQ-5D scale. Also, at the time of inclusion in the study and during the control examination after the completion of prospective follow-up, the Individual profile of patients was determined in accordance with the international classification of functioning (ICF) with the data of the «Individual Registration Card of the clinical trial participant¼. RESULTS AND DISCUSSION: In 43% (43 people) of patients of the 1th group, an improvement in respiration functions was noted with lung auscultation and with spirometry, an increase in the vital capacity of the lungs by 28.2% (p=0.0021), an increase in chest excursion by 53.1% (p=0.0019) a decrease in the level of shortness of breath by 50% and Borg by 33.3% (p=0.0016). According to the data of the quality of life questionnaire (EQ-5D), the patients of the main group showed an improvement in the quality of life by 23% (p=0.0019). In the 1st group of patients, there was a decrease in moderate disorders in the domains «b152 - emotion functions¼ in 45% of patients; «b440 - respiratory functions¼ in 87% of patients; «b455 - exercise tolerance functions¼ in 74% of patients; «b134 - sleep functions¼ in 30% of patients; «d450 - walking¼ in 100% of patients. In the general blood analysis of patients of the 1st (main) group, there was a relief of leukocytosis, normalization of the erythrocyte sedimentation rate (ESR). In the 1st group a decrease in the duration of being on the sick list was observed for 3.4±0.2 days. CONCLUSION: The inclusion of low-frequency magnetic therapy in the complex rehabilitation of patients who have suffered pneumonia associated by COVID-19 contributes to improving the function of external respiration of patients, regression of residual infiltrative changes in the lungs after pneumonia, relief of residual manifestations of the inflammatory process, reducing the duration of the rehabilitation period and the duration of disability, improving the general well-being of patients, increasing tolerance to physical exertion, normalization of the psycho-emotional state and, as a result,, restoring activity in everyday life and improving the quality of life of patients. The researchers did not register any side effects and side effects of magnetic therapy from ALMAG-02 apparatus (Elamed, Russia).
Subject(s)
COVID-19 , Magnetic Field Therapy , Pneumonia, Viral , Humans , Middle Aged , Prospective Studies , Quality of Life , SARS-CoV-2 , Treatment OutcomeABSTRACT
The number of patients who have had pneumonia caused by COVID-19 is increasing every month. However, despite the ongoing treatment, the consequences of this disease are possible, which may appear in the short term or after a while. Pneumonia caused by the new coronavirus infection COVID-19 is characterized by the presence of such complications as cough, shortness of breath, fatigue, sleep disturbances, appetite disorders, etc. Often, pneumonia leads to dysfunctions of the respiratory system, higher mental functions, functions of the cardiovascular system and, unfortunately, possible disability. The search and implementation of new methods of physical rehabilitation is an urgent task of modern medicine. Low-frequency magnetotherapy is one of the safest and most commonly recommended treatments for pneumonia. OBJECTIVE: To assess the effectiveness of the use of low-frequency magnetotherapy in the complex medical rehabilitation of patients who have had pneumonia in the phase of convalescence. MATERIAL AND METHODS: The study included 52 patients who had suffered from pneumonia caused by COVID-19 and whose average age was 56.2±5.7 years. Group I (main) group (n=30), against the background of standard therapy on the 16th day after discharge from the hospital, received low-frequency magnetotherapy on the ALMAG-02 apparatus (Elamed, Russia) daily for 20 minutes, a course of 10-12 procedures. In the second (control) group (n=22), therapy was carried out in accordance with the Temporary Clinical Recommendations of the Ministry of Health of the Russian Federation for the prevention, diagnosis and treatment of new coronavirus infection COVID-19 (version 8.1 of 01/10/2020), as well as the Temporary Clinical recommendations for medical rehabilitation for a new coronavirus infection (version 8.1 of 01/10/2020). Evaluation method: spirometry using a spirographMIR (Italy), chest excursion, rehabilitation routing scale (RRM), quality of life questionnaire (EQ-5D), Borg scale for patient assessment of exercise tolerance, ECG, oxygen saturation in the blood. RESULTS AND DISCUSSION: The patients of the 1st group showed an increase in the vital capacity of the lungs by 16.4% in comparison with the 2nd (control) group; an increase in chest excursion by 45.6%, a decrease in the level of shortness of breath from moderate to mild by 64.1%, a decrease in disabilities by 62.7%, compared with the second (control) group. According to the data of the quality of life questionnaire (EQ-5D), the patients of the main group showed improvements in general mobility (mobility) by 44.5%, everyday activity by 26.1%, a decrease in pain/discomfort by 47.9%, anxiety and depression by 42.2%, compared with the control group (p=0.001). CONCLUSION: The inclusion of low-frequency magnetic therapy in complex rehabilitation contributes to the regression of respiratory disorders, reduces the level of anxiety and depression, reduces pain and discomfort, thereby improving the patient's quality of life.