Physiotherapy-assisted prone or modified prone positioning in ward-based patients with COVID-19: a retrospective cohort study.
Physiotherapy
; 114: 47-53, 2022 03.
Article
in English
| MEDLINE | ID: covidwho-1815045
ABSTRACT
OBJECTIVES:
To evaluate short-term change in oxygenation and feasibility of physiotherapy-assisted prone or modified prone positioning in awake, ward-based patients with COVID-19.DESIGN:
Retrospective observational cohort study.SETTING:
General wards, single-centre tertiary hospital in Australia.PARTICIPANTS:
Patients were included if ≥18 years, had COVID-19, required FiO2â¯≥â¯0.28 or oxygen flow rate ≥4â¯l/minute and consented to positioning. MAIN OUTCOMEMEASURES:
Feasibility measures included barriers to therapy, assistance required, and comfort. Short-term change in oxygenation (SpO2) and oxygen requirements before and 15â¯minutes after positioning.RESULTS:
Thirteen patients, mean age 75 (SD 14) years; median Clinical Frailty Scale score 6 (IQR 4 to 7) participated in 32 sessions of prone or modified prone positioning from a total of 125 ward-based patients admitted with COVID-19 who received physiotherapy intervention. Nine of thirteen patients (69%) required physiotherapy assistance and modified positions were utilised in 8/13 (62%). SpO2 increased in 27/32 sessions, with a mean increase from 90% (SD 5) pre-positioning to 94% (SD 4) (mean difference 4%; 95%CI 3 to 5%) after 15â¯minutes. Oxygen requirement decreased in 14/32 sessions, with a mean pre-positioning requirement of 8â¯l/minute (SD 4) to 7â¯l/minute (SD 4) (mean difference 2â¯l/minute; 95%CI 1 to 3â¯l/minute) after 15â¯minutes. In three sessions oxygen desaturation and discomfort occurred but resolved immediately by returning supine.CONCLUSION:
Physiotherapy-assisted prone or modified prone positioning may be a feasible option leading to short-term improvements in oxygenation in awake, ward-based patients with hypoxemia due to COVID-19. Further research exploring longerterm health outcomes and safety is required.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
Language:
English
Journal:
Physiotherapy
Year:
2022
Document Type:
Article
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