Motor and Sensory Balance Deficits Seen in People Immediately Following Covid-19

ABSTRACT

PURPOSE/HYPOTHESIS: Patients with cardiorespiratory dysfunction, such as COPD, have postural instability and increased risk of falls compared to age matched controls. Given that COVID-19 is defined as a respiratory condition, it could be presumed that these patients may demonstrate the same balance deficits. Ninety percent of patients with a history of COVID-19 report at least one neurological symptom, and these neurological symptoms could potentially result in alterations in balance. The act of maintaining upright posture or balance depends on both sensory and motor responses. It has been previously demonstrated that people post-COVID have motor and sensory balance deficits including vestibular dysfunction after leaving the acute care institution. The purpose of this study was to determine and characterize balance in patients COVID recovered (off airborne isolation but not discharged from the hospital). NUMBER OF SUBJECTS: Twenty-five subjects were recruited. Mean age was 55.6 +/- 11.3 years, 17 males, 8 females, mean length of time since diagnosed with COVID-19 was 34 +/- 15 days. All subjects had a primary or secondary diagnosis of COVID-19 during hospitalization and were considered COVID recovered (off-airborne isolation but not discharged from the hospital) and were receiving care in an acute inpatient hospital. MATERIALS AND METHODS: Following consent, subjects completed the Activityspecific Balance Confidence Scale (ABC), a questionnaire about symptoms of dizziness, the Timed Up&Go (TUG) and the modified Clinical Test of Sensory Interaction and Balance (mCTSIB). Subjects had vital signs monitored before, during, and after the examination. RESULT(S) There were no differences in clinical test scores based on age (<65 or >=65) or order of testing. Using age appropriate normative scores, all subjects had abnormal scores on the TUG indicating difficulty with motor balance, 88% had abnormal scores on the ABC indicating low confidence in performing balance activities, and 48% of the subjects had abnormal scores on Condition 4 of the mCTSIB indicating difficulty using vestibular information for balance. There was no correlation between the clinical test scores and age, length of time with COVID-19, or O2changes during testing. Surprisingly, there was no correlation between the scores on the clinical balance tests. CONCLUSION(S) Both young and older adults present with motor and sensory balance deficits acutely following a COVID-19 infection. Subjects have low perceptions of their ability to balance that may impact their function as they are discharged. CLINICAL RELEVANCE People acutely post-COVID-19 may have balance deficits. These deficits may be due to immobility and deconditioning. It is recommended that people acutely post COVID-19 receive education and interventions to increase mobility, improve balance, and specifically receive activities that stimulate the vestibular system. It is also recommended that people acutely post-COVID-19 have these balance deficits and perceptions of balance function be considered in discharge planning.