Role of diaphragmatic sonography in evaluating the respiratory rehabilitation in COVID-19 patients

ABSTRACT

Background: The study wanted to see if diaphragmatic sonography was able to assess physical changes after a respiratory rehabilitation program in COVID-19 patients. Methods: Fifty patients (10 women and 40 males aged between 20 and 86 years) were trained by the physiotherapist to use the pep bottle and the active exercise from the beginning in the COVID-19 unit and then in Rehabilitation unit. The physiotherapist evaluated the diaphragm excursion with a sonography machine set in abdominal protocol way with a convex probe. The sonography allows to evaluate, before and upon discharge, the maximal diaphragmatic excursion and the maximal expiratory time during forced expiration as an alternative test to six minute walking test when the patients were unable to walk or could not leave the room due to infections. Results: Despite the difficulty of performing the examination due to physical conditions of work and clinical criticity of the patients in COVID unit we could observe that - 44 patients (n.11 were with tracheotomy) improved the maximal diaphragmatic excursion while 4 patients have gotten worse because they were uncooperative and 2 for physical problems. - 38 patients improved the maximal expiratory time while 4 were uncooperative and 8 patients have had a cough which interrupted the exhalation. Conclusions: The diaphragm sonography can be a simple and safe method to study, at the bed side patient, the modification of the muscle excursion and evaluate the progress of therapy during rehabilitation treatment.