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Gloeckl R, Zwick RH, Fürlinger U, Schneeberger T, Leitl D, Jarosch I, Behrends U, Scheibenbogen C, Koczulla AR. Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal. SPORTS MEDICINE - OPEN 2024; 10:47. [PMID: 38658496 PMCID: PMC11043268 DOI: 10.1186/s40798-024-00695-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/05/2024] [Indexed: 04/26/2024]
Abstract
People with long COVID may suffer from a wide range of ongoing symptoms including fatigue, exertional dyspnea, reduced exercise performance, and others. In particular, impaired exercise performance is a condition that can be recovered in many people through an individualized physical exercise training program. However, clinical experience has shown that the presence of post-exertional malaise (PEM) is a significant barrier to physical exercise training in people with long COVID. Currently, there is no guideline or consensus available on how to apply exercise training in this cohort. Therefore, we conducted a literature review in the PubMed library using the following search terms: "COVID", "post-COVID", "long COVID" and "exercise" searching for studies from January 2020 to January 2024. Data from 46 trials were included. Exercise training regimes were very heterogeneous and none of these studies reported on the management of PEM in the context of an exercise training program. Based on the feedback from an additional survey that was answered by 14 international experts in the field of exercise training in long COVID, combined with the authors´ own extensive practical experience, a best practice proposal for exercise training recommendations has been developed. This proposal differentiates exercise procedures according to the presence of no, mild/moderate or severe PEM in people with long COVID. These recommendations may guide allied healthcare professionals worldwide in initiating and adjusting exercise training programs for people with long COVID, stratified according to the presence and severity of PEM.
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Affiliation(s)
- Rainer Gloeckl
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Ralf H Zwick
- Therme Wien Med, Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Ulrich Fürlinger
- Therme Wien Med, Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Tessa Schneeberger
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Daniela Leitl
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Inga Jarosch
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Uta Behrends
- Childrens' Hospital, School of Medicine, Technical University of Munich, Munich, Germany
- German Center for Infection Research (DZIF), Berlin, Germany
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Andreas Rembert Koczulla
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany.
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
- Teaching Hospital, Paracelsus Medical University Salzburg, Salzburg, Austria.
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Sánchez Romero EA, Fernández Carnero J, Alonso Pérez JL, Martínez Rolando L, Villafañe JH. Addressing post-COVID-19 musculoskeletal symptoms through pulmonary rehabilitation and telemedicine: A study protocol. F1000Res 2024; 11:898. [PMID: 38524251 PMCID: PMC10958150 DOI: 10.12688/f1000research.122843.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 03/26/2024] Open
Abstract
Objective The purpose of the study will be to evaluate the effect of pulmonary rehabilitation on the improvement of patients with post-COVID-19 musculoskeletal symptoms, as well as to quantify the impact of telemedicine that evaluates the evolution of pain, functionality, and quality of life. Methods We will carry out a case-control study in post-COVID-19 musculoskeletal symptoms patients who will undergo pulmonary rehabilitation, together with an intervention and a follow-up using programmed telemedicine sessions. Data will be collected on the improvement of functional capacity and quality of life, in addition to assessing the evolution of musculoskeletal symptomatology, as well as pain and psychological variables. The approaches of face-to-face rehabilitation and telerehabilitation will also be compared. The telemedicine sessions will improve user adherence and follow-up, and the results are expected to be disseminated to the scientific community during and after the end of the study.
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Affiliation(s)
- Eleuterio A. Sánchez Romero
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), Madrid, Spain
- Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Josué Fernández Carnero
- Multidisciplinary Pain Treatment Center ONELIFE, Madrid, Spain
- , Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Rey Juan Carlos University, Madrid, 28032, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, 28670, Spain
| | - José Luis Alonso Pérez
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), Madrid, Spain
- Multidisciplinary Pain Treatment Center ONELIFE, Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, 28670, Spain
| | - Lidia Martínez Rolando
- , Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Rey Juan Carlos University, Madrid, 28032, Spain
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3
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Ladds E, Darbyshire JL, Bakerly ND, Falope Z, Tucker-Bell I. Cognitive dysfunction after covid-19. BMJ 2024; 384:e075387. [PMID: 38302141 DOI: 10.1136/bmj-2023-075387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Emma Ladds
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Julie L Darbyshire
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Nawar Diar Bakerly
- The Northern Care Alliance, Manchester Metropolitan University, University of Manchester
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Pleguezuelos E, Sánchez-Nuño S, Del Carmen A, Serra-Payá N, Moreno E, Molina-Raya L, Robleda G, Benet M, Santos-Ruiz S, Garrido AB, Jerez-Molina C, Miravitlles M, Serra-Prat M, Viñals X, Farrés MG, Carbonell T, Garnacho-Castaño MV. Effect of different types of supervised exercise programs on cardiorespiratory and muscular fitness, pain, fatigue, mental health and inflammatory and oxidative stress biomarkers in older patients with post-COVID-19 sequelae "EJerSA-COVID-19": a randomized controlled trial. BMC Geriatr 2023; 23:865. [PMID: 38102536 PMCID: PMC10724883 DOI: 10.1186/s12877-023-04544-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Many patients with COVID-19 present the so-called post-acute sequelae of COVID-19 such as fatigue, post-stress discomfort, dyspnea, headache, pain mental impairment, incapacity to perform daily physical tasks ant exercise intolerance. This study aims to investigate the effects of different exercise programs on physical and mental fitness, physical condition and biomarkers of the immune system and oxidative stress in older patients with post-COVID-19 sequelae. METHODS The sample will be made up of 120 eligible participants, over the age of 60 years who have had COVID-19 disease and are survivors and present persistent COVID-19 symptomatology diagnosed by the corresponding physician. The participants will be randomly assigned to the experimental groups: supervised endurance group (SEG, n = 30), supervised strength group (SSG, n = 30), supervised concurrent group (SCG, n = 30), which will perform the corresponding exercise program 3 days a week compared to the control group (CG, n = 30), which will not carry out a supervised exercise program. The design of this project will include measurements of four relevant dimensions; 1) Cardiorespiratory fitness; 2) Muscle fitness; 3) Pain and mental health; and 4) Biomarkers of inflammation and oxidative stress. CONCLUSIONS The results of this study will provide insights into the effects of different exercise programs on physical and mental fitness, physical condition and biomarkers of the immune system and oxidative stress in older patients with post-COVID-19 sequelae. These findings may be the basis for the formulation of health plans and rehabilitation programs that allow healthy aging and a reduction in the associated morbidity in patients with post-COVID-19 sequelae. TRIAL REGISTRATION NCT05848518. Registered on May 8, 2023.
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Affiliation(s)
- Eulogio Pleguezuelos
- Departamento de Medicina Física y Rehabilitación, Hospital de Mataró, Barcelona, Spain
- Departamento de Ciencias Experimentales y Sanitarias. Facultad de Ciencias de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
| | - Sergio Sánchez-Nuño
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Amin Del Carmen
- Departamento de Medicina Física y Rehabilitación, Hospital de Mataró, Barcelona, Spain
| | - Noemí Serra-Payá
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Eva Moreno
- Servicio de Medicina Física y Rehabilitación, Hospital General de Hospitalet, L´Hospitalet de Llobregat, Barcelona, Spain
| | - Lorena Molina-Raya
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Gemma Robleda
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Marta Benet
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Susana Santos-Ruiz
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Ainoa Biurrun Garrido
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Carmen Jerez-Molina
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Marc Miravitlles
- Servicio de Neumología. Hospital Universitari Vall d'HebronVall d'Hebron Institut de Recerca (VHIR), Campus Hospital Barcelona, CIBER de Enfermedades Respiratorias (CIBERES) Barcelona, Barcelona, Spain
| | - Mateu Serra-Prat
- Unidad de InvestigaciónConsorci Sanitari del Maresme, Mataró, Barcelona, Spain
| | - Xavier Viñals
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Montserrat Girabent Farrés
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Teresa Carbonell
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat de Barcelona, Barcelona, Spain
| | - Manuel V Garnacho-Castaño
- Grupo de Investigación DAFNiS (Dolor, Actividad Física, Nutrición y Salud), Campus Docent Sant Joan de Déu, Universitat de Barcelona, C/ Sant, C. de Sta. Benito Menni, 18-20, Sant Boi de Llobregat, 08830, Barcelona, Spain.
- Facultad de Ciencias de la Salud, Universidad Internacional de Valencia (VIU), 46002, Valencia, Spain.
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Wang Q, Zhang L, Pang P. Dihydrokaempferol attenuates LPS-induced inflammation and apoptosis in WI-38 cells. Allergol Immunopathol (Madr) 2023; 51:23-29. [PMID: 37937492 DOI: 10.15586/aei.v51i6.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/23/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Globally, pneumonia has been associated as a primary cause of mortality in children aged less than 5 years. Dihydrokaempferol (DHK) has been proposed for being correlated with the process of various diseases. Nevertheless, whether DHK has a role in the progression of infantile pneumonia remains unclear. This study aimed at exploring whether DHK was involved in the progression of infantile pneumonia. METHODS Human fibroblast cells WI-38 were treated with lipopolysaccharide (LPS). The viability of WI-38 cells was measured via Cell counting kit-8. Reverse transcription-quantitative polymerase chain reaction was used to evaluate the levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α). Western blot analysis revealed the protein levels of IL-1β, IL-6, TNF-α, Bax, and cleaved-caspase 3. Flow cytometry was applied for exploring the apoptosis of WI-38 cells. The concentrations of IL-1β, IL-6, and TNF-α were assessed via enzyme-linked-immunosorbent serologic assay. RESULTS DHK modulated the viability of WI-38 cells in infantile pneumonia. Furthermore, we identified that DHK treatment inversely changed LPS induction-mediated elevation on the levels of inflammation biomarkers. Besides, DHK counteracted LPS-induced production of reactive oxygen species (ROS) in WI-38 cells. DHK also decreased LPS-induced elevation of WI-38 cells apoptosis and mediated the levels of apoptosis-associated indexes. Moreover, modulating sirtuin-1 (SIRT1) protein level was lowered by the induction of LPS, and was reversed by DHK treatment. In addition, DHK counteracted LPS induction-mediated elevation of p-p65 and phosphorylated inhibitor of nuclear factor kappa-B kinase subunit alpha (p-IκBα) protein levels. CONCLUSION DHK alleviated LPS-induced WI-38 cells inflammation injury in infantile pneumonia through SIRT1/NF-κB pathway. The results shed light on the implications of DHK on the prevention and treatment of infantile pneumonia.
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Affiliation(s)
- Qiao Wang
- Department of Pediatrics, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China;
| | - Liwen Zhang
- Department of Pediatrics, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Ping Pang
- Department of Pediatrics, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
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Abdelwahab SI, Taha MME, Aldhahi MI. Comprehensive analysis of research related to rehabilitation and COVID-19, hotspots, mapping, thematic evolution, trending topics, and future directions. Eur J Med Res 2023; 28:434. [PMID: 37833811 PMCID: PMC10571379 DOI: 10.1186/s40001-023-01402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND This study conducted a comprehensive analysis of research pertaining to the intersection of rehabilitation and COVID-19 (COV-REH). The main aim of this study is to analyze the thematic progression and hotspots, detect emerging topics, and suggest possible future research directions in the COV-REH. METHODS Appropriate keywords were selected based on the Medical Subject Headings (MeSH) PubMed database and the Scopus database were used to retrieve a total of 3746 original studies conducted in the English language. The data extraction was performed on June 30, 2023. VOSviewer and Bibliometrix utilize CVS and BibTex files to facilitate the performance analysis and generate visual maps. The performance indicators reported for the research components of the COV-REH were compiled using the Scopus Analytics tool. RESULTS From 2003 to 2023, 3470 authors from 160 organizations in 119 countries generated 3764 original research documents, with an annual growth of 53.73%. 1467 sources identified these scholarly works. Vitacca, M. (Italy), Harvard University (USA), and the USA published the most articles. This study included 54.1% of medical scholars. Telerehabilitation, exercise, quality of life, case reports, anxiety, and pulmonary rehabilitation were the primary themes of the COV-REH. One component of "telerehabilitation" is now the cardiac rehabilitation cluster. The trending topics in COV-REH are "symptoms," "protocol," and "community-based rehabilitation". CONCLUSIONS This study proposed several significant research directions based on the current thematic map and its evolution. Given that COV-REH investigations have been determined to be multidisciplinary, this study contributes conceptually to several fields and has wide-ranging implications for practitioners and policymakers.
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Affiliation(s)
| | | | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), P.O. Box 84428, 11671, Riyadh, Saudi Arabia.
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Torres G, Gradidge P. The quality and pattern of rehabilitation interventions prescribed for post-COVID-19 infection patients: A systematic review and meta-analysis. Prev Med Rep 2023; 35:102395. [PMID: 37705882 PMCID: PMC10495653 DOI: 10.1016/j.pmedr.2023.102395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Patients with prior COVID-19 infection may present with lasting multisystem symptoms that require intervention and includes exercise rehabilitation. The aim of this systematic review was to investigate the quality of articles, with emphasis on exercise rehabilitation, and conduct a meta-analysis on experimental and observational rehabilitation intervention studies on cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for evaluating rehabilitation interventions in clinical practice. A methodical search of cohort and experimental studies occurred from January 2019 up to March 2023. Thirty-two studies were included for complete analysis. The quality of the eligible studies for complete review was fair overall. The studies did not provide a detailed account of key descriptors of exercise such as volume, progression, motivational strategies, adherence and replication. There was a significant difference in the 6-minute walk test (Mean difference (MD) = 51.69 m; confidence intervals (CIs) = 36.99 to 66.38; p < 0.001, level of heterogeneity (I2) = 0), percent of predicted forced expiratory volume in one second (MD = 7.95%; CIs = 3.46 to 12.44; p = 0.0005, I2 = 65%) and percent of predicted forced vital capacity (MD = 3.49%; 95% CI = 1.25 to 5.73; p = 0.002; I2 = 37%) between the experiment and control groups. The current evidence suggests that rehabilitation interventions significantly improve cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients; however, there is a need for conceptualising high-quality and long-term rehabilitation interventions, especially exercise interventions.
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Affiliation(s)
- G. Torres
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - P.J. Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
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Mills G, Daynes E, McAuley HJ, Greening NJ, Briggs-Price S, Baldwin MM, Singh SJ. Resistance Training in Post-COVID Recovery: Rationale and Current Evidence. J Frailty Sarcopenia Falls 2023; 8:188-194. [PMID: 37663156 PMCID: PMC10472035 DOI: 10.22540/jfsf-08-188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
During hospitalisation with COVID-19, individuals may experience prolonged periods of immobilisation. Combined with the inflammatory effects of the virus, this may lead to a significant reduction in both muscle mass and strength. Data from several long-term studies suggest that these symptoms may not fully resolve within one year. Owing to its effectiveness at inducing muscle fibre hypertrophy and improving neuromuscular efficiency, resistance training is of great interest in the rehabilitation of this population. This narrative review aims to identify the rationale and potential efficacy of resistance training for restoring physical function following infection with SARS-CoV-2, as well as evidence of its use in clinical practice. The studies included in this narrative review consisted mostly of multi-component rehabilitation trials. Of these, widespread improvements in muscle strength were reported using intensities of up to 80% of participants' 1-repetition-maximum. Evidence thus far indicates that resistance training may be safe and effective in patients following COVID-19, although its individual contribution is difficult to discern. Future exercise intervention studies investigating the efficacy of resistance training as a sole modality are needed.
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Affiliation(s)
- George Mills
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
| | - Enya Daynes
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Hamish J.C. McAuley
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Neil J. Greening
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Samuel Briggs-Price
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Molly M. Baldwin
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
| | - Sally J. Singh
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Wedig IJ, Durocher JJ, McDaniel J, Elmer SJ. Blood flow restriction as a potential therapy to restore physical function following COVID-19 infection. Front Physiol 2023; 14:1235172. [PMID: 37546539 PMCID: PMC10400776 DOI: 10.3389/fphys.2023.1235172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Accumulating evidence indicates that some COVID-19 survivors display reduced muscle mass, muscle strength, and aerobic capacity, which contribute to impairments in physical function that can persist for months after the acute phase of illness. Accordingly, strategies to restore muscle mass, muscle strength, and aerobic capacity following infection are critical to mitigate the long-term consequences of COVID-19. Blood flow restriction (BFR), which involves the application of mechanical compression to the limbs, presents a promising therapy that could be utilized throughout different phases of COVID-19 illness. Specifically, we hypothesize that: 1) use of passive BFR modalities can mitigate losses of muscle mass and muscle strength that occur during acute infection and 2) exercise with BFR can serve as an effective alternative to high-intensity exercise without BFR for regaining muscle mass, muscle strength, and aerobic capacity during convalescence. The various applications of BFR may also serve as a targeted therapy to address the underlying pathophysiology of COVID-19 and provide benefits to the musculoskeletal system as well as other organ systems affected by the disease. Consequently, we present a theoretical framework with which BFR could be implemented throughout the progression from acute illness to outpatient rehabilitation with the goal of improving short- and long-term outcomes in COVID-19 survivors. We envision that this paper will encourage discussion and consideration among researchers and clinicians of the potential therapeutic benefits of BFR to treat not only COVID-19 but similar pathologies and cases of acute critical illness.
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Affiliation(s)
- Isaac J. Wedig
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
- Health Research Institute, Michigan Technological University, Houghton, MI, United States
| | - John J. Durocher
- Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, IN, United States
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, OH, United States
| | - Steven J. Elmer
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
- Health Research Institute, Michigan Technological University, Houghton, MI, United States
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10
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Wang C, Ramasamy A, Verduzco-Gutierrez M, Brode WM, Melamed E. Acute and post-acute sequelae of SARS-CoV-2 infection: a review of risk factors and social determinants. Virol J 2023; 20:124. [PMID: 37328773 PMCID: PMC10276420 DOI: 10.1186/s12985-023-02061-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/02/2023] [Indexed: 06/18/2023] Open
Abstract
SARS-CoV-2 infection leading to Coronavirus Disease 2019 (COVID-19) has caused more than 762 million infections worldwide, with 10-30% of patients suffering from post-acute sequelae of SARS-CoV-2 infections (PASC). Initially thought to primarily affect the respiratory system, it is now known that SARS-CoV-2 infection and PASC can cause dysfunction in multiple organs, both during the acute and chronic stages of infection. There are also multiple risk factors that may predispose patients to worse outcomes from acute SARS-CoV-2 infection and contribute to PASC, including genetics, sex differences, age, reactivation of chronic viruses such as Epstein Barr Virus (EBV), gut microbiome dysbiosis, and behavioral and lifestyle factors, including patients' diet, alcohol use, smoking, exercise, and sleep patterns. In addition, there are important social determinants of health, such as race and ethnicity, barriers to health equity, differential cultural perspectives and biases that influence patients' access to health services and disease outcomes from acute COVID-19 and PASC. Here, we review risk factors in acute SARS-CoV-2 infection and PASC and highlight social determinants of health and their impact on patients affected with acute and chronic sequelae of COVID-19.
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Affiliation(s)
- Chumeng Wang
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Akshara Ramasamy
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Monica Verduzco-Gutierrez
- Department of Physical Medicine and Rehabilitation, University of Texas at San Antonio, San Antonio, TX, USA
| | - W Michael Brode
- Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Esther Melamed
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
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11
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Voruz P, Cionca A, Jacot de Alcântara I, Nuber-Champier A, Allali G, Benzakour L, Lalive PH, Lövblad KO, Braillard O, Nehme M, Coen M, Serratrice J, Reny JL, Pugin J, Guessous I, Ptak R, Landis BN, Adler D, Griffa A, Van De Ville D, Assal F, Péron JA. Brain functional connectivity alterations associated with neuropsychological performance 6-9 months following SARS-CoV-2 infection. Hum Brain Mapp 2023; 44:1629-1646. [PMID: 36458984 PMCID: PMC9878070 DOI: 10.1002/hbm.26163] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Neuropsychological deficits and brain damage following SARS-CoV-2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6-9 months following SARS-CoV-2 infection. SARS-CoV-2 infection causes long-term memory and executive dysfunctions, related to large-scale functional brain connectivity alterations.
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Affiliation(s)
- Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre Cionca
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Isabele Jacot de Alcântara
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Anthony Nuber-Champier
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Gilles Allali
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lamyae Benzakour
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Psychiatry Department, Geneva University Hospitals, Geneva, Switzerland
| | - Patrice H Lalive
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Karl O Lövblad
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diagnostic and Interventional Neuroradiology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Braillard
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Mayssam Nehme
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jacques Serratrice
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jérôme Pugin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Intensive Care Department, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Radek Ptak
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Neurorehabilitation Department, Geneva University Hospitals, Geneva, Switzerland
| | - Basile N Landis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Rhinology-Olfactology Unit, Otorhinolaryngology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Dan Adler
- Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Alessandra Griffa
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Dimitri Van De Ville
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Julie A Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland
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12
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Mińko A, Turoń-Skrzypińska A, Rył A, Szylińska A, Denisewicz I, Rotter I. Effects of Comprehensive Rehabilitation on Pulmonary Function in Patients Recovering from COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3985. [PMID: 36900996 PMCID: PMC10001994 DOI: 10.3390/ijerph20053985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study is to evaluate the effect of inpatient rehabilitation on pulmonary function in patients recovering from COVID-19, a multifaceted disease caused by the SARS-CoV-2 virus. This aspect of recovery is crucial, as pneumonia associated with this disease can cause lung-function abnormalities with varying degrees of hypoxemia. This study involved 150 patients qualified for inpatient rehabilitation following SARS-CoV-2 infection. Functional assessment of the lungs was performed by spirometry. The mean age of patients was 64.66 (±11.93) years, and the mean body mass index (BMI) was 29.16 (±5.68). The tests showed a statistically significant improvement in spirometric parameters. The rehabilitation program based on aerobic, strength, and endurance exercises improved lung-function parameters in the long term. The improvement in spirometric parameters in patients after COVID-19 may be related to body mass index (BMI).
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Affiliation(s)
- Alicja Mińko
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Agnieszka Turoń-Skrzypińska
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Aleksandra Rył
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Aleksandra Szylińska
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Iwona Denisewicz
- Saint Charles Borromeo Rehabilitation Hospital, 71-899 Szczecin, Poland
| | - Iwona Rotter
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland
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13
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Kupferschmitt A, Langheim E, Tüter H, Etzrodt F, Loew TH, Köllner V. First results from post-COVID inpatient rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2023; 3:1093871. [PMID: 36756465 PMCID: PMC9899863 DOI: 10.3389/fresc.2022.1093871] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023]
Abstract
Background COVID-19 is associated with various symptoms and psychological involvement in the long term. In view of the multifactorial triggering and maintenance of the post-COVID syndrome, a multimodal therapy with somatomedical and psychotherapeutic content is expedient. This paper compares the psychological stress of post-COVID patients and their course in rehabilitation to psychosomatic and psychocardiological patients. Method Observational study with control-groups and clinical, standardized examination: psychological testing (BDI-II, HELATH-49), 6-MWT as somatic parameter, two measurement points (admission, discharge). Sample characteristics, including work related parameters, the general symptom-load and the course of symptoms during rehabilitation are evaluated. Results At admission in all measures post-COVID patients were significantly affected, but less pronounced than psychosomatic or psychocardiological patients (BDI-II post-COVID = 19.29 ± 9.03, BDI-II psychosomatic = 28.93 ± 12.66, BDI-II psychocardiology = 24.47 ± 10.02). During rehabilitation, in all complaint domains and sub-groups, symptom severity was significantly reduced (effect sizes ranging from d = .34 to d = 1.22). Medium positive effects were seen on self-efficacy (d = .69) and large effects on activity and participation (d = 1.06) in post-COVID patients. In the 6-MWT, the walking distance improved by an average of 76.43 ± 63.58 meters (d = 1.22). Not a single patient deteriorated in walking distance, which would have been a possible sign of post exercise malaise (PEM). Conclusion Post-COVID patients have a slighter psychological burden as psychocardiological or psychosomatic patients. Although rehabilitation is not curative, post-COVID patients benefit significantly from the interventions and there were no signs of PEM.
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Affiliation(s)
- Alexa Kupferschmitt
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany,Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – Universitätsmedizin Berlin, Berlin, Germany,Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany,Correspondence: Alexa Kupferschmitt
| | - Eike Langheim
- Department of Cardiology, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
| | - Haris Tüter
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Franziska Etzrodt
- Department of Cardiology, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
| | - Thomas H. Loew
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – Universitätsmedizin Berlin, Berlin, Germany,Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
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14
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Rahmati M, Molanouri Shamsi M, Woo W, Koyanagi A, Won Lee S, Keon Yon D, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:149-158. [PMID: 36717302 PMCID: PMC9851951 DOI: 10.1016/j.joim.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hospitalized patients recovering from coronavirus disease 2019 (COVID-19) may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge. However, to date, no attempt has been made to collate and synthesize literature in this area. OBJECTIVE This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital. SEARCH STRATEGY A systematic search of MEDLINE/PubMed, CINAHL, Scopus and medRxiv was conducted to identify articles published up to March 2022. INCLUSION CRITERIA This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity, exercise, or breathing training to enhance or restore functional capacity, pulmonary function, quality of life, and mental health or function. DATA EXTRACTION AND ANALYSIS Selection of included articles, data extraction, and methodological quality assessments were conducted by two review authors respectively, and consensus was reached through discussion and consultation with a third reviewer. Finally, we review the outcomes of studies based on four categories including: (1) functional capacity, (2) pulmonary function, (3) quality of life, and (4) mental health status. RESULTS A total of 7534 titles and abstracts were screened; 10 cohort studies, 4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review. Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity, pulmonary function, quality of life and mental health status. CONCLUSION Physical rehabilitation interventions may be safe, feasible and effective in COVID-19 patients discharged from the hospital, and can improve a variety of clinically relevant outcomes. Further studies are warranted to determine the underlying mechanisms. Please cite this article as: Rahmati M, Shamsi MM, Woo W, Koyanagi A, Lee SW, Yon DK, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, 6816785468 Khoramabad, Iran.
| | - Mahdieh Molanouri Shamsi
- Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, 1411713116 Tehran, Iran.
| | - Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Gangnam-gu, Seoul 06273, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona 08010, Spain
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Dong Keon Yon
- Medical Science Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea.
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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15
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Gil S, de Oliveira Júnior GN, Sarti FM, Filho WJ, Longobardi I, Turri JAO, Shinjo SK, Ferriolli E, Avelino-Silva TJ, Busse AL, Gualano B, Roschel H. Acute Muscle Mass Loss Predicts Long-Term Fatigue, Myalgia, and Health Care Costs in COVID-19 Survivors. J Am Med Dir Assoc 2023; 24:10-16. [PMID: 36493804 PMCID: PMC9682050 DOI: 10.1016/j.jamda.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We examined the impact of loss of skeletal muscle mass in post-acute sequelae of SARS-CoV-2 infection, hospital readmission rate, self-perception of health, and health care costs in a cohort of COVID-19 survivors. DESIGN Prospective observational study. SETTING AND PARTICIPANTS Tertiary Clinical Hospital. Eighty COVID-19 survivors age 59 ± 14 years were prospectively assessed. METHODS Handgrip strength and vastus lateralis muscle cross-sectional area were evaluated at hospital admission, discharge, and 6 months after discharge. Post-acute sequelae of SARS-CoV-2 were evaluated 6 months after discharge (main outcome). Also, health care costs, hospital readmission rate, and self-perception of health were evaluated 2 and 6 months after hospital discharge. To examine whether the magnitude of muscle mass loss impacts the outcomes, we ranked patients according to relative vastus lateralis muscle cross-sectional area reduction during hospital stay into either "high muscle loss" (-18 ± 11%) or "low muscle loss" (-4 ± 2%) group, based on median values. RESULTS High muscle loss group showed greater prevalence of fatigue (76% vs 46%, P = .0337) and myalgia (66% vs 36%, P = .0388), and lower muscle mass (-8% vs 3%, P < .0001) than low muscle loss group 6 months after discharge. No between-group difference was observed for hospital readmission and self-perceived health (P > .05). High muscle loss group demonstrated greater total COVID-19-related health care costs 2 ($77,283.87 vs. $3057.14, P = .0223, respectively) and 6 months ($90,001.35 vs $12, 913.27, P = .0210, respectively) after discharge vs low muscle loss group. Muscle mass loss was shown to be a predictor of total COVID-19-related health care costs at 2 (adjusted β = $10, 070.81, P < .0001) and 6 months after discharge (adjusted β = $9885.63, P < .0001). CONCLUSIONS AND IMPLICATIONS COVID-19 survivors experiencing high muscle mass loss during hospital stay fail to fully recover muscle health. In addition, greater muscle loss was associated with a higher frequency of post-acute sequelae of SARS-CoV-2 and greater total COVID-19-related health care costs 2 and 6 months after discharge. Altogether, these data suggest that the loss of muscle mass resulting from COVID-19 hospitalization may incur in an economical burden to health care systems.
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Affiliation(s)
- Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Gersiel Nascimento de Oliveira Júnior
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Flavia Mori Sarti
- School of Arts, Sciences and Humanities, University of São Paulo (USP), São Paulo, Brazil, SP, BR
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Igor Longobardi
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | - Samuel Katsuyuki Shinjo
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Eduardo Ferriolli
- Division of Internal and Geriatric Medicine, Department of Internal Medicine - Ribeirão Preto Medical School, Universidade de Sao Paulo, Ribeirao Preto, SP, BR
| | - Thiago Junqueira Avelino-Silva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
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16
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Morandi A, Gual N, Cesari M, Mota M, Buttò V, Gentile S, Balestreri G, Camussi A, Platto C, Roig T, de Andrés AM, Bellelli G, Inzitari M. Geriatric syndromes and functions in older adults with COVID-19 hospitalized in sub-acute care: a multicenter study. Aging Clin Exp Res 2023; 35:221-226. [PMID: 36280623 PMCID: PMC9591316 DOI: 10.1007/s40520-022-02264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Alternatives to conventional acute hospitalizations have been particularly useful during the COVID-19 pandemic. However, little is known on the management and outcomes of COVID-19 in older patient admitted to non-acute settings. The main aim of this study was to determine the effect of geriatrics syndromes on functional outcomes in older COVID-19 patients cared in sub-acute units. METHODS Prospective multicenter observational cohort study of patients aged 65 years and older with COVID-19, admitted to sub-acute units in Italy and Spain. Multivariable logistic regression models were used to test the association between geriatric syndromes and other clinical variables, and the functional status at discharge, defined by a Barthel Index > = 80. RESULTS A total of 158 patients were included in the study with a median age of 82 [Interquartile Range 81, 83]; of these 102 (65%) patients had a Barthel Index ≥ 80 at discharge. In the main multivariable logistic regression model a higher severity of frailty-measured with the Clinical Frailty Scale-(OR 0.30; CI 0.18-0.47), and the presence of delirium (OR 0.04; CI 0.00-0.35) at admission were associated with lower odds of a higher functional status at discharge. Other variables associated with lower functional status were female gender (OR 0.36; CI 0.13-0.96), and a higher number of comorbidities (OR 0.48; CI 0.26-0.82). CONCLUSION The study reports a relatively high prevalence of functional recovery for older COVID-19 patients admitted to sub-acute units. Additionally, it underlines the importance of targeting geriatrics syndromes, in particular frailty and delirium, for their possible effects on functional recovery.
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Affiliation(s)
- Alessandro Morandi
- Azienda Speciale Cremona Solidale, Via Zocco 21, 26100, Cremona, Italy.
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain.
| | - Neus Gual
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Matteo Cesari
- IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Miriam Mota
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Valeria Buttò
- Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
| | - Simona Gentile
- Azienda Speciale Cremona Solidale, Via Zocco 21, 26100, Cremona, Italy
| | - Genny Balestreri
- Geriatric Clinic Unit, University-Hospital of Parma, Parma, Italy
| | - Alessandro Camussi
- Ginecologia, Dipartimento Materno Infantile, ISSR Sa Raffaele, Milan, Italy
| | - Caterina Platto
- Department of Internal Medicine, ASST Cremona, Cremona, Italy
| | - Thais Roig
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Ana M de Andrés
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Giuseppe Bellelli
- Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Inzitari
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
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17
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de Azevedo HMJ, dos Santos NWF, Lafetá ML, de Albuquerque ALP, Tanni SE, Sperandio PA, Ferreira EVM. Persistence of symptoms and return to work after hospitalization for COVID-19. J Bras Pneumol 2022; 48:e20220194. [PMID: 36449816 PMCID: PMC9747179 DOI: 10.36416/1806-3756/e20220194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/16/2022] [Indexed: 11/12/2022] Open
Abstract
Many patients hospitalized with COVID-19 were unable to return to work or their return was delayed due to their health condition. The aim of this observational study was to evaluate the impact of moderate-to-severe and critical COVID-19 infection on persistence of symptoms and return to work after hospital discharge. In this study, two thirds of hospitalized patients with pulmonary involvement reported persistence of symptoms six months after COVID-19 infection, such as memory loss (45.5%), myalgia (43.9%), fatigue (39.4%), and dyspnea (25.8%), and 50% slowly returned to work, with repercussions due to fatigue and/or loss of energy.
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Affiliation(s)
- Helena Moraes Jardim de Azevedo
- . Faculdades Metropolitanas Unidas, São Paulo (SP) Brasil
- . Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, - EPM/Unifesp - São Paulo (SP) Brasil
| | - Nataly Winni Fernandes dos Santos
- . Faculdades Metropolitanas Unidas, São Paulo (SP) Brasil
- . Setor de Função Pulmonar e Fisiologia Clínica do Exercício - SEFICE - Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, - EPM/Unifesp - São Paulo (SP) Brasil
| | - Mariana Lima Lafetá
- . Setor de Função Pulmonar e Fisiologia Clínica do Exercício - SEFICE - Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, - EPM/Unifesp - São Paulo (SP) Brasil
| | - André Luis Pereira de Albuquerque
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Suzana Erico Tanni
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu (SP) Brasil
| | - Priscila Abreu Sperandio
- . Setor de Função Pulmonar e Fisiologia Clínica do Exercício - SEFICE - Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, - EPM/Unifesp - São Paulo (SP) Brasil
| | - Eloara Vieira Machado Ferreira
- . Setor de Função Pulmonar e Fisiologia Clínica do Exercício - SEFICE - Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, - EPM/Unifesp - São Paulo (SP) Brasil
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18
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Yang J, Li X, He T, Ju F, Qiu Y, Tian Z. Impact of Physical Activity on COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114108. [PMID: 36360985 PMCID: PMC9657212 DOI: 10.3390/ijerph192114108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seriously endangering human health worldwide. This study finds effective intervention modalities of physical activity on COVID-19 through a narrative review. METHODS In this study, 41 papers were selected for a narrative literature review after a comprehensive database search from 20 December 2019, to 30 August 2022. RESULTS 41 articles meet the established criteria, and in this review, we comprehensively describe recent studies on exercise and COVID-19, including the impact and recommendations of exercise on COVID-19 prevention, patients with COVID-19, and noninfected populations. CONCLUSIONS The literature suggests that physical activity (PA) contributes to the prevention and treatment of COVID-19, can promote recovery of physical function, alleviate post-acute COVID-19 syndrome, and improve patients' psychological well-being. It is recommended to develop appropriate exercise prescriptions for different populations under the guidance of a physician.
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Affiliation(s)
- Jia Yang
- College of Physical Education, Hunan University, Changsha 410012, China
| | - Xiang Li
- College of Physical Education, Hunan University, Changsha 410012, China
| | - Taiyu He
- Chongqing Medical University, Chongqing 400016, China
| | - Fangyuan Ju
- College of Physical Education, Yangzhou University, Yangzhou 225012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
| | - Ye Qiu
- College of Biology, Hunan University, Changsha 410012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
| | - Zuguo Tian
- College of Physical Education, Hunan University, Changsha 410012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
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19
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Wimmer C, Egger M, Bergmann J, Huge V, Müller F, Jahn K. Critical COVID-19 disease: Clinical course and rehabilitation of neurological deficits. Front Neurol 2022; 13:1012685. [PMID: 36388208 PMCID: PMC9649895 DOI: 10.3389/fneur.2022.1012685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The COVID-19 disease frequently causes neurological symptoms. Critically ill patients often require neurorehabilitation for manifestations like intensive care unit (ICU) acquired weakness or encephalopathy. The outcome of these patients, however, is largely unknown. Here we report the clinical course of critical affected COVID-19 patients from hospital admission to discharge from inpatient neurorehabilitation. METHODS Prospective cohort study. COVID-19 patients admitted to neurorehabilitation were included based on a laboratory-confirmed SARS-CoV-2 infection. Assessments [modified Rankin Scale (mRS), Barthel-Index, Fatigue-Severity-Scale-7 and health-related quality of life (EQ-5D-5L)] were conducted at admission and before discharge from inpatient care. Data were compared to the preclinical health status. RESULTS Sixty-one patients (62 ± 13 years, 16 female) were included in the analysis. Most patients had been treated on ICU (n = 58; 57 ± 23 days) and had received invasive ventilation (n = 57; 46 ± 21 days). After discharge from ICU, patients spent on average 57 ± 26 days in neurorehabilitation. The most frequent neurological diagnoses were ICU-acquired weakness (n = 56) and encephalopathy (n = 23). During rehabilitation overall disability improved [mRS median (IQR) 4.0 (1.0) at inclusion and 2.0 (1.0) at discharge]. However, the preclinical health state [mRS 0.0 (0.0)] was not regained (p < 0.001). This was also reflected by the Barthel-Index [preclinical 100.0 (0.0), at inclusion 42.5 (35.0), at discharge 65.0 (7.5); p < 0.001]. Patients had only minor fatigue during inpatient care. Quality of life generally improved but was still low at discharge from hospital. CONCLUSION Patients with neurological sequelae after critical COVID-19 disease showed substantial deficits at discharge from inpatient care up to 4 months after the initial infection. They were restricted in activities of daily living and had reduced health-related quality of life. All patients needed continued medical support and physical treatment.
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Affiliation(s)
- Corinna Wimmer
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Marion Egger
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Jeannine Bergmann
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Volker Huge
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Friedemann Müller
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Klaus Jahn
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University (LMU), Munich, Germany
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20
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Llarch-Pinell E, Monsó-Monsó A, Ars J, Udina C, Inzitari M, Grau-Sánchez J. [Occupational therapy intervention to improve autonomy in individuals postinfection by SARS-CoV-2]. Rehabilitacion (Madr) 2022; 56:294-301. [PMID: 34844780 PMCID: PMC8556589 DOI: 10.1016/j.rh.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In the post-infection stage by SARS-CoV-2, the functional capacity of the person may be reduced, requiring admission to rehabilitation units. OBJECTIVE To describe an occupational therapy program to improve the level of autonomy in the rehabilitation of individuals after the infection by SARS-CoV-2. MATERIAL AND METHODS Longitudinal observational study of 36 patients admitted between April and June 2020 to an intermediate care facility for functional rehabilitation after SARS-CoV-2 infection. Participants received an occupational therapy program and their autonomy in activities of daily living was evaluated at admission and discharge. RESULTS Patients improved their autonomy in basic (P<.001) and instrumental (P<.001) activities of daily living after the treatment. However, patients but did not return to their baseline levels, especially in instrumental activities. CONCLUSIONS Rehabilitation programs that include occupational therapy are effective to improve the level of autonomy in individuals post-infection by SARS-CoV-2.
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Affiliation(s)
- E Llarch-Pinell
- Unidad de media estancia y Rehabilitación Geriátrica, Hospital de Atención Intermedia Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación RE-FiT Barcelona, Parc Sanitari Pere Virgili y Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - A Monsó-Monsó
- Unidad de media estancia y Rehabilitación Geriátrica, Hospital de Atención Intermedia Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación RE-FiT Barcelona, Parc Sanitari Pere Virgili y Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - J Ars
- Unidad de media estancia y Rehabilitación Geriátrica, Hospital de Atención Intermedia Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación RE-FiT Barcelona, Parc Sanitari Pere Virgili y Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - C Udina
- Unidad de media estancia y Rehabilitación Geriátrica, Hospital de Atención Intermedia Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación RE-FiT Barcelona, Parc Sanitari Pere Virgili y Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - M Inzitari
- Unidad de media estancia y Rehabilitación Geriátrica, Hospital de Atención Intermedia Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación RE-FiT Barcelona, Parc Sanitari Pere Virgili y Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España; Estudios de Ciencias de la Salud, Universitat Oberta de Catalunya (UOC), España
| | - J Grau-Sánchez
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa; Universidad Autónoma de Barcelona, Terrasa, Barcelona, España; Unidad de Cognición y Plasticidad Cerebral, Instituto de Investigación Biomédica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
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21
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Martínez Rolando L, Villafañe JH, Cercadillo García S, Sanz Argüello A, Villanueva Rosa M, Sánchez Romero EA. Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912396. [PMID: 36231696 PMCID: PMC9566039 DOI: 10.3390/ijerph191912396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 05/10/2023]
Abstract
COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.
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Affiliation(s)
- Lidia Martínez Rolando
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Jorge Hugo Villafañe
- IRCCS Fondazione Don Carlo Gnocchi, 20141 Milan, Italy
- Correspondence: (J.H.V.); (E.A.S.R.)
| | - Soledad Cercadillo García
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Ana Sanz Argüello
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Marta Villanueva Rosa
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Eleuterio A. Sánchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.H.V.); (E.A.S.R.)
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22
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Haunhorst S, Bloch W, Wagner H, Ellert C, Krüger K, Vilser DC, Finke K, Reuken P, Pletz MW, Stallmach A, Puta C. Long COVID: a narrative review of the clinical aftermaths of COVID-19 with a focus on the putative pathophysiology and aspects of physical activity. OXFORD OPEN IMMUNOLOGY 2022; 3:iqac006. [PMID: 36846561 PMCID: PMC9494493 DOI: 10.1093/oxfimm/iqac006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 11/14/2022] Open
Abstract
The pandemic coronavirus disease 2019 (COVID-19) can cause multi-systemic symptoms that can persist beyond the acute symptomatic phase. The post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, describe the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms and are estimated to affect at least 20% of the individuals infected with SARS-CoV-2 regardless of their acute disease severity. The multi-faceted clinical picture of long COVID encompasses a plethora of undulating clinical manifestations impacting various body systems such as fatigue, headache, attention disorder, hair loss and exercise intolerance. The physiological response to exercise testing is characterized by a reduced aerobic capacity, cardiocirculatory limitations, dysfunctional breathing patterns and an impaired ability to extract and use oxygen. Still, to this day, the causative pathophysiological mechanisms of long COVID remain to be elucidated, with long-term organ damage, immune system dysregulation and endotheliopathy being among the hypotheses discussed. Likewise, there is still a paucity of treatment options and evidence-based strategies for the management of the symptoms. In sum, this review explores different aspects of long COVID and maps the literature on what is known about its clinical manifestations, potential pathophysiological mechanisms, and treatment options.
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Affiliation(s)
- Simon Haunhorst
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena 07749, Germany,Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne 50933, Germany
| | - Heiko Wagner
- Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Claudia Ellert
- Department for Vascular Surgery, Lahn-Dill Clinics Wetzlar, Wetzlar 35578, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen 35394, Germany
| | - Daniel C Vilser
- Hospital for Pediatrics and Adolescent Medicine, Jena University Hospital, Jena 07747, Germany
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena 07747, Germany
| | - Philipp Reuken
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena 07747, Germany
| | - Andreas Stallmach
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Christian Puta
- Correspondence address. Department for Sports Medicine and Health Promotion, Friedrich-Schiller-Universität Jena, Wöllnitzer Straße 42, Jena 07749, Germany. Tel: +49 3641 9-45607; Fax: +49 3641 9-45652; E-mail:
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23
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Zasadzka E, Tobis S, Trzmiel T, Marchewka R, Kozak D, Roksela A, Pieczyńska A, Hojan K. Application of an EMG-Rehabilitation Robot in Patients with Post-Coronavirus Fatigue Syndrome (COVID-19)-A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10398. [PMID: 36012033 PMCID: PMC9407702 DOI: 10.3390/ijerph191610398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/17/2022] [Indexed: 05/27/2023]
Abstract
This pilot study aimed to assess the safety and feasibility of an EMG-driven rehabilitation robot in patients with Post-Viral Fatigue (PVF) syndrome after COVID-19. The participants were randomly assigned to two groups (IG-intervention group and CG-control group) in an inpatient neurological rehabilitation unit. Both groups were assessed on admission and after six weeks of rehabilitation. Rehabilitation was carried out six days a week for six weeks. The patients in the IG performed additional training using an EMG rehabilitation robot. Muscle fatigue was assessed using an EMG rehabilitation robot; secondary outcomes were changes in hand grip strength, Fatigue Assessment Scale, and functional assessment scales (Functional Independence Measure, Barthel Index). Both groups improved in terms of the majority of measured parameters comparing pre- and post-intervention results, except muscle fatigue. Muscle fatigue scores presented non-significant improvement in the IG and non-significant deterioration in the CG. Using an EMG rehabilitation robot in patients with PVF can be feasible and safe. To ascertain the effectiveness of such interventions, more studies are needed, particularly involving a larger sample and also assessing the participants' cognitive performance.
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Affiliation(s)
- Ewa Zasadzka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Sławomir Tobis
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Tomasz Trzmiel
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Renata Marchewka
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
| | - Dominika Kozak
- Department of Physiotherapy, University of Health Science, 85-067 Bydgoszcz, Poland
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
| | - Anna Roksela
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Anna Pieczyńska
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland
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24
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Bailly M, Pélissier L, Coudeyre E, Evrard B, Bingula R, Rochette C, Mériade L, Blavignac C, Fournier AC, Bignon YJ, Rannou F, Dutheil F, Thivel D, Duclos M. Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159025. [PMID: 35897400 PMCID: PMC9331032 DOI: 10.3390/ijerph19159025] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.
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Affiliation(s)
- Mélina Bailly
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Léna Pélissier
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
- Correspondence:
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Bertrand Evrard
- Service d’Immunologie, Centre Hospitalier Universitaire (CHU) Gabriel-Montpied, 63000 Clermont-Ferrand, France;
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Rea Bingula
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Corinne Rochette
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Laurent Mériade
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Christelle Blavignac
- Centre Imagerie Cellulaire Santé, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Anne-Cécile Fournier
- Cluster Auvergne-Rhône-Alpes Innovation Innovatherm, 63000 Clermont-Ferrand, France;
| | - Yves-Jean Bignon
- U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne, 63000 Clermont Ferrand, France;
- Département d’Oncogénétique, Centre Jean Perrin, 63011 Clermont-Ferrand, France
| | - Fabrice Rannou
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, LaPSCo, Physiological and Psychosocial Stress, Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Witty Fit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - David Thivel
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Martine Duclos
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
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25
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Cuenca-Zaldivar JN, Monroy Acevedo Á, Fernández-Carnero J, Sánchez-Romero EA, Villafañe JH, Barragán Carballar C. Effects of a Multicomponent Exercise Program on Improving Frailty in Post-COVID-19 Older Adults after Intensive Care Units: A Single-Group Retrospective Cohort Study. BIOLOGY 2022; 11:biology11071084. [PMID: 36101461 PMCID: PMC9313031 DOI: 10.3390/biology11071084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 12/21/2022]
Abstract
Background: Older adult patients with post-COVID-19 syndrome present greater physical impairment accompanied by frailty than younger patients, which is why multicomponent exercise programs (MEP) are recommended for their positive effects on improving frailty and physical capacity. The aim of this study was to evaluate the effects of a short MEP (Vivifrail; <4 weeks) on improving frailty in post-COVID-19 older adults after intensive care units. Methods: To develop a retrospective cohort study, data were collected from the functional gait training program based on selected Vivifrail MEP in a single-group and applied to patients admitted with a diagnosis of post-COVID-19 functional impairment. The MEP was carried out for 3 weeks, with daily sessions lasting 40 min. Patients included were assessed at the beginning and at the end of the protocol by using the Short Performance Physical Battery (SPPB), the number of falls in the last year, the number of falls with medical attention, the Timed Up and Go (TUG) test, the presence of dementia, the Trunk Control Test (TCT), the Tinetti balance and gait test, Barthel Index, Medical Research Council Sum Score (MRCSS) and handgrip strength dynamometry. Results: The results of this study show statistically significant improvements in physical fitness and frailty with increases in the Short Physical Performance Battery (Z = 9.12, p < 0.001) by means of the MET applied in its short version (<4 weeks) showing even clinically relevant improvements (>2.5 points). Statistically significant improvements were also found in Medical Research Council Sum Score (Z = 12.345, p < 0.001), Barthel Index Score (Z = 12.272, p < 0.001), Trunk Control Test (Z = 12. 36, p < 0.001), Tinetti−POMA (Z = 12.293, p < 0.001) including the balance (Z = 12.11, p < 0.001), gait (Z = 12.164, p < 0.001) subscales and in the hand dynamometry (Z = 12.172, p < 0.001). Conclusions: The selected Vivifrail MEP is effective and safe for improving frailty in post-COVID-19 older adult’s patients.
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Affiliation(s)
- Juan Nicolás Cuenca-Zaldivar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (J.N.C.-Z.); (Á.M.A.)
- Rehabilitation Service, Guadarrama Hospital, 28440 Madrid, Spain
| | - Álvaro Monroy Acevedo
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (J.N.C.-Z.); (Á.M.A.)
- Rehabilitation Service, Guadarrama Hospital, 28440 Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.F.-C.); (E.A.S.-R.); Tel.: +34-659-70-67-22 (J.F.-C.); +34-617-12-35-63 (E.A.S.-R.); Fax: +34-633-11-53-28 (E.A.S.-R.)
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.F.-C.); (E.A.S.-R.); Tel.: +34-659-70-67-22 (J.F.-C.); +34-617-12-35-63 (E.A.S.-R.); Fax: +34-633-11-53-28 (E.A.S.-R.)
| | | | - Carlos Barragán Carballar
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- OnelifeCenter, Multidisciplinary Center for the Prevention and Treatment of Pain, 28924 Alcorcón, Spain
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Prabawa IMY, Silakarma D, Prabawa IPY, Manuaba IBAP. Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background. Coronavirus disease 19 (COVID-19) infection has been a global pandemic since late 2019. Clinical manifestation ranges from mild to severe. Even though most COVID-19 patients recover fully from the disease, approximately 5–10% experience prolonged symptoms for several months following the acute COVID-19 phase, defined as long COVID-19 syndrome. Rehabilitation therapy is needed for them to overcome their symptoms and improve their functional capacity. This systematic review aims to discuss rehabilitation therapy for a patient with long COVID-19 syndrome.
Method. A systematic review using PubMed and Google Scholar was conducted based on PRISMA guidelines. Inclusion criteria were study about rehabilitation therapy for long COVID-19 patients. Exclusion criteria were letters to the editor, editorial or commentary reports, and studies not available in full-text and not in English or Bahasa.
Result. Nine studies are included in this systematic review consisting of two consensus statements or recommendations, one cohort retrospective study, two case studies or case reports, one review and three experimental studies. The recommended rehabilitation program pathway using a three-tier model depends on the severity of the disease. Several rehabilitation exercises for long COVID patients include cardiorespiratory rehabilitation, breathing exercise, therapeutic exercise, and even traditional Chinese fitness models such as Liuzijue exercise.
Conclusion. Rehabilitation therapy exercise helps to improve the patient's breathing effort, improving dyspnea and muscle strength.
Keywords: long COVID-19 syndrome, physical rehabilitation, post-COVID-19 infection, rehabilitation therapy
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Rolin S, Chakales A, Verduzco-Gutierrez M. Rehabilitation Strategies for Cognitive and Neuropsychiatric Manifestations of COVID-19. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022; 10:182-187. [PMID: 35602927 PMCID: PMC9107067 DOI: 10.1007/s40141-022-00352-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2022] [Indexed: 01/08/2023]
Affiliation(s)
- Summer Rolin
- Department of Rehabilitation Medicine, Joe R. and Teresa Lozano Long School of Medicine at the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MC7798, San Antonio, TX 78229 USA
| | - Ashley Chakales
- Joe R. and Teresa Lozano Long School of Medicine at the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MC7798, San Antonio, TX 78229 USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, Joe R. and Teresa Lozano Long School of Medicine at the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MC7798, San Antonio, TX 78229 USA
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Cerasola D, Argano C, Corrao S. Lessons From COVID-19: Physical Exercise Can Improve and Optimize Health Status. Front Med (Lausanne) 2022; 9:834844. [PMID: 35646959 PMCID: PMC9136917 DOI: 10.3389/fmed.2022.834844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19) has caused increasing challenges for healthcare systems globally. The disease spread rapidly from Wuhan to the rest of the world, involving more than 400 million individuals and including more than 5 million deaths. In dealing with the pandemic, China and other countries took protective measures such as promoting social distancing, canceling public gatherings, closing schools, quarantining, and imposing lockdowns. All these measures lead to physical inactivity. Being physically inactive has significant repercussions on the status of physical and mental wellbeing, and it is associated with anxiety, stress, increased chronic disease risk, and worsening of chronic conditions. In this sense, the relevance of maintaining a healthy lifestyle through physical exercise has been outlined by the World Health Organization (WHO). The aim of this mini review is to discuss the importance of physical activity in the context of the COVID-19 pandemic, highlighting the benefits of physical activity and exercise that could be potentially effective treatment strategies for comorbid chronic conditions, long covid syndrome (LCS), and symptoms such as depression and anxiety.
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Affiliation(s)
- Dario Cerasola
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Christiano Argano
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G.D'Alessandro”, PROMISE, University of Palermo, Palermo, Italy
- Internal Medicine COVID-19 Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Salvatore Corrao
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G.D'Alessandro”, PROMISE, University of Palermo, Palermo, Italy
- Internal Medicine COVID-19 Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
- *Correspondence: Salvatore Corrao
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Barman A, Sinha MK, Sahoo J, Jena D, Patel V. Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis. Heart Lung 2022; 53:11-24. [PMID: 35108624 PMCID: PMC8758335 DOI: 10.1016/j.hrtlng.2022.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/29/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND With an increase in published reports on respiratory rehabilitation (RR) in severe acute respiratory syndrome (SARS), there is a need for a meta-analysis and systematic review to measure the effects of the RR in SARS. OBJECTIVE Objective of the review was to evaluate the efficacy and safety of RR in patients recovering from SARS. METHODS PubMed/ MEDLINE, CENTRAL, EMBASE, and Clinical Trial Registries were systematically searched (between January 1, 2003, to July 31, 2021) to identify all patients who received RR, at least for six days, following SARS. The primary outcome was exercise capacity [6-meter walking distance (6-MWD)], and secondary outcomes were change in pulmonary function test (PFT) parameters, activities in daily livings (ADLs), and quality of life (QoL). Meta-analysis was performed by using RevMan 5.4. RESULTS Twenty-one observational studies, including eight comparative studies, were included. Eight comparative studies participated in quantitative meta-analysis. The intervention group, who received RR, improved significantly in exercise capacity (6-MWD) [mean difference (MD):45.79, (95% CI:31.66-59.92)] and PFT parameters, especially in forced vital capacity (FVC%) [MD:4.38, (95% CI:0.15-8.60)], and diffusion lung capacity for carbon monoxide (DLCO%) [MD:11.78, (95% CI:5.10-18.46)]. The intervention group failed to demonstrate significant improvement in ADLs and QoL outcomes. No significant adverse events were reported during the intervention. CONCLUSION Respiratory rehabilitation can improve exercise capacity and PFT parameters in patients recovering from SARS infection. The RR does not cause serious adverse events. Clinical trials to determine the best RR program (in terms of initiation, duration, and components) in SARS and its treatment efficacy, both in the short and long- term are needed.
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Affiliation(s)
- Apurba Barman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Mithilesh K Sinha
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jagannatha Sahoo
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Debasish Jena
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Vikas Patel
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
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Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042290. [PMID: 35206483 PMCID: PMC8871540 DOI: 10.3390/ijerph19042290] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023]
Abstract
Millions of people worldwide are infected with COVID-19, and COVID-19 survivors have been found to suffer from functional disabilities and mental disorders such as depression and anxiety. This is a matter of concern because COVID-19 is still not over. Because reinfection is still possible in COVID-19 survivors, decreased physical function and increased stress and anxiety can lower immune function. However, the optimal exercise intensity and volume appear to remain unknown. Therefore, the current systematic review aimed to evaluate the effect of resistance or aerobic exercises in post-COVID-19 patients after hospital discharge. We conducted searches in the Scopus, SciELO, PubMed, Web of Science, Science Direct, and Google Scholar databases. Studies that met the following criteria were included: (i) English language, (ii) patients with COVID-19 involved with resistance or aerobic exercise programs after hospital discharge. Out of 381 studies reviewed, seven studies met the inclusion criteria. Evidence shows that exercise programs composed of resistance exercise (e.g., 1–2 sets of 8–10 repetitions at 30–80% of 1RM) along with aerobic exercise (e.g., 5 to 30 min at moderate intensity) may improve the functional capacity and quality of life (reduce stress and mental disorders) in post-COVID-19 patients. In addition, only one study reported reinfection of three subjects involved with the exercise program, suggesting that exercise programs may be feasible for the rehabilitation of the patients. A meta-analysis was not conducted because the included studies have methodological heterogeneities, and they did not examine a control group. Consequently, the results should be generalized with caution.
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Baker FL, Smith KA, Zúñiga TM, Batatinha H, Niemiro GM, Pedlar CR, Burgess SC, Katsanis E, Simpson RJ. Acute exercise increases immune responses to SARS CoV-2 in a previously infected man. Brain Behav Immun Health 2021; 18:100343. [PMID: 34514439 PMCID: PMC8423674 DOI: 10.1016/j.bbih.2021.100343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.
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Affiliation(s)
- Forrest L. Baker
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Kyle A. Smith
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Tiffany M. Zúñiga
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Helena Batatinha
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Grace M. Niemiro
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Charles R. Pedlar
- Faculty of Sport, Health and Applied Performance Science, St. Mary's University, London, United Kingdom
| | - Shane C. Burgess
- Department of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Pathology, University of Arizona, Tucson, AZ, United States
| | - Richard J. Simpson
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
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Musheyev B, Janowicz R, Borg L, Matarlo M, Boyle H, Hou W, Duong TQ. Characterizing non-critically ill COVID-19 survivors with and without in-hospital rehabilitation. Sci Rep 2021; 11:21039. [PMID: 34702883 PMCID: PMC8548441 DOI: 10.1038/s41598-021-00246-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 10/05/2021] [Indexed: 12/16/2022] Open
Abstract
This study investigated pre-COVID-19 admission dependency, discharge assistive equipment, discharge medical follow-up recommendation, and functional status at hospital discharge of non-critically ill COVID-19 survivors, stratified by those with (N = 155) and without (N = 162) in-hospital rehabilitation. “Mental Status”, intensive-care-unit (ICU) Mobility, and modified Barthel Index scores were assessed at hospital discharge. Relative to the non-rehabilitation patients, rehabilitation patients were older, had more comorbidities, worse pre-admission dependency, were discharged with more assistive equipment and supplemental oxygen, spent more days in the hospital, and had more hospital-acquired acute kidney injury, acute respiratory failure, and more follow-up referrals (p < 0.05 for all). Cardiology, vascular medicine, urology, and endocrinology were amongst the top referrals. Functional scores of many non-critically ill COVID-19 survivors were abnormal at discharge (p < 0.05) and were associated with pre-admission dependency (p < 0.05). Some functional scores were negatively correlated with age, hypertension, coronary artery disease, chronic kidney disease, psychiatric disease, anemia, and neurological disorders (p < 0.05). In-hospital rehabilitation providing restorative therapies and assisting discharge planning were challenging in COVID-19 circumstances. Knowledge of the functional status, discharge assistive equipment, and follow-up medical recommendations at discharge could enable appropriate and timely post-discharge care. Follow-up studies of COVID-19 survivors are warranted as many will likely have significant post-acute COVID-19 sequela.
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Affiliation(s)
- Benjamin Musheyev
- Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY, 10467, USA.,Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, NY, USA
| | - Rebeca Janowicz
- Department of Physical and Occupational Therapy, Renaissance School of Medicine at Stony Brook Medicine, Stony Brook, NY, USA
| | - Lara Borg
- Department of Physical and Occupational Therapy, Renaissance School of Medicine at Stony Brook Medicine, Stony Brook, NY, USA
| | - Michael Matarlo
- Department of Physical and Occupational Therapy, Renaissance School of Medicine at Stony Brook Medicine, Stony Brook, NY, USA
| | - Hayle Boyle
- Department of Physical and Occupational Therapy, Renaissance School of Medicine at Stony Brook Medicine, Stony Brook, NY, USA
| | - Wei Hou
- Department of Family, Population and Preventative Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
| | - Tim Q Duong
- Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY, 10467, USA.
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Piotrowicz K, Gąsowski J, Michel JP, Veronese N. Post-COVID-19 acute sarcopenia: physiopathology and management. Aging Clin Exp Res 2021; 33:2887-2898. [PMID: 34328636 PMCID: PMC8323089 DOI: 10.1007/s40520-021-01942-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022]
Abstract
In this review, we discuss the pathophysiologic and management aspects of acute sarcopenia in relation to SARS-CoV-2 infection. COVID-19 is as a multi-organ infectious disease characterized by a severe inflammatory and highly catabolic status, influencing the deep changes in the body build, especially the amount, structure, and function of skeletal muscles which would amount to acutely developed sarcopenia. Acute sarcopenia may largely impact patients’ in-hospital prognosis as well as the vulnerability to the post-COVID-19 functional and physical deterioration. The individual outcome of the COVID-19 and the degree of muscle mass and functional loss may be influenced by multiple factors, including the patient’s general pre-infection medical and functional condition, especially in older adults. This paper gathers the information about how the SARS-CoV-2 hyper-inflammatory involvement exacerbates the immunosenescence process, enhances the endothelial damage, and due to mitochondrial dysfunction and autophagy, induces myofibrillar breakdown and muscle degradation. The aftermath of these acute and complex immunological SARS-CoV-2-related phenomena, augmented by anosmia, ageusia and altered microbiota may lead to decreased food intake and exacerbated catabolism. Moreover, the imposed physical inactivity, lock-down, quarantine or acute hospitalization with bedrest would intensify the acute sarcopenia process. All these deleterious mechanisms must be swiftly put to a check by a multidisciplinary approach including nutritional support, early physical as well cardio-pulmonary rehabilitation, and psychological support and cognitive training. The proposed holistic and early management of COVID-19 patients appears essential to minimize the disastrous functional outcomes of this disease and allow avoiding the long COVID-19 syndrome.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland.
| | | | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
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Shirado K, Furuno Y, Kanamaru K, Kawabata N, Okuno S, Yamashita T. Effect of Rehabilitation Nutrition on a Post-Acute Severe COVID-19 Patient: A Case Report. Healthcare (Basel) 2021; 9:healthcare9081034. [PMID: 34442171 PMCID: PMC8394625 DOI: 10.3390/healthcare9081034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) may lead to post-acute physical function deterioration due to intensive-care-unit-acquired weakness-related sarcopenia and dyspnea. Limited reports have examined the effects of rehabilitation and nutritional therapy on patients with post-acute COVID-19. We present the case of a 67-year-old man, who was admitted for the treatment of post-acute severe COVID-19, who benefited from rehabilitation nutrition. When the patient's condition stabilized, sarcopenia and malnutrition were observed, and rehabilitation nutrition was implemented. The physical therapist implemented a program focused mainly on resistance training and aerobic exercise, and the dietitian provided oral nutritional supplements and hospital food that met the patient's energy and protein intake requirements. Comparing the initial evaluations with those at discharge, factors affecting nutritional status, such as body mass index and skeletal muscle mass index, and physical functions, such as grip strength and walking speed, and dyspnea, had improved. The patient was discharged and returned to work. This case suggests improvements in the nutritional status and physical functions of post-acute severe COVID-19 patients by interventions following rehabilitation nutrition.
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Affiliation(s)
- Kengo Shirado
- Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan; (Y.F.); (N.K.); (S.O.); (T.Y.)
- Correspondence: ; Tel.: +81-44-844-3333
| | - Yuji Furuno
- Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan; (Y.F.); (N.K.); (S.O.); (T.Y.)
| | - Kozue Kanamaru
- Department of Nutrition, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan;
| | - Naoto Kawabata
- Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan; (Y.F.); (N.K.); (S.O.); (T.Y.)
| | - Shota Okuno
- Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan; (Y.F.); (N.K.); (S.O.); (T.Y.)
| | - Toshihiro Yamashita
- Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-8505, Japan; (Y.F.); (N.K.); (S.O.); (T.Y.)
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Andrenelli E, Negrini F, de Sire A, Patrini M, Lazzarini SG, Ceravolo MG. Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of February 28, 2021. Eur J Phys Rehabil Med 2021; 57:481-484. [PMID: 33861041 DOI: 10.23736/s1973-9087.21.06995-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Elisa Andrenelli
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy -
| | | | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia, " Catanzaro, Italy
| | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
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