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Miner D, Smith K, Wu PT, Price JH, Piscitelli D, Chui K. Pragmatic approach to mobilizing individuals with critical illness due to COVID-19: clinical perspective. Disabil Rehabil 2024; 46:4040-4048. [PMID: 37752855 DOI: 10.1080/09638288.2023.2263370] [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: 06/01/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To provide pragmatic guidance for acute rehabilitation management and implementation of early mobility for individuals with critical illness due to COVID-19. METHODS Clinical perspective developed through reflective clinical practice and narrative review of best available evidence. RESULTS Current clinical practice guidelines do not provide guidance for implementation of early mobility interventions for individuals with critical illness due to COVID-19 who require enhanced ventilatory support or support of inhaled pulmonary artery vasodilators. Many individuals who may benefit from implementation of early mobility interventions are excluded by strict interpretation of current guidelines. CONCLUSIONS Risk vs benefit of implementing early mobility interventions in individuals with critical illness due to COVID-19 can be mitigated through coordinated efforts of interdisciplinary teams to promote shared decision-making through therapeutic alliances with patients and their families. Clinicians must clearly define the goals of care, understand the limitations of monitoring equipment in the intensive care unit, prepare to titrate levels of oxygen based on an individual's physiologic response to mobility interventions, and help individuals maintain external goal-directed focus of attention to optimize outcomes of early mobility interventions.
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Affiliation(s)
- Daniel Miner
- Department of Physical Therapy, Carilion Clinic, Radford University Carilion, Radford, VA, USA
| | - Kellen Smith
- Department of Physical Therapy, Carilion Clinic, Radford University, Roanoke, VA, USA
| | - Pei-Tzu Wu
- Department of Physical Therapy, Pacific University, Hillsboro, OR, USA
| | - Justin H Price
- Carilion Clinic, VA Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Daniele Piscitelli
- Department of Physical Therapy, University of Connecticut, Storrs, CT, USA
| | - Kevin Chui
- Department of Physical Therapy, Radford University, Radford, VA, USA
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Rodrigues IM, Lima AG, dos Santos AE, Santos ACA, do Nascimento LS, Serra MVCL, Pereira TDJS, Barbosa FDS, Seixas VM, Monte-Silva K, Scipioni KRDDS, da Cruz DMC, Piscitelli D, Goffredo M, Gois-Junior MB, Zanona ADF. A Single Session of Virtual Reality Improved Tiredness, Shortness of Breath, Anxiety, Depression and Well-Being in Hospitalized Individuals with COVID-19: A Randomized Clinical Trial. J Pers Med 2022; 12:829. [PMID: 35629250 PMCID: PMC9143462 DOI: 10.3390/jpm12050829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) has been used. However, whether patients hospitalized for COVID-19 can benefit from this intervention remains unclear. Therefore, this study aimed to investigate whether VR contributes to the control of pain symptoms, the sensation of dyspnea, perception of well-being, anxiety, and depression in patients hospitalized with COVID-19. METHODS A randomized, double-blind clinical trial was designed. Patients underwent a single session of VR and usual care. The experimental group (n = 22) received VR content to promote relaxation, distraction, and stress relief, whereas the control group (n = 22) received non-specific VR content. RESULTS The experimental group reported a significant decrease in tiredness, shortness of breath, anxiety, and an increase in the feeling of well-being, whereas the control group showed improvement only in the tiredness and anxiety. CONCLUSIONS VR is a resource that may improve the symptoms of tiredness, shortness of breath, anxiety, and depression in patients hospitalized with COVID-19. Future studies should investigate the effect of multiple VR sessions on individuals with COVID-19.
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Affiliation(s)
- Isabele Moraes Rodrigues
- Department of Occupational Therapy, Universidade Federal de Sergipe, Lagarto 49400-000, SE, Brazil; (I.M.R.); (A.d.F.Z.)
| | - Adriana Gomes Lima
- Occupational Therapy Service, Hospital Universitário Lagarto, Lagarto 49400-000, SE, Brazil; (A.G.L.); (F.D.S.B.)
| | - Ana Evelyn dos Santos
- Occupational Therapy Service, Hospital Regional Dr. Jessé Fontes, Estância 49400-000, SE, Brazil;
| | | | - Luciana Silva do Nascimento
- Occupational Therapy Service, Hospital Getúlio Vargas, Recife 49095-000, PE, Brazil; (L.S.d.N.); (M.V.C.L.S.)
| | | | | | - Felipe Douglas Silva Barbosa
- Occupational Therapy Service, Hospital Universitário Lagarto, Lagarto 49400-000, SE, Brazil; (A.G.L.); (F.D.S.B.)
| | | | - Katia Monte-Silva
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife 50670-901, PE, Brazil;
| | | | - Daniel Marinho Cezar da Cruz
- Occupational Therapy (Pre-Registration) Programme, School of Health, Leeds Beckett University, Leeds LS1 3HE, UK;
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy;
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
| | - Miburge Bolivar Gois-Junior
- Laboratory of Motor Control and Body Balance (LCMEP), Center for Health Science, Universidade Federal de Sergipe, Aracaju 49400-000, SE, Brazil;
| | - Aristela de Freitas Zanona
- Department of Occupational Therapy, Universidade Federal de Sergipe, Lagarto 49400-000, SE, Brazil; (I.M.R.); (A.d.F.Z.)
- Postgraduate Program in Applied Health Sciences (PPGCAS), Lagarto 49400-000, SE, Brazil;
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