Objective
To determine the benefits associated with brief inpatient rehabilitation for Covid-19 patients.
Design
Retrospective chart review.
Setting
A newly created specialized rehabilitation unit in a tertiary care medical center
Participants
Consecutive sample of the first 100 patients with Covid-19 infection admitted to rehabilitation.
Intervention
Inpatient rehabilitation for post-acute care Covid-19 patients
Main Outcome Measures
Measurements, at admission and discharge, comprised a Barthel Activities of Daily Living Index (including baseline value before Covid-19 infection), time to perform 10 sit-to-stands with associated cardio-respiratory changes, and grip strength (dynamometry). Correlations between these outcomes and the time spent in ICU were explored.
Results
Patient characteristics upon admission to rehabilitation were: men 66%, age 66±22 years, mean delay from symptom onset 20.4±10.0 days, BMI 26.0±5.4 kg/m
2
, hypertension 49%, diabetes 29%, with 26% having >50% pulmonary damage on CT-scans. Mean length of rehabilitation stay was 9.8±5.6 days. From admission to discharge, the Barthel index (/100) increased from 77.3±26.7 to 88.8±24.5 (
p
<0.001), without recovering baseline values (94.5±16.2;
p
<0.001). There was a 37% improvement in sit-to-stand frequency (0.27±0.16 to 0.37±0.16 Hz;
p
<0.001), a 13% decrease in post-test respiratory rate (30.7±12.6 to 26.6±6.1;
p
=0.03), and a 15% increase in grip strength (18.1±9.2 to 20.9±8.9 kg;
p
<0.001). At both admission and discharge, Barthel score correlated with grip strength (rho=0.39-0.66;
p
<0.01), which negatively correlated with time spent in ICU (rho=-0.57 to -0.49,
p
<0.05).
Conclusions
Inpatient rehabilitation for Covid-19 patients was associated with substantial motor, respiratory and functional improvement, especially in severe cases, even though there remained mild persistent autonomy loss upon discharge. Following acute stages, Covid-19, primarily a respiratory disease, might convert into a motor impairment correlated with the time spent in intensive care.
Background: Adolescent idiopathic scoliosis is characterized by a three-dimensional deviation of the vertebral column and its etiopathogenesis is unknown. Various factors cause idiopathic scoliosis, and among these a prominent role has been attributed to the vestibular system. While the deficits in sensorimotor transformations have been documented in idiopathic scoliosis patients, little attention has been devoted to their capacity to integrate vestibular information for cognitive processing for space perception. Seated idiopathic scoliosis patients and control subjects experienced rotations of different directions and amplitudes in the dark and produced saccades that would reproduce their perceived spatial characteristics of the rotations (vestibular condition). We also controlled for possible alteration of the oculomotor and vestibular systems by measuring the subject's accuracy in producing saccades towards memorized peripheral targets in absence of body rotation and the gain of their vestibulo-ocular reflex.
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