BACKGROUND The recovery after prolonged immobilization during hospitalization because of COVID-19 is the primary goal of moderate to severe COVID-19 rehabilitation. Lower extremity muscle function assessment after immobilization is needed before starting mobilization. Hence, this study aimed to evaluate the feasibility of the modified 30-second sit-to-stand test (m30STS) as one of the prospective tools of functional capacity assessment in moderate COVID-19. METHODS This cross-sectional study recruited the subjects consecutively. All eligible subjects with oxygen saturation (SaO2) ≥95% with or without oxygen supplementation performed the m30STS following the Bohannon’s guidelines. The score of m30STS was calculated based on the number of stands completed within 30 sec. A higher score of the m30STS indicated better lower extremity function. RESULTS Mean score of m30STS was 13.3. No subjects had oxygen desaturation or increased heart rate, and no fall incidents occurred. CONCLUSIONS The m30STS is feasible and safe to evaluate lower extremity for moderate COVID-19 patients with SaO2 >95%. The absence of oxygen desaturation and increase in heart rate showed no increased oxygen consumption during the test.

Background: COVID-19 affects the multiorgan system, mostly the respiratory system. Symptoms might vary from upper respiratory manifestation to acute respiratory distress syndrome, with the main feature being impairment of gas exchange. This pulmonary impairment might lead to a decrease in functional capacity, which cause activity limitation. Thus, COVID-19 patient requires the right pulmonary rehabilitation strategy to improve pulmonary function and prevent further pulmonary complications. This study aimed to compare the effectiveness of incentive spirometry and diaphragm breathing exercise on cardiorespiratory functional capacity in COVID-19 patients. Methods: Subjects were divided into two groups of breathing exercises, the incentive spirometry group and the diaphragm breathing exercise group. They performed breathing exercises for 5 days, and the functional capacity was measured by a test named 4-meter gait time test (4MGT) and 30 sit-to-stand test (30STS). The test was taken before and after performing breathing exercises. Results: These two respiratory exercises significantly affected the functional capacity in a good manner (p < 0.05). The incentive spirometry had improved 30STS (P = 0.763) and 4MGT results (P = 0.674), as well as diaphragm breathing exercise did to 30STS (P = 0.456) and 4MGS (P = 0.441). Conclusion: In conclusion, diaphragm breathing exercises and incentive spirometry improved the functional capacity of COVID-19 patients. However, incentive spirometry showed a larger effect on 30STS and 4MGT compared to diaphragm breathing exercises.

Multiple System Atrophy (MSA) is a progressive neurodegenerative disorder with various symptoms that propose impaired muscle performance and loss of balance. A male 65 year old complaining of fatigue easily and dizziness when doing activities. He had walking difculty and limb weakness. The 6-minute walk test (6MWT) showed impaired cardiorespiratory tness with shortened walking distance and reduced maximal oxygen uptake (VO2max: 5,39, METs: 1,54). Moreover, there was decreasing thorax expansion (2-1.5-2.5), and balance instability measured by lower Time Up and Go test (17) and Berg Balance test (49). Cardiorespiratory Rehabilitation programs focus on physical therapy (passive and active strengthening exercise, treadmill aerobic cardiorespiratory exercise) and home program exercises. Three months after therapy, there were signicant improvement in cardiorespiratory tness characterized by improving VO2max (VO2max 9.07, Mets 2.59), increased thoracic expansion (2-4-4) and improving balance stability (TUG 11 s) although overall BBS score was reduced (45).

The radial nerve divides into two terminal branches the superficial radial nerve and the posterior interosseous nerve. Posterior interosseous nerve entrapment is associated with weakness in the extension of fingers, atrophy of the forearm muscles, and localized pain in the lateral aspect of the elbow and proximal forearm without sensory deficits. A 37-year-old man complained of difficulty of right finger extension (MMT 2) and persistent pain (VAS 5) at the forearm after a fall from a motorcycle six months before admission. We treated the patient with a physical rehabilitation program for three months and a total of 12 visits. Sonography and electromyography (EMG) biofeedback were performed to evaluate improvement after the physical rehabilitation program. After three months, the pain was relieved, and forearm extensor muscle strength increased. This showed that sonography and EMG biofeedback play a role in the detection and evaluation of muscle and nerve abnormality due to posterior interosseous nerve (PIN) syndrome.

Metastatic spinal disease is considered a terminal stage of primary cancer and palliative treatment focuses around symptom control and reducing spinal complications such as cord compression. A 60 years man with complete spinal cord injury AIS A post laminectomy with Th2-Th4 decompression and tumor biopsy due to canal stenosis et causa Th3 compression fracture. Patient has history of paraparesis in level Th4-Th8, also bladder and bowel incontinence. The prognosis of patients with epidural metastasis is not promising and difcult to predict. Tokuhashi and Tomita scores are one of tools that used widely to predict the patient’s survival prognosis, in particularly for spinal metastatic treatment decision. These scores provide guidance decision whether aggressive operative or palliative. Tokuhashi score in this patient indicated the survival rate was below 6 months and Tomita score referred to palliative treatment. Physical medicine and rehabilitation treatment focus on palliative treatment for this patient include diminished pain, maintain vertebral stability, improve physical tness and mobility to reduce further complication of prolonged bedridden and improve quality of life. Other treatment was given according to complaint and symptom. Patient was died less than 2-month post-surgery after readmission to the hospital due to bed ridden complications.