Background and Objectives: Patients who survive severe COVID-19 require significant pulmonary rehabilitation. Heart rate (HR) has been used as a safety variable in the evaluation of the results of interventions in patients undergoing pulmonary rehabilitation. The aim of this research was to analyse HR during a pulmonary rehabilitation program in post-severe COVID-19 patients who survived mechanical ventilation (MV). The study includes the initial and final evaluations and aerobic training sessions. Materials and Methods: Twenty patients (58 ± 13 years, 11 men) were trained for 8 weeks. A 6-minute walk test (6 MWT) was performed and, subsequently, a supervised and individualised training plan was created. Resting heart rate (RHR), heart rate recovery (HRR), heart rate at minute 6 (HR6 min) and the product of HR6 min and systolic blood pressure (HR6 minxSBP) were measured at 6 MWT. In addition, HR was measured at each training session. Results: After 8 weeks of pulmonary rehabilitation, patients decreased their RHR from 81.95 ± 9.36 to 73.60 ± 9.82 beats/min (p < 0.001) and significantly increased their HRR from 12.45 ± 10.22 to 20.55 ± 7.33 beats/min (p = 0.005). HR6 min presented a significant relationship with walking speed and walked distance after the pulmonary rehabilitation period (r = 0.555, p = 0.011 and r = 0.613, p = 0.011, respectively). HR6 minxSBP presented a significant relationship with walking speed and walked distance after training (r = 0.538, p = 0.014 and r = 0.568, p = 0.008, respectively). In the pulmonary rehabilitation sessions, a significant decrease in HR was observed at minutes 1, 6 and 15 (p < 0.05) between sessions 1 and 6 and at minute 1 between sessions 1 and 12. Conclusions: Eight weeks of individualised and supervised pulmonary rehabilitation were effective in improving RHR and HRR in COVID-19 patients surviving MV. HR is an easily accessible indicator that could help to monitor the evaluation and development of a pulmonary rehabilitation program in COVID-19 patients who survived MV.
Introduction
Patients who suffered severe COVID-19 need pulmonary rehabilitation. Training may be prescribed objectively based on the maximum speed in the six-minute walk test. The objective of this study was to determine the effects of a personalized pulmonary rehabilitation program based on the six-minute walk test speed for post-COVID-19 patients.
Methods
Observational quasi-experimental study. The pulmonary rehabilitation program consisted of 8 weeks of training, twice a week for 60 minutes per session of supervised exercise. Additionally, the patients carried out home respiratory training. Patients were evaluated by exercise test, spirometry and the Fatigue Assessment Scale before and after the eight-week pulmonary rehabilitation program.
Results
After the pulmonary rehabilitation program, forced vital capacity increased from 2.47 ± 0.60 to 3.06 ± 0.77 L (
p
< .001) and the six-minute walk test result increased from 363.50 ± 88.87 to 480.9 ± 59.25 m (
p
< .001). In fatigue perception, a significant decrease was observed, from 24.92 ± 7.01 to 19.10 ± 7.07 points (
p
< .01). Isotime evaluation of the Incremental Test and the Continuous Test showed a significant reduction in heart rate, dyspnoea and fatigue.
Conclusion
The eight-week personalized pulmonary rehabilitation program prescribed on the basis of the six-minute walk test speed improved respiratory function, fatigue perception and the six-minute walk test result in post-COVID-19 patients.
KEY MESSAGES
COVID-19 is a multisystem disease with common complications affecting the respiratory, cardiac and musculoskeletal systems.
The 6MWT speed-based training plan allowed for increased speed and incline during the eight-week RP program.
Aerobic, strength and flexibility training reduced HR, dyspnoea and fatigue in severe post-COVID-19 patients.
RESUMEN: Terminologia Histologica (TH) fue confeccionada siguiendo las indicaciones del Comité Federativo Internacional en Terminología Anatómica (FIPAT), sin embargo, no está exenta de errores e incongruencias. Lo anterior se evidencia al analizar el término músculo (TM) cuando se considera: el idioma en que se encuentra, número de palabras utilizadas o si las palabras que la componen efectivamente describen la forma de su estructura. En este contexto, el objetivo de esta investigación fue analizar en la TH el TM y su contexto histórico para proponer cambios consistentes con los lineamientos de la FIPAT. Desde el punto de vista histórico, fue descrito primeramente como un tejido contráctil, con acción capaz de originar movimiento; conformado por dos tendones y un relleno de carne. En el Renacimiento fueron incorporados los ligamentos, nervios, venas y arterias como parte del tejido y en el siglo XIX se reconoce la existencia de dos tipos de músculo, voluntario e involuntario; finalmente, Testut incorpora el término estriado a las fibras
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