Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 Rehabilitation Unit and proposal of a treatment protocol

Curci, Claudio; Pisano, Fabrizio; Bonacci, Eleonora; Camozzi, Danila M; Ceravolo, Claudia; Bergonzi, Roberto; Franceschi, Silvia De; Moro, Paolo; Guarnieri, Rodolfo; Ferrillo, Martina; Negrini, Francesco; Sire, Alessandro de

doi:10.23736/s1973-9087.20.06339-x

Cited by 172 publications

(221 citation statements)

References 29 publications

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“…[ 7 ] In post-acute COVID-19 Italian patients, Grade 4-5 dyspnea on mMRC, minimal activity shortness of breath, higher inspired oxygen requirement, and impaired 6MWT performance have been documented. [ 30 ] Extubated COVID-19 survivors develop ICU-associated inspiratory (diaphragm) and limb muscles weakness (combined myopathy and neuropathy), limited joint ROM, and overall poor physical function. [ 31 , 55 , 56 ] Poor nutrition with serum hypoalbuminemia is reportedly linked with ARDS.…”

Section: Discussionmentioning

confidence: 99%

“…[ 33 ] Deep breathing exercise is an important component of PR; however, successful PR depends on coordination between diaphragm strength, trunk-limb posture and balance, joint ROM, nutrition and adequate fluid intake. [ 24 , 30 , 32 ] Therefore, during early PR these factors should be considered. [ 30 , 56 ] Early inpatient rehabilitation includes respiratory care, bed mobilization, bed-to- chair transfer, sit-to-stand training, assisted walking, and neuromuscular electrical stimulation in limb muscles result in improved respiratory function, quadriceps muscle function, and walking capacity measured on Barthel dyspnea index, quadriceps size, and EuroQoL questionnaire.…”

Section: Discussionmentioning

confidence: 99%

“…[ 24 , 30 , 32 ] Therefore, during early PR these factors should be considered. [ 30 , 56 ] Early inpatient rehabilitation includes respiratory care, bed mobilization, bed-to- chair transfer, sit-to-stand training, assisted walking, and neuromuscular electrical stimulation in limb muscles result in improved respiratory function, quadriceps muscle function, and walking capacity measured on Barthel dyspnea index, quadriceps size, and EuroQoL questionnaire. [ 30 , 34 ] Besides, a dynamic patient-guided robotic suspension system assists in developing ambulation, ADL performance, 6MWT, and 10-meter walk test speed.…”

Section: Discussionmentioning

confidence: 99%

“…[ 30 , 56 ] Early inpatient rehabilitation includes respiratory care, bed mobilization, bed-to- chair transfer, sit-to-stand training, assisted walking, and neuromuscular electrical stimulation in limb muscles result in improved respiratory function, quadriceps muscle function, and walking capacity measured on Barthel dyspnea index, quadriceps size, and EuroQoL questionnaire. [ 30 , 34 ] Besides, a dynamic patient-guided robotic suspension system assists in developing ambulation, ADL performance, 6MWT, and 10-meter walk test speed. [ 35 ] In COVID-19, an eight-segment traditional Chinese PR exercises regime is considered promising, particularly when prescribed with conventional breathing techniques and proprioceptive neuromuscular facilitation.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic

Siddiq

Rathore²,

Clegg

et al. 2020

Turk J Phys Med Rehab

128

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The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic

Siddiq

Rathore²,

Clegg

et al. 2020

Turk J Phys Med Rehab

128

View full text Add to dashboard Cite

show abstract

“…Good foot health is key to enabling people to remain physically active and mobile, and able to participate fully in activities of occupation and daily living (11). With the emergence of a recently recognised post-COVID-19 syndrome causing persistent symptoms, fatigue, dyspnoea, pain and psychological effects after COVID-19 infection, rehabilitation is likely to include weight-bearing activity (12), and as such attention to foot health is a central rehabilitative concern. Being able to walk and move around freely is a cornerstone of healthy living and could signi cantly confound rehabilitation potential for post-COVID -19 disease.…”

Section: Background and Rationalementioning

confidence: 99%

COVID-19 Lockdown Disrupts Support Networks Integral to Maintaining Foot Health: A Mixed-methods Study

Cherry

Gates

Culliford

et al. 2021

Preprint

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Background: In response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals’ engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living.Methods: A population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation.Results: 255 respondents completed the survey. Most (n=193, 75.69%) reported an ongoing foot pain or problem that had been present for four weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n=139, 54.51%), whilst change in appearance of the foot was also commonly reported (n=122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n=123, 48%), and were significantly associated with reported reduced physical activity (X2=6.61, p=0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. ‘cope or crumble’ scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity.Conclusions: COVID-19 lockdown restrictions disrupted support networks integral to maintaining foot health. Foot pain was common and poor foot health impacted people’s ability to remain physically active during lockdown. Foot problems previously considered relatively ‘minor’ such as support for skin and nail care were exacerbated by the restricted support networks leading to greater negative impact. Lockdown highlighted a lack of support to self-care.

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COVID‐19 related fatigue: Which role for rehabilitation in post‐COVID‐19 patients? A case series

Ferraro

Calafiore

Dambruoso

et al. 2020

Journal of Medical Virology

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Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 Rehabilitation Unit and proposal of a treatment protocol

Cited by 172 publications

References 29 publications

Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic

Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic

COVID-19 Lockdown Disrupts Support Networks Integral to Maintaining Foot Health: A Mixed-methods Study

COVID‐19 related fatigue: Which role for rehabilitation in post‐COVID‐19 patients? A case series

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