Inspiratory muscle training for recovered COVID-19 patients after weaning from mechanical ventilation

Abodonya, Ahmed M; Abdelbasset, Walid Kamal; Awad, Elsayed A; Elalfy, Ibrahim E; Salem, Hosni A; Elsayed, Shereen

doi:10.1097/md.0000000000025339

Cited by 104 publications

(206 citation statements)

References 33 publications

Supporting

Mentioning

182

Contrasting

Unclassified

Order By: Relevance

“…The difference in the average distance we obtained with 1-MNA supplementation was comparable to the results for pulmonary rehabilitation (44 meters) after COVID-19 reported by Abodonya [42]. In a study by Spielmanns et al [45], a group of patients after COVID-19 were given 30 treatment sessions over 3 weeks of comprehensive pulmonary rehabilitation.…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

Chudzik¹,

Kapusta

Burzyńska

2021

Preprint

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 (COVID-19) is a serious respiratory disease that results from infection with a newly discovered coronavirus (SARS-COV-2). Unfortunately, COVID-19 is not only a short-term infection but that patients (pts) recovering from SARS-CoV2 infection complain of persisting symptoms including: fatigue, diffuse myalgia and weakness, which may lead to chronic fatigue syndrome. There is currently no evidence that nutritional supplements and/or physical exercise can assist in the recovery of pts with chronic fatigue syndrome. 1-Methylnicotinamide (1-MNA) is an endogenic substance that is produced in the liver when nicotinic acid is metabolized. 1-MNA demonstrates anti-inflammatory and anti-thrombotic properties. Therefore, we investigated whether 1-MNA supplements could improve exercise tolerance and decrease fatigue among patients recovering from SARS-CoV-2. Methods: The study population was composed of pts after COVID-19, expressing subjective feelings of limited tolerance to exercise. The selected pts were randomized into two groups: GrM0 without supplementation; GrM1 with 1-MNA supplementation. At the beginning of the study (Phase 0), in both groups, a 6-minute walk test (6MWT) was carried out and fa-tigue assessment with Fatigue Severity Scale (FSS) was performed. After 1 month (Phase 1), a follow up FSS and 6MWT once more were performed in both groups. Results: A significant improvement in the mean distance covered in the 6MWT was noted among the pts in GrM1, compared to those in GrM0. We also noted that in GrM1 the 6MWT distance was significantly higher after 1 month of supplementation with 1-MNA, compared to the beginning of the study (515.18 m in Phase 0 vs 557.8m in Phase 1; p = 0.000034). In GrM1, significantly more pts improved their distance in the 6MWT (23 out of 25 pts, equal to 92%), by a mean of 47 meters, compared to GrM0 (15 of 25 pts, equal to 60%) (p = 0.0061). After one month, significantly more patients in the group without 1-MNA had severe fatigue (FSS ≥ 4) compared to the group with supplementation (GrM1 = 5 pts (20%) vs GrM0 = 14pts (56%); p = 0.008). Conclusions: 1-MNA supplementation significantly improved physical performance in a 6-minute walk test and reduced the percentage of patients with severe fatigue after COVID-19. The comprehensive action of 1-MNA, including anti-inflammatory and anticoagulant effects, as well as activation of the SIRT1 enzyme, may be beneficial for the recovery of patients with persistent symptoms of fatigue and low tolerance to exercise after COVID-19. Keywords: COVID-19, MNA, chronic fatigue syndrome, post-COVID syndrome

show abstract

Section: Discussionsupporting

confidence: 85%

“…In our study, population of non-hospitalized pts, the mean distance in the 6MWT of more than 500 meters was much higher than the distances reported for hospitalized patients (333 meters in Ahmed M Abodonya AM et al [42] or 240 meters in Curci et al [43]). Of course, this discrepancy may be due to the milder course of COVID-19.…”

Section: Discussioncontrasting

confidence: 68%

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

Chudzik¹,

Kapusta

Burzyńska

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Future studies should evaluate the effectiveness of HAG in other conditions different from LBP which may improve the diaphragm function and consequently the clinical course of these pathologies, i.e., patients who suffer from COVID-19 [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

The Main Role of Diaphragm Muscle as a Mechanism of Hypopressive Abdominal Gymnastics to Improve Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

Vicente-Campos

Sánchez-Jorge

Terrón-Manrique

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Chronic low back pain (LBP) has been stated as one of the main health concerns in the XXI century due to its high incidence. Objective: The objective of this study was to determine the effects of an 8-week program of hypopressive abdominal gymnastics (HAG) on inspiratory muscle strength, diaphragm thickness, disability and pain in patients suffering from non-specific chronic LBP. Methods: A total of 40 patients with chronic LBP were randomly divided into two groups. The experimental group carried out an 8-week supervised program of HAG (two sessions/week), whereas the control group did not receive any treatment. Outcomes were measured before and after the intervention, comprising diaphragm thickness during relaxed respiratory activity, maximal inspiratory pressure (PImax), pain intensity (NRS), pressure pain threshold and responses to four questionnaires: Physical Activity Questionnaire (PAQ), Roland–Morris Disability Questionnaire (RMQ), Central Sensitization Inventory (CSI) and Tampa Scale of Kinesiophobia-11 Items (TSK-11). Results: Statistically significant differences (p < 0.05) were observed for greater thickness of the left and right hemi-diaphragms at inspiration, as well as higher PImax and decreased NRS, CSI and RMQ scores in the intervention group. After treatment, the increases in the thickness of the left and right hemi-diaphragms at inspiration and PImax, as well as the decrease in the NRS and RMQ scores, were only predicted by the proposed intervention (R2 = 0.118–0.552). Conclusions: An 8-week HAG intervention seemed to show beneficial effects and predicted an increase in diaphragm thickness and strength during inspiration, as well as a reduction in pain intensity, central sensitization and disability, in patients suffering from chronic non-specific LBP with respect to non-intervention.

show abstract

“…The increased contribution from the abdomen to breathing may be the effect of the respiratory muscle weakness after invasive mechanical ventilation. 36 Obesity is a contributing factor in either acquiring the virus or even worsening the disease's condition in patients with COVID-19 . 37 38 In our study, there was a higher proportion of obese patients in ITU (63%) and wards (53%) patients compared with healthy (16.6%) cohorts.…”

Section: Open Accessmentioning

confidence: 99%

Measurement of breathing in patients with post-COVID-19 using structured light plethysmography (SLP)

et al. 2021

View full text Add to dashboard Cite

IntroductionCOVID-19 pandemic has had a huge impact on global health to date, with 5.6 million cases in the UK since its emergence. The respiratory symptoms largely mimic those of pneumonia’ with symptoms ranging from mild to severe. The effects on respiratory physiology are not yet fully understood, but evidence is emerging that there is much dysfunctional breathing reported but little information on tidal ventilation from the acute phase of the infection. Structured light plethysmography (SLP) is a contactless technique of respiratory function testing that measures tidal breathing parameters by assessing thoracoabdominal displacement.MethodsIn a postdischarge clinic, SLP was performed routinely on 110 hospitalised patients recovering from COVID-19 who had been screened for respiratory symptoms to confirm any respiratory changes occurring after the disease. Patients were categorised based on their hospital treatment in (1) the intensive therapy unit (ITU) (requiring intubation) (n=65) or (2) respiratory wards only (n=45). Data from these two patient cohorts were compared with preacquired data from healthy controls (n=30).ResultsWe have found a significantly increased respiratory rate (p=0.006) in ITU patients compared with the healthy cohort and also a significant decrease in the inspiratory time (p=0.01), expiratory time (p=0.005) and the total breathing cycle (p=0.008). There were no significant differences between ITU and ward patients and no significant differences in healthy compared with ward patients. We examined the variability of breathing (‘entropy’) both in terms of the breath-to-breath interval and the volume-to-volume change. The breath-to-breath interval alone was significantly lower in ITU patients compared with healthy cohorts (p=0.02).ConclusionOur findings suggest that abnormalities in tidal breathing can be detected in COVID-19 recovery patients, and SLP may be a promising tool in assessing the aftermath of diseases such as COVID-19, particularly if more intensive management strategies such as mechanical ventilation are required.

show abstract

Inspiratory muscle training for recovered COVID-19 patients after weaning from mechanical ventilation

Cited by 104 publications

References 33 publications

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

The Main Role of Diaphragm Muscle as a Mechanism of Hypopressive Abdominal Gymnastics to Improve Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

Measurement of breathing in patients with post-COVID-19 using structured light plethysmography (SLP)

Contact Info

Product

Resources

About