Post-COVID-19 rehabilitation in the post-hospitalization period – case study

Abstract

Aim of the research work. The main goal of the research work was to show an author’s plan of physiotherapeutic intervention for people suffering of COVID-19 in the post-acute stage. The therapeutic procedure highlighted pulmonary rehabilitation, aerobic and resistance training and patient’s education. Case study. The research work was performed on a 62-year old woman, who was diagnosed with infection by SARS-CoV-2 virus. The patient was admitted to ICU with acute ARDS in a heavily severe condition. The medical history showed obesity, chronic ischemic heart disease, arterial hypertension and cardiac arrest (2011). The patient was admitted to the rehabilitation unit in the post-acute stage of infection, and was using passive oxygen therapy with oxygen flow set to 4 l/min. During the qualification for therapy the patient was tested using a questionnaire which consisted of clinical tests such as 6MWT, MRC, 30CST and FIM scale. Furthermore, the lungs were examined using spirometry. Identical measurements were being used every 2 weeks of the therapy process. After 8 weeks of physiotherapeutic procedure there was a significant increase of score in 6-MWT which upgraded by 750%. Systematic improvement was also visible in dyspnoea and fatigue, which completely surceased after finishing the therapeutic process. Functional state of the patient improved considerably which is shown by 30CST score, improved by 380%. Spirometry score analysis shows FVC, FEV1 and Tiffeneau-Pinelli index improve respectively by 40%, 53% and 9.6%. Summary. The therapeutic program based on pulmonary rehabilitation, aerobic and resistance training and patient’s education looks very promising. Implemented procedure contributed to the patient's relatively quick recovery to a pre-COVID-19 state. Patient’s physical and pulmonary efficiency were noticed, exertional tolerance increased, dyspnoea and fatigue gave way which all combined led to improved functional efficiency. Pulmonary system function was also enhanced which was demonstrated by spirometry.