The Effects of Early Pulmonary Rehabilitation and Diaphragm Kinesiotaping on Diaphragm Muscle Thickness in Patients with Severe COVID-19 Pneumonia in the Intensive Care Unit

Abstract

Purpose: The efficacy of early rehabilitation in patients in the intensive care unit (ICU) is apparent. However, it is still unclear in COVID-19 patients. Also, the effects of diaphragm kinesiotaping (KT) on outcomes and muscle thickness were not shown previously. Thus, we aimed to investigate the efficacy of rehabilitation and diaphragm KT in patients with severe COVID-19 pneumonia by evaluating with the US of the diaphragm. Methodology: Patients with severe COVID-19 pneumonia in ICU requiring high flow oxygen therapy included in the study. Patients with severe COVID-19 pneumonia in ICU requiring high flow oxygen therapy were divided into three groups: Group 1 (n=22) rehabilitation, group 2 (n=26) rehabilitation and diaphragm KT, Group 3 (n=24) control group-only standard ICU care. Ultrasonographic measurements of diaphragm thickness (DT) and thickening fraction (TF) were recorded repeatedly.Results: The demographic characteristics, mortality, and length of stay were not different between groups. However, invasive mechanic ventilation (IMV) requirement and the decrease in DT and TF values were significantly lower in the KT group. Baseline DT and TF values were found to impact IMV requirement. Cut-off values for these parameters are 2.85 mm and 37.95%, respectively. Conclusion: Baseline DT can be used to predict noninvasive ventilation failure. By the way, the patients who are more likely to develop respiratory failure should receive inspiratory muscle training exercises combined with general rehabilitation principles. Also, diaphragm KT should be included in the rehabilitation protocol.