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The Effect of Pulmonary Rehabilitation on Pain, Respiratory Functions and Activities of Daily Living in COVID-19 Patients

Year 2023, Volume: 13 Issue: 1, 30 - 35, 31.01.2023
https://doi.org/10.16899/jcm.1227489

Abstract

Abstract
Introduction: Coronavirus disease 2019 (COVID-19) requires a multidisciplinary approach owing to its multisystem involvement. Pulmonary rehabilitation may be required in patients with COVID-19. In our study, we aimed to examine the effect of the pulmonary rehabilitation program applied after the acute period of back pain in patients with severe pulmonary involvement, dyspnea and health profiles of the patients.
Method: In our retrospectively planned study, 50 patients with advanced pulmonary involvement who were treated for COVID-19 and discharged from the hospital and who were diagnosed with shortness of breath, back pain and difficulties in daily living activities in the 1st month chest diseases polyclinic controls and who were given a pulmonary rehabilitation program for a period of
1 month were included in our study. Before and 1 month after the pulmonary rehabilitation program, back pain was evaluated with the VAS, respiratory functions were evaluated with the Modified Medical Research Council Scale, and activities of daily living were evaluated with the Notthingham scale.
Results: A statistically significant difference was found between the beginning and the end of the pulmonary rehabilitation program in the Modified Medical Research Council Scale scores (p<0.001) and back pain VAS scores (p<0.001) was detected. Moreover, it was obtained significant improvement at baseline scores of “The Nottingham Health Profile” scores after the pulmonary rehabilitation program in all subgroups (NHP “pain”: p<0.001, NHP “emotional reactions”: p<0.001, NHP “sleep”: p<0.001, NHP “social isolation”: p<0.001, NHP “physical activity”: p<0.001, NHP “energy level”: p<0.001).
Conclusion: Post-COVID syndrome treatment and follow-up are important for early prevention. The pulmonary rehabilitation program applied after the acute period of with severe lung involvement COVID-19 has been seen to improve back pain, dyspnea symptoms and health profile. There is a need for new randomized controlled studies on this subject.

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References

  • 1. Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novel Coronavirus Infection (COVID-19) in Humans. J Clin Med. 2020;9(4):941.
  • 2. Zhu Y, Wang Z, Zhou Y, et al. Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. J Phys Ther Sci. 2020;32(8):545-549.
  • 3. Cieloszczyk, A., Lewko, A., Śliwka, A., Włoch, T., Pyszora, A. (2020) Recommendations for physiotherapy of adult patients with COVID-19. (https://www.wcpt.org/sites/wcpt.org/files/files/wcptnews/images/Recommendations%20for %20physiotherapy%20of%20adult%20patients%20with%20COVID-19_POLISH.pdf)
  • 4. Gosselink R, Bott J, Johnson M, et al. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med. 2008 Jul;34(7):1188-99.
  • 5. Turkey Association of Physical Medicine and Rehabilitation. Pulmonary Rehabilitation After SARS-COV-2 (COVID-19) Guide. Access: (https://www.tftr.org.tr/covid19/files/doc01.pdf Access Date: 15.11.2022
  • 6. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988 Mar;93(3):580-6.
  • 7. Bestall J.C, Paul E.A, Garrod R. Usefulness Of The Medical Research Council (MRC) Dyspnea Scale As A Measure Of Disability İn Patients With Chronic Obstructive Pulmonary Disease. Thorax 1999; 54: 581-586.
  • 8. Amelot A, Jacquot A, Terrier LM, et al. Chronic low back pain during COVID-19 lockdown: is there a paradox effect? Eur Spine J. 2022 Jan;31(1):167-175.
  • 9. Kücükdeveci AA, McKenna SP, Kutlay S, et al. The Development and Psychometric Assessment of the Turkish Version of The Nottingham Health Profile. International Journal of Rehabilitation Research. 2000;23(1):31-38.
  • 10. Kind P, Hill CR. The Nottingham Health Profile: A Useful Tool For Epidemiologist, Soc. Sci Med. 1987;25(8):905-910.
  • 11. Faul F, Erdfelder E, Lang A.-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39:175-191.
  • 12. Fritz C. Effect Size Estimates: Current Use, Calculations, and Interpretation. J Exp Psychol Gen. 2012;141(1):2-18.
  • 13. Tuzun S, Keles A, Okutan D, et al. Assessment of musculoskeletal pain, fatigue and grip strength in hospitalized patients with COVID-19. Eur J Phys Rehabil Med. 2021;57(4):653-662.
  • 14. Yaşa Öztürk, G. , Berik Safçi, S. "Effects of Eucalyptus Essential Oil in Post-COVID Syndrome: A Pilot Study". Journal of Immunology and Clinical Microbiology 7 (2022 ): 74-79
  • 15. Yang F, Liu N, Hu JY, et al. [Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):180-182. Chinese.
  • 16. Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020 May;39:101166.
  • 17. Chinese Association of Rehabilitation Medicine, Respiratory rehabilitation committee of Chinese Association of Rehabilitation Medicine, Cardiopulmonary Rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation. [Recommendations for respiratory rehabili tation of COVID-19 in adults]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E029.
  • 18. Kiekens C, Boldrini P, Andreoli A, et al. Rehabilitation and respiratory management in the acute and early post-acute phase. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency. Eur J Phys Rehabil Med. 2020 Jun;56(3):323-326.
  • 19. Smith JM, Lee AC, Zeleznik H, et al. Home and Community-Based Physical Therapist Management of Adults With Post-Intensive Care Syndrome. Phys Ther. 2020;100:1062–1073.
  • 20. Sheehy LM. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill. 2020 May 8;6(2):e19462. doi: 10.2196/19462.
  • 21. Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020 Dec;81(6):e4-e6.
  • 22. Demeco A, Marotta N, Barletta M, et al. Rehabilitation of patients post-COVID-19 infection: a literature review. J Int Med Res. 2020 Aug;48(8):300060520948382.
  • 23. Stam HJ, Stucki G, Bickenbach J. Covid-19 and Post Intensive Care Syndrome: A Call for Action. J Rehab Med. 2020;52: jrm00044
  • 24. Turkey Association of Physical Medicine and Rehabilitation. Pulmonary Rehabilitation Principles After SARS-COV-2 (COVID-19): A Guide For The Management Of The Acute and Subacute Process Group 13 April 2020 Version 1.0.
  • 25. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64.
  • 26. Bolton CE, Bevan-Smith EF, Blakey JD, et al. British Thoracic Society Pulmonary Rehabilitation Guideline Development Group; British Thoracic Society Standards of Care Committee. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013 Sep;68 Suppl 2:ii1-30.
  • 27. Chinese Association of Rehabilitation M, Respiratory rehabilitation committee of Chinese Association of Rehabilitation M, Cardiopulmonary rehabilitation Group of Chinese Society of Physicai M, Rehabilitation: [Recommendations for respiratory rehabilitation of COVID-19 in adult]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43(0):E029.
  • 28. Ambrosino N. Clini EM: Response to pulmonary rehabilitation: toward personalised programmes? Eur Respir J. 2015;46(6):1538-1540.
  • 29. Zhao H, Xie Y, Wang C. Recommendations for respiratory rehabilitation in adults with COVID-19. Chin Med J (Engl). 2020;133(13):1595-1602.
  • 30. Clinical management of severe acute respiratory infection when COVID-19 is suspected Interimguidance. Access: (https://www.who.int/publications/i/item/10665-332299). Access Date: 15.11.2022
  • 31. Duarte A, Bojke C, Cayton W, et al. Impact of specialist rehabilitation services on hospital length of stay and associated costs. Eur J Health Econ. 2018 Sep;19(7):1027-1034.

Pulmoner rehabilitasyonun COVID-19 Hastalarında Ağrı, Solunum Fonksiyonları ve Günlük Yaşam Aktivitelerine Etkisi

Year 2023, Volume: 13 Issue: 1, 30 - 35, 31.01.2023
https://doi.org/10.16899/jcm.1227489

Abstract

Giriş: Koronavirüs hastalığı 2019 (COVID-19), çoklu sistem tutulumu nedeniyle multidisipliner bir yaklaşım gerektirir. COVID-19 hastalarında pulmoner rehabilitasyon gerekebilir. Çalışmamızda şiddetli akciğer tutulumu, nefes darlığı olan hastalarda sırt ağrısı sonrası uygulanan pulmoner rehabilitasyon programının etkisini ve hastaların sağlık profillerini incelemeyi amaçladık.
Yöntem: Retrospektif olarak planlanan çalışmamıza, ileri akciğer tutulumu tanısı ile COVID-19 tedavisi gören, hastaneden taburcu edilen ve göğüs hastalıkları polikliniği 1.ay kontrollerinde nefes darlığı, sırt ağrısı ve günlük yaşam aktivitelerinde güçlük saptanması sonrası 1 ay süre ile pulmoner rehabilitasyon programına alınan 50 hasta dahil edildi. Pulmoner rehabilitasyon programı öncesi ve 1 ay sonrasında sırt ağrısı Vizüel Analog Skala (VAS) ile, dispne düzeyi Modifiye Tıbbi Araştırma Konseyi Skalası (mMRC) ile ve sağlık profili Notthingham skalası ile değerlendirilmişti.
Bulgular: Pulmoner rehabilitasyon programının başlangıcı ile bitişi arasında mMRC Skalası puanları (p<0.001) ve sırt ağrısı VAS puanları (p<0.001) arasında istatistiksel olarak anlamlı fark bulundu (p<0.001). Ayrıca pulmoner rehabilitasyon programı sonrası “Nottingham Sağlık Profili” puanlarında tüm alt gruplarda (NHP “ağrı”: p<0,001, NHP “duygusal reaksiyonlar”: p<0,001, NHP “uyku” :p<0.001, NHP “sosyal izolasyon”: p<0.001, NHP “fiziksel aktivite”: p<0.001, NHP “enerji düzeyi”: p<0.001) başlangıç puanlarına göre anlamlı iyileşme tespit edildi
Tartışma ve Sonuç: Post COVİD sendrom erken tanı takip açısından önemlidir. Bu çalışmada şiddetli akciğer tutulumu olan COVID-19'un akut döneminden sonra uygulanan pulmoner rehabilitasyon programının sırt ağrısı, nefes darlığı semptomları ve sağlık profilini iyileştirdiği görülmüştür. Bu konuda yapılmış randomize kontrollü yeni çalışmalara ihtiyaç olduğunu düşünmekteyiz.

Project Number

NON

References

  • 1. Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novel Coronavirus Infection (COVID-19) in Humans. J Clin Med. 2020;9(4):941.
  • 2. Zhu Y, Wang Z, Zhou Y, et al. Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. J Phys Ther Sci. 2020;32(8):545-549.
  • 3. Cieloszczyk, A., Lewko, A., Śliwka, A., Włoch, T., Pyszora, A. (2020) Recommendations for physiotherapy of adult patients with COVID-19. (https://www.wcpt.org/sites/wcpt.org/files/files/wcptnews/images/Recommendations%20for %20physiotherapy%20of%20adult%20patients%20with%20COVID-19_POLISH.pdf)
  • 4. Gosselink R, Bott J, Johnson M, et al. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med. 2008 Jul;34(7):1188-99.
  • 5. Turkey Association of Physical Medicine and Rehabilitation. Pulmonary Rehabilitation After SARS-COV-2 (COVID-19) Guide. Access: (https://www.tftr.org.tr/covid19/files/doc01.pdf Access Date: 15.11.2022
  • 6. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988 Mar;93(3):580-6.
  • 7. Bestall J.C, Paul E.A, Garrod R. Usefulness Of The Medical Research Council (MRC) Dyspnea Scale As A Measure Of Disability İn Patients With Chronic Obstructive Pulmonary Disease. Thorax 1999; 54: 581-586.
  • 8. Amelot A, Jacquot A, Terrier LM, et al. Chronic low back pain during COVID-19 lockdown: is there a paradox effect? Eur Spine J. 2022 Jan;31(1):167-175.
  • 9. Kücükdeveci AA, McKenna SP, Kutlay S, et al. The Development and Psychometric Assessment of the Turkish Version of The Nottingham Health Profile. International Journal of Rehabilitation Research. 2000;23(1):31-38.
  • 10. Kind P, Hill CR. The Nottingham Health Profile: A Useful Tool For Epidemiologist, Soc. Sci Med. 1987;25(8):905-910.
  • 11. Faul F, Erdfelder E, Lang A.-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39:175-191.
  • 12. Fritz C. Effect Size Estimates: Current Use, Calculations, and Interpretation. J Exp Psychol Gen. 2012;141(1):2-18.
  • 13. Tuzun S, Keles A, Okutan D, et al. Assessment of musculoskeletal pain, fatigue and grip strength in hospitalized patients with COVID-19. Eur J Phys Rehabil Med. 2021;57(4):653-662.
  • 14. Yaşa Öztürk, G. , Berik Safçi, S. "Effects of Eucalyptus Essential Oil in Post-COVID Syndrome: A Pilot Study". Journal of Immunology and Clinical Microbiology 7 (2022 ): 74-79
  • 15. Yang F, Liu N, Hu JY, et al. [Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):180-182. Chinese.
  • 16. Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020 May;39:101166.
  • 17. Chinese Association of Rehabilitation Medicine, Respiratory rehabilitation committee of Chinese Association of Rehabilitation Medicine, Cardiopulmonary Rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation. [Recommendations for respiratory rehabili tation of COVID-19 in adults]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E029.
  • 18. Kiekens C, Boldrini P, Andreoli A, et al. Rehabilitation and respiratory management in the acute and early post-acute phase. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency. Eur J Phys Rehabil Med. 2020 Jun;56(3):323-326.
  • 19. Smith JM, Lee AC, Zeleznik H, et al. Home and Community-Based Physical Therapist Management of Adults With Post-Intensive Care Syndrome. Phys Ther. 2020;100:1062–1073.
  • 20. Sheehy LM. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill. 2020 May 8;6(2):e19462. doi: 10.2196/19462.
  • 21. Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020 Dec;81(6):e4-e6.
  • 22. Demeco A, Marotta N, Barletta M, et al. Rehabilitation of patients post-COVID-19 infection: a literature review. J Int Med Res. 2020 Aug;48(8):300060520948382.
  • 23. Stam HJ, Stucki G, Bickenbach J. Covid-19 and Post Intensive Care Syndrome: A Call for Action. J Rehab Med. 2020;52: jrm00044
  • 24. Turkey Association of Physical Medicine and Rehabilitation. Pulmonary Rehabilitation Principles After SARS-COV-2 (COVID-19): A Guide For The Management Of The Acute and Subacute Process Group 13 April 2020 Version 1.0.
  • 25. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64.
  • 26. Bolton CE, Bevan-Smith EF, Blakey JD, et al. British Thoracic Society Pulmonary Rehabilitation Guideline Development Group; British Thoracic Society Standards of Care Committee. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013 Sep;68 Suppl 2:ii1-30.
  • 27. Chinese Association of Rehabilitation M, Respiratory rehabilitation committee of Chinese Association of Rehabilitation M, Cardiopulmonary rehabilitation Group of Chinese Society of Physicai M, Rehabilitation: [Recommendations for respiratory rehabilitation of COVID-19 in adult]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43(0):E029.
  • 28. Ambrosino N. Clini EM: Response to pulmonary rehabilitation: toward personalised programmes? Eur Respir J. 2015;46(6):1538-1540.
  • 29. Zhao H, Xie Y, Wang C. Recommendations for respiratory rehabilitation in adults with COVID-19. Chin Med J (Engl). 2020;133(13):1595-1602.
  • 30. Clinical management of severe acute respiratory infection when COVID-19 is suspected Interimguidance. Access: (https://www.who.int/publications/i/item/10665-332299). Access Date: 15.11.2022
  • 31. Duarte A, Bojke C, Cayton W, et al. Impact of specialist rehabilitation services on hospital length of stay and associated costs. Eur J Health Econ. 2018 Sep;19(7):1027-1034.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Gülşah Yaşa Öztürk 0000-0002-9033-5095

Ozlem Ercen Diken 0000-0001-8388-9500

Tarık Salcan 0000-0002-3830-6801

Bayram Kelle 0000-0002-0424-8623

Project Number NON
Publication Date January 31, 2023
Acceptance Date January 16, 2023
Published in Issue Year 2023 Volume: 13 Issue: 1

Cite

AMA Yaşa Öztürk G, Ercen Diken O, Salcan T, Kelle B. The Effect of Pulmonary Rehabilitation on Pain, Respiratory Functions and Activities of Daily Living in COVID-19 Patients. J Contemp Med. January 2023;13(1):30-35. doi:10.16899/jcm.1227489