Effect of pulmonary rehabilitation program on post hospitalization severe COVID-19 patients (Experimental study)
Main Article Content
Keywords
Pulmonary, Rehabilitation, Hospitalization, COVID-19
Abstract
Background: COVID-19 infection was discovered to be the major global cause of a serious respiratory illness toward the end of 2019. The majority of COVID-19 patients experience mild disease, while about 14% go on to have severe disease and 6% end up in critical condition. An evidence-based standard of therapy called pulmonary rehabilitation includes exercise-training, education, and behavior modification to help people had a lung illness feel better physically and mentally.
Aim: current study aimed to evaluate the effect of pulmonary rehabilitation program on severe post covid19 patients (post hospitalization) regarding pulmonary function tests and dyspnea score. Methods: Randomized control experimental study design enrolled 100 patients of post hospitalization due to severe COVID 19 infection. Dyspnea score, Spirometry and 6-minute walk test were performed upon discharge. Pulmonary rehabilitation program in the form of respiratory exercises and walking exercise was done to 50 patients. Follow up assessment of the same parameters was done 6 weeks after the program. Other 50 patients had no pulmonary rehabilitation program to them.
Results: Post COVID -19 cases in the experimental group show much improvement in percentage of normal breathing score (mMRC) 30% versus no cases in control group. In addition, the experimental group showed a significant higher percentage of normal spirometry findings (66% versus 28% in control group). As regards oxygen saturation, 6MWT score and distance, it showed a higher mean after practicing the exercise program.
Conclusion: pulmonary rehabilitation program was effective in achieving much improvement in recovery of severe cases of COVID 19 infection
References
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2. de Groot RJ, Baker SC, Baric RS, et al.(2013): Commentary: Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol;87:7790–7792.
3. World Health Organization . World Health Organization; Geneva: (2020): Coronavirus disease 2019 (COVID-19): situation report – 67.
4. European Centre for Disease Prevention and Control.(2020): Risk assessment on COVID-19. Available at : https://www.ecdc.europa.eu/en/current-risk-assessment-novel-coronavirus-situation. Accessed July 14, 2020.
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6. Chen JY, Qiao K, Liu F, et al. (2020): Lung transplantation as therapeutic option in acute respiratory distress syndrome for COVID-19-related pulmonary fibrosis. Chin Med J (Engl);133:1390–1396.
7. Antonio GE, Wong KT, Hui DSC, et al.(2003): Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: preliminary experience. Radiology;228:810–815.
8. Hui DS, Wong KT, Ko FW, et al.(2005):The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest. 2005;128:2247–2261.
9. Ngai JC, Ko FW, Ng SS, et al.(2010): The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology;15:543–550.
10. Hui D, Joynt G, Wong K, et al.(2005): Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax;60:401–409.
11. Spruit M., Holland A., Singh S. (2020): COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a european respiratory society and american thoracic society-coordinated international task force. Eur. Respir. J. (In press)
12. Thomas P, Baldwin C, Bissett B, et al.(2020): Physiotherapy management for COVID-19 in the
acute hospital setting: clinical practice recommendations. J Physiother;66:73–82.
13. Spruit MA, Singh SJ, Garvey C, et al. (2013): An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med;188:e13–e64.
14. Lau HMC, Ng GYF, Jones AYM, et al. (2005): A randomised controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory syndrome. Aust J Physiother;51:213–219.
15. Yu X, Li X, Wang L, et al. (2019): Pulmonary rehabilitation for exercise tolerance and quality of life in IPF patients: a systematic review and meta-analysis. Biomed Res Int;2019
16. American College of Sports Medicine. (2017): ACSM’s guidelines for exercise testing and prescription. 10th ed. Philadelphia (PA): Lippincott Williams & Wilkins.
17. Choi JY, Rha DW, Park ES. (2016):Change in pulmonary function after incentive spirometer exercise in children with spastic cerebral palsy: a randomizedcontrolledstudy.YonseiMedJ;57:769–775).
18. American Thoracic Society (1991): Lung function testing: selection of reference values and interpretative strategies. Am. Rev. Respir. Dis., 144 (5), pp. 1202-1218
19. ATS statement (2002): guidelinesforthesix-minutewalktest.AmJRespirCritCareMed,166:111–117).
20. Wu Z., McGoogan J.M. (2020): Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease Control and prevention. J. Am. Med. Assoc;323(13):1239–1242.
21. Guan, W.J.; Ni, Z.Y.; Hu, Y.; Liang, W.H.; Ou, C.Q.; He, J.X.; Liu, L.; Shan, H.; Lei, C.L.; Hui, D.S.C.; et al. (2020): Clinical Characteristics of Coronavirus Disease 2019 in China. N. Engl. J. Med, 382, 1708–1720.
22. Wang, L.; He, W.; Yu, X.; Hu, D.; Bao, M.; Liu, H.; Zhou, J.; Jiang, H. (2020): Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. J. Infect, 80, 639–645.
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24. Bangash, M.N.; Patel, J.; Parekh, D. (2020): COVID-19 and the liver: Little cause for concern. Lancet Gastroenterol. Hepatol, 5, 529–530.
25. La Fisioterapia, (2020): Clave en la Recuperación de la Función Pulmonar Afectada por el Coronavirus. Available online: https://www.colfisio.org/comunicacion_y_prensa/noticias/1092_La_Fisioterapia_clave_en_la_recuperaci_n_de_la_funci_n_pulmonar_afectada_por_el_Coronavirus.html(accessed on 21 May 2020).
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27. Y. Al Chikhanie, D. Veale, M. Schoeffler, J.L. Pépin, S. Verges, and F. Hérengt(2021) : Effectiveness of pulmonary rehabilitation in COVID-19 respiratory failure patients post-ICU. Respir Physiol Neurobiol; 287: 103639.
28. Matthias Hermann, Anna-Maria Pekacka-Egli, Fabienne Witassek, Reiner Baumgaertner, Sabine Schoendorf and Marc Spielmanns (2020): Feasibility and Efficacy of Cardiopulmonary Rehabilitation following COVID-19. Am J Phys Med Rehabil;99(10):865-869
29. Sara Reina-Gutiérrez, Ana Torres-Costoso, Vicente Martínez-Vizcaíno, Sergio Núñez de Arenas-Arroyo Rubén Fernández-Rodríguez, and Diana P. Pozuelo-Carrascosa (2021): Effectiveness of Pulmonary Rehabilitation in Interstitial Lung Disease, Including Coronavirus Diseases: A Systematic Review and Meta-analysis.Arch Phys Med Rehabil;102(10):1989-1997
30. Lau HMC, Ng GYF, Jones AYM, et al. (2005): A randomised controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory syndrome. Aust J Physiother;51:213–219.
31. Jiandani, M.P.; Salagre, S.B.; Kazi, S.; Iyer, S.; Patil, P.; Khot, W.Y.; Patil, E.; Sopariwala, M. Preliminary Observations and Experiences of Physiotherapy Practice in Acute Care Setup of COVID 19: A Retrospective Observational Study. J. Assoc. Physicians India 2020, 68, 18–24.
32. Nopp, S., Moik, F., Klok, F. A., Gattinger, D., Petrovic, M., Vonbank, K., Koczulla, A. R., Ay, C., & Zwick, R. H. (2022). Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life. Respiration; international review of thoracic diseases, 101(6), 593–601. https://doi.org/10.1159/000522118
33. Spruit MA, Holland AE, Singh SJ, Tonia T, Wilson KC, Troosters T. COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force. Eur Respir J. 2020;56(6):2002197.
34. Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020;66(2):73–82.
35. Ceravolo MG, Arienti C, de Sire A, Andrenelli E, Negrini F, Lazzarini SG, et al. Rehabilitation and COVID-19: the cochrane rehabilitation 2020 rapid living systematic review. Eur J Phys Rehabil Med. 2020;56 (5):642–51.
36. Onu, I.; Iordan, D.-A.; Matei, D.; Hrisca-Eva, O.-D.; Buculei, I.; Galaction, A.-I.; Serban, I.L.; Dobrin, M.-E.; Popa-Velea, O.; Costin,D.E.; et al. Impact of Physiotherapy on Patients Suffering from COVID-19: An Observational Study. Appl. Sci. 2022, 12, 5795. https://doi.org/ 10.3390/app12125795
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Apr 15, 2023
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Hany Mahmoud Fares, Asmaa Younis Elsary, Basant Hamdy Elrefaey, Asmaa Abdel Maksoud Ghanem, Eman Mahmoud Fares, & Enas Sayed Farhat. (2023). Effect of pulmonary rehabilitation program on post hospitalization severe COVID-19 patients (Experimental study). Journal of Population Therapeutics and Clinical Pharmacology, 30(7), 133–140. https://doi.org/10.47750/jptcp.2023.30.07.016
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