Authors (including presenting author) :
Kwok CKC (1), Lee DCK (1), Yu DTW (1), Chan ACM (1)
Affiliation :
(1) Department of Physiotherapy, Queen Elizabeth Hospital
Introduction :
The coronavirus 2019 (COVID-19) pandemic brings about enormous stress the public healthcare system. Whilst a vast majority of COVID-19 patients experienced mild symptoms or were even asymptomatic, around 10% of the patients presented with dyspnoea, hypoxaemia and extensive lung involvements. Around 5% of patients developed severe symptoms including respiratory failure, shock, multiorgan failure and required intensive care. This group of patients remained bedridden and required multiple life support for an extended period, thus were doomed to acquire muscle weakness, physical deconditioning and neuropathy. Alongside their physical decline, lung fibrosis as a result of COVID-19 infection led to decrease in lung function. Rehabilitation become essential for this group of COVID-19 patients.
Objectives :
To provide pulmonary rehabilitation (PR) programme for COVID-19 patients with rehabilitative needs
To prepare COVID-19 patients for returning to their premorbid activity level or returning to work
To evaluate the rehabilitative outcomes for PR programme
Methodology :
This is a prospective longitudinal study. Referral sources of PR programme includes: 1) Medical Infectious Disease Clinic (MIDC); and 2) proactive screening of patients during MIDC follow-up by physiotherapists. Patients with COVID-19 infection, complained of dyspnea during activities of daily living and physical activities, or expressed limitation returning to premorbid physical level or work due to dyspnea or limitation in physical status were recruited to PR programme. The 8-week programme consisted of 2 sessions of 60-minute individualized training per week, including stretching and cool-down sessions, cardiovascular training, strengthening exercise and submaximal training. St.George’s Respiratory Questionnaire (SGRQ), 6-Minute Walk Distance (6MWD), 30-second sit-to-stand test (STST) hand grip strength (HGS), Body Mass Index (BMI), body composition and maximal rate of oxygen consumption (VO2 max) were taken at baseline and upon completion of the programme.
Result & Outcome :
14 COVID-19 patients were recruited to PR programme, 8 of which completed the programme. 4 participants dropped out and their telephone follow-up reported that their physical condition returned to premorbid level and 2 participants could not be contacted. Among the 8 participants, there was significant reduction in SGRQ symptoms subscore (p=0.028), while there was no overall significant difference in SGRQ total score. There was also a nearly significant improvement in 6MWD by 85 metres (p=0.056), and a significant improvement in STST by 3 repetitions (p=0.09). No significant improvement in BMI and VO2 max was detected. No adverse effects were reported.
This concluded that PR programme is safe and effective to restore functional capacities for COVID-19 patients who experienced limitation returning to premorbid physical level or work due to dyspnoea and physical deconditioning.
