Оцінка ефективності фізичної терапії в реабілітації пацієнтів із COVID 19 пневмонією

Abstract

The purpose of the study was to evaluate the effectiveness of physical therapy in the rehabilitation of persons who have suffered from COVID-19 pneumonia, in terms of its effect on health-related quality of life and functional status of patients. Materials and methods. Using the questionnaire, an anonymous survey of 68 people who suffered from COVID-19 pneumonia was conducted: 27 men and 41 women aged 18-90 years (median – 58 years). To determine the effectiveness of physical therapy, we used the assessment of quality of life on a 100-point percentage scale and the level of functioning on the scale of Post-COVID-19 Functional Status. Results and discussion. Among the examined persons, physical therapy was carried out only in 37 cases (54%). Two groups of patients were formed: group 1 (37 people) – with the use of physical therapy, group 2 (31 people) – without the use. Physical therapy methods were positioning, breathing exercises, aerobic exercises for different muscle groups, walking, and swimming. In group 1, 23 people out of 35 (66%) followed prone positioning, while in group 2 – only 4 people out of 21 (19%) (p=0.001). The vast majority of patients in group 1, 31 out of 34 (91%), were engaged in physical therapy on one's own (participation of rehabilitators was only in 2 cases, 6%), and they mainly used Internet resources to study the physical therapy techniques (18 out of 29, 62%). According to the quality of life before the onset of the disease, groups 1 and 2 did not differ from each other (respectively, 80.7 ± 13.3% vs 82.6 ± 11.5%, p >0.05). After the acute period of the disease, the quality of life decreased more prominent in people of group 1 and was 58.1 ± 17.0% against 66.8 ± 15.4% in group 2 (p=0.026). After recovery, the quality of life of patients of group 1 significantly increased in relation to the state after the acute period compared to group 2, namely by 15.9 ± 11.5% vs 9.7 ± 8.9%, respectively (p=0.019). In patients who started physical therapy in the acute phase of the disease (9 out of 25, 36%), compared to those who started physical therapy only in the post-acute phase (16 people, 64%), there was a significantly less pronounced decrease in the quality of life after the acute phase compared with the condition before the onset of the disease (respectively, by 11.1 ± 7.8% vs 30.0 ± 14.1%, p=0.002). In general, 28 patients out of 30 people (93%) of group 1 indicated the effectiveness of the rehabilitation, most often a good effect (21 people, 70%). Level of functioning on the Post-COVID-19 Functional Status scale significantly improved compared to the state before the start of rehabilitation (respectively, 0.83 ± 1.07 vs 1.9 ± 3.0, p=0.008). However, the quality of life after recovery in group 1 did not reach the level that was before the disease (respectively, 74.1 ± 13.0% vs 80.7 ± 13.3%, p=0.001), which was also observed in group 2. Conclusion. The results of the study indicate efficiency of the use of physical therapy for the rehabilitation of patients with COVID-19 pneumonia. Physical therapy should be started already in the acute phase of the disease, as it contributes to a less pronounced deterioration of the quality of life after this phase