Підходи до фізичної терапії пацієнтів із COVID -19 у гострій і післягострій фазах хвороби

Abstract

Coronavirus disease 2019 (COVID-19) has created global problems around the world, and because of the great international health threat, the World Health Organization has recognized its spread as a pandemic. The severity of the disease may be mild, moderate, severe and critical. There are such peculiarities of COVID-19 as changes in the lungs with a tendency to develop rapidly progressive atypical pneumonia, the course of which is often complicated by acute respiratory failure and acute respiratory distress syndrome, and in the future, there is a risk of pulmonary fibrosis and, consequently, chronic respiratory failure. Quite common cases of long COVID, which includes ongoing symptomatic COVID-19 and post-COVID-19 syndrome, are characterized by persistent pulmonary dysfunction, muscle weakness, pain, fatigue, depression, anxiety, decreased exercise tolerance, occupational problems, and poor quality of life. Appropriate protocols have been developed for the treatment of patients with COVID-19, which are constantly updated and supplemented. Concerning methods of physical therapy and pulmonary rehabilitation in the management of patients with COVID-19, they are elaborated insufficiently, especially for patients in acute and post-acute phases of the disease. Rational use of means and methods of physical therapy in combination with pharmacological treatment and psychotherapy will allow mobilizing, as much as possible, restorative and compensatory resources of patients with COVID-19 in overcoming disease at all phases, irrespective of a place of treatment and rehabilitation. Therefore, standards of care for patients with COVID-19 should include an optimal set of methods of physical therapy and pulmonary rehabilitation, taking into account the period and severity of the disease, including critical disease in patients undergoing mechanical ventilation. The education of a patient and people from his immediate surroundings with the aim of their active participation in the process of treatment and rehabilitation is very important. In the implementation of pulmonary rehabilitation programs, methods of distant communication with patients should be used as much as possible, and if they are unable, live courses with strict adherence to anti-epidemic measures should be provided. Taking into account all aspects of treatment and rehabilitation will help patients recover as quickly as possible and return to active life, as well as prevent the development of complications of the disease and the spread of infection