EVALUATION OF THE THERAPEUTIC EFFECTS OF TRANSCUTANEOUS INTERFERENTIAL CURRENT THERAPY AND THERAPEUTIC EXERCISES ON MUSCULOSKELETAL SYMPTOMS IN PATIENTS WITH POST COVID-19

Abstract

The aim of this research was to investigate the therapeutic effectiveness of a multi-component rehabilitation program including: transcutaneous interferential current therapy and therapeutic exercises in patients with musculoskeletal symptoms in post COVID-19 syndrome. Materials and Methods: 62 patients, mean age 55.9(13.99), aged 21 to 79 years, with persistent musculoskeletal symptoms in the recovery phase after experiencing COVID-19 were included in this study. All patients underwent a ten-day treatment course in an outpatient setting, including transcutaneous application of interferential current with four electrodes. The therapeutic parameters were selected with analgesic, trophic and stimulating effects (90-100 Hz, 5min and 0-100 Hz, 15min). Immediately after electrotherapy, kinesitherapy was performed including: breathing exercises, aerobic training, active and resistance exercises for the limbs, postural control exercises and exercises to improve the mobility of the peripheral joints and the axial skeleton. Results were evaluated by: Visual Analogue Scale (VAS) for assessment of back pain, Numerical Rating Scale (NRS) for arthralgia and myalgia assessment, Brief Fatigue Inventory (BFI) – fatigue assessment, functional tests of mobility, Goniometry in the spine, Ott Sign- for measuring the range of motion (ROM) of the thoracic spine, Schober’s test to determine a lumbar spine range of motion (flexion), Tom Meyer’s test for total hip joint and spine flexion mobility. The results were reported before and after the rehabilitation. The statistical significance level was specified as (p<0.05). Results: Musculoskeletal symptoms in the observed patients persisted for an average of 12 weeks, ranging from 7 to 20 weeks, and included: myalgia in 46.8% (29), arthralgia 29.0% (18), pain in various back departments 79.0% (49), fatigue 66.1% (41). Inpatient treatment for acute COVID-19 was performed in 35.5% (22) of patients, and home and outpatient treatment in 64.5% (40). There was a statistically significant reduction (Mean (SD)) after therapy in back pain (VAS) from 4.88(1.5) to 1.93(1.1), myalgia (NRS) from 3.66(1.2) to 1.29(1.1), arthralgia (NRS) from 3.27(1.2) to 0.89 (0.8), and fatigue index (BFI) showed a reduction from 5.73(1.4) to 3.22(1.4). There was an increase in mobility in Ott’s symptom from 2.24(1.2) to 2.86(0.9) cm, Schober’s test 1.41(1.2) to 2.38(0.9) cm, Tom Meyer’s test from - 8.23(6.5) to - 2.46(3.7) cm. Conclusion: In the recovery phase post COVID-19, some of the patients had long-time persistent musculoskeletal symptoms (fatigue, myalgia, arthralgia, back pain). These are a common reason for these patients to be referred for outpatient rehabilitation. In order to design a multi-component rehabilitation programme, it is necessary to take into account individual characteristics and comorbidities. The inclusion of physical modalities such as electrotherapy requires an accurate assessment of the rehabilitation potential and the presence of any counterindications. Therapeutic exercises have been proven to be effective in post COVID-19 patients. The results of this study show that the combination of interferential current therapy and therapeutic exercise can effectively reduce back pain, myalgia, arthralgia, and perception of fatigue. On the other hand, this multicomponent program resulted in improvement in functional tests in the studied patients. Due to the small sample size, it is advisable to continue the study in the future, covering a larger number of patients with long-standing musculoskeletal symptoms as part of post-COVID-19 syndrome, in order to design an effective strategy that can efficiently reduce negative health consequences and improve functional activity in these patients.