POS1453 INTERVAL HYPOXIC-HYPEROXIC TRAINING IN REHABILITATION OF PATIENTS WITH OSTEOARTHRITIS AND POST-COVID SYNDROME

Abstract

BackgroundIntermittent hypoxia conditioning reduces the levels of inflammatory parameters and cytokines (C-reactive protein, TNF-α, IL-4, IL-6, IL-8), increases the tolerance to acute hypoxia, the functional capacity and improves parameters of respiratory and cardiovascular systems [1–4].ObjectivesTo evaluate the efficiency of the interval hypoxic-hyperoxic training (Reoxy therapy) in the rehabilitation of patients with osteoarthritis (OA) and post-COVID syndrome.Methods36 patients with OA (78% females, age of 43 to 68 years, generalized OA, OA of the knee or hip joints) where included in the randomized placebo-controlled study. Coronavirus infection COVID-19 were diagnosed from 12 to 26 weeks before the study. The main symptoms of post-COVID syndrome were dry cough, smell loss, breathlessness, weakness, fatigue, sleep disorders, cognitive symptoms, memory problems, anxiety, depression, headache, dizziness, joint and muscle pain. All patients were randomized into 3 groups. 13 study group patients received 10 Reoxy therapy procedures, 9 placebo group patients – 10 placebo procedures of Reoxy therapy, 14 control group patients – only standard rehabilitation. The patients of all groups underwent 2-week standard rehabilitation program: 10 procedures of electrostatic massage for muscles and periarticular tissues, 10 sessions of general magnetic therapy, 10 group sessions of physical exercises with elements of breathing exercises. All patients received NSAIDs and SYSADOA at standard dosages. Intra-articular corticosteroids was not used. The study group patients were breathing hypoxic (FiO2 13–15%) and hyperoxic (FiO2 up to 40%) gas mixture through the mask in the interval mode with biofeedback using device «ReOxy» (Ai Mediq S.A., Luxembourg). 10-min hypoxic test (FiO2 12–13%) was performed before the first and fourth procedures. The duration of 1–4 procedures was 30 min, 5–10 procedures – 40 min. The placebo procedures were performed using the mask with the atmospheric air hole. Joint pain and general health on 100-mm VAS, Lequesne and WOMAC indexes, Spielberger-Khanin anxiety test, Beck depression inventory and breathlessness on Modified Borg scale were evaluated at baseline and at 2 weeks.ResultsAfter 2 weeks in the study group pain on VAS decreased by 49,6% (p<0,05), Lequesne index – by 39,3% (p<0,05), WOMAC – by 1,4 times (р<0,01), anxiety level on Spielberger-Khanin test – by 40,9% (p<0,05), depression level on Beck depression inventory – by 64,1% (p<0,01), general health on VAS improved by 69,3% (р<0,01). The level of breathlessness on Modified Borg scale in the study group initially was 2,5±0,9 score (moderate – slight breathlessness). After rehabilitation in the study group the level of breathlessness decreased to 0,3±0,4 score (extremely slight – no breathlessness). In the study group there were statistically significant differences from the placebo group (р<0,05) and the control group (р<0,05) in all parameters.Conclusion2-week complex rehabilitation program, including interval hypoxic-hyperoxic training (Reoxy therapy), reduces pain, breathlessness, depression and anxiety, improves functional status and general health in patients with OA and post-COVID syndrome.