Experience in the use of physical rehabilitation in patients after pneumonia associated with covid-19, as part of the implementation of the national project “healthcare”

Authors:

Victoria V. Afanasyeva, head of the Department of physical methods of treatment and rehabilitation of the Clinic of the Scientific and Clinical Research Center, Pavlov First St. Petersburg State Medical University, 6-8 L’va Tolstogo Street, 197022 St. Petersburg, Russian Federation, ORCID 0000-0002-4225-1356.

Potapchuk Alla Askoldovna, Grand PhD in Medical sciences, Professor, head of the Department of medical rehabilitation and adaptive physical culture, Pavlov First St. Petersburg State Medical University, 6-8 L’va Tolstogo Street, 197022 St. Petersburg, Russian Federation, ORCID 0000-0001-6943-8949.

Annotation:

Introduction. A generally accepted system of rehabilitation measures has not been created. In this regard, the development of methods for assessing the rehabilitation profile, criteria for the effectiveness of medical rehabilitation of patients who have undergone a new coronavirus infection COVID-19 meets the requirements of the time.

Aim. The aim is to develop a scientifically based medical rehabilitation program for patients who have undergone a new coronavirus infection and to determine its effectiveness from the standpoint of the International Classification of Functioning (ICF).

Materials and methods. A center for the treatment of patients with new coronavirus infection was deployed on the basis of the clinic of the Pavlov State Medical University. Some of the patients treated at the center who suffered a new coronavirus infection in severe and moderate severity were re-hospitalized for the purpose of conducting a course of medical rehabilitation 2-3 months after discharge. 2 groups were formed: control group — 21 people who received only drug therapy, and experimental group — 38 people who received drug therapy, respiratory gymnastics, physical therapy with an emphasis on muscle strength endurance training, Nordic walking and physiotherapy procedures. We have identified the relationship between the severity of functional disorders (categories) in patients who have undergone a new coronavirus infection with changes in the indicators of instrumental, clinical and laboratory studies.

Results and discussion. As a result of the application of the medical rehabilitation program in patients of the experimental group, significant improvements were revealed in b440 Respiratory functions (p<0.005), b455 Exercise tolerance function (p<0.005) and the d450 Walking (p<0.005). In patients from control group, changes in the ICF categories were detected only in b455 Function of exercise tolerance (p<0.005). The greatest importance in the formation of rehabilitation potential in patients with experimental group and control group is the impact on activity and participation (21.9 % in experimental group, 12.6 % in control group). In experimental group, the effect of the medical rehabilitation program on the structures and functions of the respiratory system was 20.9 %, while in control group only 5.4 %. The relative increase in rehabilitation potential in experimental group compared to control group was 79 %. The results of the study indicate the effectiveness of the proposed program of medical rehabilitation of patients who have undergone COVID-19.

Summary. The results of the study and the statistically significant parameter introduced — the potential of patients’ rehabilitation (Pr) — allowed us to evaluate the effectiveness of the proposed program of medical rehabilitation of patients who underwent COVID-19.

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