Nursing rehabilitation care for patients with postCOVID syndrome: mobility limitations

Authors:

Bakhtina Irina Sergeevna, PhD in Medical sciences, Director of the Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation;tel.: +79219074717; e-mail: ibakhtina@yandex.ru; https://orcid.org/0000-0002-4046-0605.

Kalinina Svetlana Alekseevna, PhD in Medical sciences, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79668597425; e-mail: kalinina@spbcpo.ru; https://orcid.org/0000-0003-1033-5210.

Garderobova Larisa Vladimirovna, PhD in Medical sciences, Deputy director for scientific and methodological work of the Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7911821857; e-mail: lvg@spbcpo.ru; https://orcid.org/0000-0001-5191-8741.

Smirnova Svetlana Sergeevna, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79052661547; e-mail: svet.smirnova.s@mail.ru.

Kolobanova Natalia Gennadievna, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79213983323; e-mail: kolobanova79@gmail.com.

Balandina Irina Nikolaevna, Head of practical training, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79213134504; e-mail: irinabalandi@yandex.ru; https://orcid.org/0000-0002-9654-6387.

Gainutdinova Olga Valerievna, Head of the Department of the organization of the educational process, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the FMBA of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79119232004; e-mail: gainutdinova@spbcpo.ru.

Annotation:

Introduction. The relevance of this study is determined by the high prevalence and social significance of the negative consequences of COVID-19, including the formation of mobility restrictions.

Aim. To analyze the prevalence of mobility limitations — the results of self-assessment in people who have undergone a new coronavirus infection COVID-19 and to determine the target areas of nursing rehabilitation care in accordance with the domains of the International Classification of Functioning, Disability and Health (ICF).

Materials and methods. The patient’s self-assessment was carried out by filling out a specially designed questionnaire including of mobility restrictions according to the nursing domains of ICF. The study of 496 units involved 83.9% of women, 16.1% of men; of these 68.2% were treated on an outpatient basis, 10% — in a hospital; 21.8% were asymptomatic. In the post-COVID period, respondents complained of disorders of the nervous system (87.2%), cardiovascular system (68.5%), respiratory system (55%), urogenital system (45.3%), gastrointestinal tract (57.9%), mental and behavioral disorders (85.6%). The frequency of occurrence and the average severity of various mobility restrictions were calculated. From among the respondents, a focus group of patients who had COVID-19 and expressed a desire to take a course of exercise therapy in a hybrid format was created: classes 1-sth and 10 were offline, the rest — online, using telerehabilitation technologies.

Results. Regardless of gender, mobility limitations in the spine were noted by 45.5% of the respondents, mobility limitations in the joints — 41.7%; difficulties in changing the position of the body in the initial position lying or sitting had 38.4%, more often women; restrictions on bending — 38%, more often men; restrictions on lifting and moving objects — 34.5%, more often women. Half of the respondents found it difficult to walk long distances (53%), while walking several tens of meters did not cause any difficulties for 82%. For the majority, the conditions for movement do not matter, in less than a third of cases the ability to walk on uneven surfaces is limited (27.7%), about one fifth of patients have difficulty moving along the street (22.8%) or in unfamiliar premises (19.6 %); the majority have limited ability to run (63.7%) and jump (57.5%).

Discussion. Mobility limitations were found in the majority of respondents who underwent COVID-19. Mobility limitations included: limitations of the ability to walk, run, jump, limitations of mobility in the spine, joints, difficulties in changing the position of the body, bending, moving objects.

Conclusion. Most patients with COVID-19 infection experience moderate to mild mobility limitations, requiring the nurse to dynamically monitor the risk of falls, create a safe environment, and ensure a measured increase in physical activity. It is necessary to include this topic in the program of additional professional education of nursing staff in the specialties “Nursing” and “Rehabilitation nursing”.

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