Efectos de la fisioterapia cardiopulmonar sobre la fisiología en pacientes post-COVID-19

Introduction

The respiratory difficulty caused by COVID-19 in severe cases leads to Intensive Care Units Acquired Weakness (ICUAW) after prolonged bed rest and treatment by invasive mechanical ventilation (IMV), which leads to a decrease in health status due to deconditioning.

Objective

To study the effects of a cardiopulmonary training program on muscle mass and strength in post-COVID-19 patients.

Methods

A quasi-experimental study was conducted with post-COVID-19 patients who were admitted to the ICU and developed ICUAW. The main variables were the diameter of the rectus femoris muscle (assessed with ultrasound), the knee extensors strength (assessed with a manual dynamometer), the strength of the inspiratory and expiratory muscles (assessed with a RPM™ system) measured at the beginning and end of the program. The program was composed of warm-up, aerobic exercise on a cycle ergometer, strength exercise and relaxation; guided by a physiotherapist. Student's t-test was used to study changes in the variables and Cohen's d statistic to study the magnitude of the change, with an alpha significance level of 0.05.

Results

25 patients completed the program (48% men). Statistically significant changes were obtained in all variables at the end of the program (P < .05) and a moderate effect size (d > 0.5) for knee strength, and large (d > 0.8) for the diameter of the rectus femoris and respiratory muscle strength.

Conclusions

The cardiopulmonary program in post-COVID-19 patients with ICUAW may have beneficial effects and clinically relevant impact on muscle mass and strength.