长期COVID-19：个性化康复计划的影响

Q3 Medicine

Rehabilitacion Pub Date : 2025-03-28 DOI:10.1016/j.rh.2025.100903

J.C. Perrot , M. Segura , G. Flotats , C. Closa , I. Gich , C. Garcia , A. Alba , M.J. Nadal , A. Pintor , J. Terra , E. Ramirez , M. Beranuy , H. Bascuñana , V. Plaza , M.R. Güell-Rous

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引用次数: 0

摘要

一些指南提出了特定的康复方案来治疗急性后COVID综合征（PACS）患者的症状/后遗症。只有少数研究表明，康复可以减少COVID-19后的残疾。目的描述PACS患者在运动耐量、肌肉功能、呼吸困难、生活质量和虚弱状态方面对个性化康复计划的反应。方法对社区住院患者进行观察性前瞻性队列研究。康复计划包括三种模式（门诊、家庭和自我管理），选择性地辅以呼吸肌训练。研究变量：6分钟步行距离（6MWD）、吸气肌力量（PImax）、呼吸困难、肌肉力量（用医学研究委员会量表和握力评估）、健康相关生活质量（HRQoL）和虚弱程度(用短体能性能测试（SPPB）评估，基线后3个月和6个月。结果178例PACS患者中，101例（56.7%）参加了康复计划，其中41.6%为家庭康复，27.7%为门诊康复，24.8%为自我康复。56例患者接受了吸气肌训练（IMT），其中50例纳入康复计划，6例（5.9%）单独接受了吸气肌训练。3个月时mMRC强度（p = 0.001）、SPPB (p <；0.0001)，握力（p = 0.017）， mMRC呼吸困难，PImax (p <；0.0001)和6-MWD （p = 0.008）。6个月后mMRC强度（p = 0.048）、SPPB （p = 0.002）、PImax (p <；0.0001), 6MWD （p = 0.048）。HRQoL精神和身体成分评分仅在3个月时改善。结论个性化康复治疗可改善PACS患者6个月前的肌肉参数、呼吸困难和运动能力，但没有改善HRQoL。呼吸肌力量的改善与呼吸困难的减少和运动能力的增加有关。

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Long COVID-19: Impact of a personalized rehabilitation program

Introduction

Several guidelines have proposed specific rehabilitation programs to treat symptoms/sequelae in patients with post-acute COVID syndrome (PACS). Only a few studies show that rehabilitation reduce disability after COVID-19.

Objective

To describe the response to a personalized rehabilitation program in terms of exercise tolerance, muscle function, dyspnea, quality of life, and frailty state in a cohort of patients with PACS.

Methods

Observational prospective cohort study of community-dwelling patients. The rehabilitation program included three modalities (outpatient, home-based, and self-administered), optionally supplemented with respiratory muscle training. Study variables: 6-minute walking distance (6MWD), inspiratory muscle strength (PI_max), dyspnea, muscle strength (estimated with the Medical Research Council scale and handgrip), health-related quality of life (HRQoL), and frailty estimated with the Short Physical Performance Battery (SPPB) and at 3- and 6-months following baseline.

Results

Of 178 patients with PACS, 101 (56.7%) were enrolled in a rehabilitation program: 41.6% home-based, 27.7% outpatient, and 24.8% self-administered. Inspiratory muscle training (IMT) was provided to 56 patients, with 50 included in the rehabilitation program and 6 (5.9%) receiving IMT alone. Significant improvements were observed at 3 months in mMRC strength (p = 0.001), SPPB (p < 0.0001), handgrip strength (p = 0.017), mMRC dyspnea, PI_max (p < 0.0001), and 6-MWD (p = 0.008). Improvements persisted at 6 months for mMRC strength (p = 0.048), SPPB (p = 0.002), PI_max (p < 0.0001), and 6MWD (p = 0.048). HRQoL mental and physical component scores improved only at 3 months.

Conclusions

Personalized rehabilitation for patients with PACS improved muscle parameters, dyspnoea, and exercise capacity, but not HRQoL, up to 6 months. Improvements in respiratory muscle strength were associated with reductions in dyspnoea and increased exercise capacity.

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来源期刊

Rehabilitacion Medicine-Rehabilitation

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： La revista que es desde hace más de 40 años la publicación oficial de la Sociedad Española de Rehabilitación y referente de la mayoría de las Sociedades de la Especialidad de los países americanos de habla hispana. Se publican 5 números pluritemáticos al año y uno monográfico sobre un tema del mayor interés y actualidad designado por el consejo de redacción.