Post-COVID-19 rehabilitation in the post-hospitalization period – case study

Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka


Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka – Post-COVID-19 rehabilitation in the post-hospitalization period – case study. Fizjoterapia Polska 2022; 22(3); 102-115

DOI: https://doi.org/10.56984/8ZG142HN3

Abstract
Aim of the research work. The main goal of the research work was to show an author’s plan of physiotherapeutic intervention for people suffering of COVID-19 in the post-acute stage. The therapeutic procedure highlighted pulmonary rehabilitation, aerobic and resistance training and patient’s education.
Case study. The research work was performed on a 62-year old woman, who was diagnosed with infection by SARS-CoV-2 virus. The patient was admitted to ICU with acute ARDS in a heavily severe condition. The medical history showed obesity, chronic ischemic heart disease, arterial hypertension and cardiac arrest (2011). The patient was admitted to the rehabilitation unit in the post-acute stage of infection, and was using passive oxygen therapy with oxygen flow set to 4 l/min. During the qualification for therapy the patient was tested using a questionnaire which consisted of clinical tests such as 6MWT, MRC, 30CST and FIM scale. Furthermore, the lungs were examined using spirometry. Identical measurements were being used every 2 weeks of the therapy process. After 8 weeks of physiotherapeutic procedure there was a significant increase of score in 6-MWT which upgraded by 750%. Systematic improvement was also visible in dyspnoea and fatigue, which completely surceased after finishing the therapeutic process. Functional state of the patient improved considerably which is shown by 30CST score, improved by 380%. Spirometry score analysis shows FVC, FEV1 and Tiffeneau-Pinelli index improve respectively by 40%, 53% and 9.6%.
Summary. The therapeutic program based on pulmonary rehabilitation, aerobic and resistance training and patient’s education looks very promising. Implemented procedure contributed to the patient’s relatively quick recovery to a pre-COVID-19 state. Patient’s physical and pulmonary efficiency were noticed, exertional tolerance increased, dyspnoea and fatigue gave way which all combined led to improved functional efficiency. Pulmonary system function was also enhanced which was demonstrated by spirometry.

Key words:
SARS-CoV-2, COVID-19, physiotherapy, rehabilitation

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Vibrotherapy in respiratory disorders, including COVID-19

Rafał Aleksander Guzik, Alicja Pasterczyk-Szczurek

R. A. Guzik, A. Pasterczyk-Szczurek – Vibrotherapy in respiratory disorders, including COVID-19. Fizjoterapia Polska 2021; 21(4); 174-182

Abstract
Successfully used for years in the rehabilitation of various diseases, the techniques of manual vibration massage and therapeutic vibrations generated by medical devices distinguish a new type of physical therapy – vibrotherapy. Therapeutic vibration stimulates blood and lymph circulation, the neuromuscular system, and, in the form of respiratory vibration therapy, helps clear airways of secretions and strengthens respiratory muscles, improving tissue oxygenation in patients with cystic fibrosis and, more recently, in patients with chronic obstructive pulmonary disease or coronavirus 2019 disease (COVID-19). Although the use of respiratory vibration therapy is well established in cystic fibrosis, it has yet to be sufficiently studied in other pulmonary disorders, and since the clinical potential of respiratory vibration therapy is broad, the authors of this literature review wish to point out that it should not be neglected. Particularly in automated form during pandemic times, as in the case of the COVID-19 pandemic – hindering rehabilitation services, quarantine isolations – respiratory vibration therapy can be crucial in rehabilitation, enriching both hospital and home physiotherapy offers.
Key words:
vibrotherapy, whole body vibration, COVID-19, rehabilitation, respiratory disorders
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Shoulder joint function evaluation after reverse total shoulder arthroplasty – preliminary reports

Ewelina Żyżniewska-Banaszak, Magdalena Gębska, Sebastian Sokołowski, Anna Sobczak, Łukasz Kołodziej

E. Żyżniewska-Banaszak, M. Gębska, S. Sokołowski, A. Sobczak, Ł. Kołodziej – Shoulder joint function evaluation after reverse total shoulder arthroplasty – preliminary reports . Fizjoterapia Polska 2021; 21(4); 142-151

Abstract
Introduction. Physiotherapy is an important part of the comprehensive treatment of patients after reverse total shoulder arthroplasty (RTSA). Patients qualified for RTSA struggle with shoulder joint dysfunctions of various aetiologies – most often with irreparable damage to the rotator cuff tendons. The aim of physiotherapy after RTSA is to restore the lost functions of the shoulder joint based on a targeted rehabilitation protocol taking into account the changed biomechanical conditions of the shoulder.
Materials and methods. The study material consisted of 6 patients after RTSA. Patients were examined before the procedure and after rehabilitation with the use of the Constant-Murley Score. The rehabilitation model was implemented on the day before surgery and continued for 12 weeks.
Results. Each patient experienced an improvement in shoulder mobility and a reduction in pain intensity.
Conclusions. Rehabilitation after RTSA improves the functions of the shoulder joint expressed by an increased range of joint mobility, elimination of pain and improved quality of life.
Key words:
shoulder joint, total shoulder arthroplasty, orthopaedics, rehabilitation
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Analysis of pain and quality of life in women after radical and sparing mastectomy

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski – Analysis of pain and quality of life in women after radical and sparing mastectomy. Fizjoterapia Polska 2021; 21(3); 214-225

Abstract
Objective. The objective of the study was to analyse pain and quality of life in women after radical and sparing mastectomy. The quality of life after radical mastectomy compared to sparing mastectomy was characterized, assessing difficulties in everyday life and work, as well as limitations in undertaking various activities caused by pain after the procedure. The study verified whether the type of mastectomy significantly impacted selected aspects of life.
Material and method. The questionnaire-based study was carried out among 100 patients of Holy Cross Cancer Centre, aged 29 to 88 years, after radical and sparing breast cancer treatment. In order to compare the values of quantitative and qualitative variables between the groups, Student’s t-test, chi-square test, Mann-Whitney test and Shapiro-Wilk test were used. A significance level of p <0.05 was adopted in the course of the analysis. Statistical analysis was performed using Statistica 13.1 by StatSoft; the data was collected in Excel 2016.
Results. The analysis showed no statistically significant differences in the level of pain intensity in each analysed area between the groups of women, however, it confirmed a statistically significant correlation between the type of surgery performed and the onset of pain as well as limitations in everyday functioning. The analysis showed no statistically significant differences in pain intensity depending on the treatment period.
Conclusions. The level of pain after radical and sparing mastectomy was similar. After radical mastectomy, the patients’ quality of life was lower than after sparing mastectomy. Rehabilitation reduced pain intensity and improved the patients’ quality of life.
Key words:
radical mastectomy, sparing mastectomy, rehabilitation, quality of life
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An evaluation of the effectiveness of electroanalgesia using the Stiwell method in the rehabilitation of patients with lumbar back pain syndrome

Mirosław Janiszewski, Maciej Chyliński

Mirosław Janiszewski, Maciej Chyliński – An evaluation of the effectiveness of electroanalgesia using the Stiwell method in the rehabilitation of patients with lumbar back pain syndrome. Fizjoterapia Polska 2001; 1(1); 45-46

Abstract
Background. Pain symptoms in the lumbar segment of the spine constitute a problem that is not only medical, but also social and economic. The goal of this article is to evaluate the therapeutic effectiveness of electroanalgesis in treating this disorder. Material and method. The experimental group consisted of 80 patients aged 40-60, who underwent a two-month rehabilitation program using the Stiwell electroanalgesic method. The control group included 80 patients who received a traditional rehabilitation program. Results. A significant reduction in pain symptoms was discovered in the experimental group, as compared to the control group. Conclusion. The Stiwell electroanalgesic method serve to improve the ultimate outcome of the patients with lumbar back pain syndrome.

Key words:
electroanalgesia, lumbar back pain syndrome, Rehabilitation

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The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński – The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system. Fizjoterapia Polska 2001; 1(1); 43-44

Abstract
The authors present various symptoms that may indicate developmental disorders of the visual apparatus in connection with associations of the neuronal pathway with the sometimes very complicates reflex arches. The Direct Light Stimulation method (DLS) is presented, which may be helpful in the stimulation and rehabilitation of children with damage to the central nervous system.

Key words:
Vision, CNS injury, diagnositics, Rehabilitation

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An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices

Mirosław Janiszewski, Anna Błaszczyk

Mirosław Janiszewski, Anna Błaszczyk – An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices. Fizjoterapia Polska 2001; 1(1); 39-42

Abstract
The aim of this study was to examine the impact of longterm magnetic field stimulation on the rehabilitation of post-stroke patients and to determine how quickly these patients gain locomotor efficiency. A group of 180 patients 50-70 years old after stroke received rehabilitation and low frequency magnetic field stimulation. As a criterion for evaluation purposes the authors used selected biomechanical and psychotechnical indices. The study shows that magnetotherapy in post-stroke patients undergoing rehabilitation has a positive effect in the improvement of muscle function, motor coordination indices, and some biomechanical parameters (strength under dynamic and static circumstances).

Key words:
Stroke, magnetic fields, Rehabilitation

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The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon – The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury. Fizjoterapia Polska 2001; 1(2); 143-154

Abstract
Background. The purpose of this article is to evaluate the relative effectiveness of differentiated rehabilitation programs for patients with hemispatial neglect subsequent to traumatic brain injury (TBI). In the literature, neglect is classified into two basic types: egocentric (“body-centered”), in which the patient neglect object situated in a given area of his field of vision, and allocentric )”objected-focused”), in which the patient neglects one side of objects presented to him, regardless of their location. The authors’ clinical practice indicates that the visual scanning technique traditionally used in neglect therapy is generally ineffective in patients with egocentric neglect. A spatio-motor training program has therefore been developed by the authors, elaborated on the basic of their program of semantically controlled motion patterns for the rehabilitation of apraxia, whose goal is to reestablish the proper relations between automatic and voluntary movements, to improve interhemisphere cooperation by symmetrical and asymmetrical modeling of motor exercises with both healthy and affected limbs, and to increase patient motivation by establishing clearcut goals and rewarding success. Both programs, visual scanning and spatio-motor training, have been implemented in clinical practice in the represented by the authors. Material and methods. The article describes in detail the rehabilitation of two TBI patients (JK, male, age 27, and AS, female, age 28) treated by the authors in the chronic phase of recovery after automobile accidents, as a result of which both patients were comatose for more than 4 weeks. In neuropsychological testing JK and AS both presented with persistent and significant leftsided hemispatial neglect: allocentric neglect in JK, and egocentric in AS. A modified AB-BA experimental design was used, where A represents spatio-motor training, and B is visual scanning. For patient JK, program A was first applied, followed by B, while for patient AS the reverse sequence was used. Each program included 10 therapy sessions, with a four-week interval between programs. The degree of neglect was measured using standard neuropsychological tests for quantitative and qualitative assessment of neglect, along with the analysis of drawings made during therapy by both patients. The patients were tested four times, before and after each of the two programs. Results. As the authors had hypothesized, patient JK did not show any progress in terms of neglect after conclusion of program A, while after program B he showed virtually no lingering neglect. In the case of patient AS the results were exactly opposite: after concluding program B (which she received first) there was no significant change, while after program A (administered second) there were no signs of neglect.Conclusion. The theoretical and clinical implications of these results for neuropsychological practice are discussed, and a model solution is proposed to explain the basic pathomechanism of both allocentric and egocentric neglect. These two types of neglect are sufficiently different in etiology and symptomatology to necessitate differentiated therapy programs in the course of neurorehabilitation.

Key words:
hemispatial neglect, traumatic brain injury, rehabilitation

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Sport training as an alternative form of rehabilitation for heart transplant patients

Dominika Batycka, Grzegorz Mańko, Michał Stachnik

Dominika Batycka, Grzegorz Mańko, Michał Stachnik – Sport training as an alternative form of rehabilitation for heart transplant patients. Fizjoterapia Polska 2001; 1(2); 111-116

Abstract
Background. The goal of this study was to evaluate „sports training” as an alternative to the traditional forms of cardiac rehabilitation for patients in advanced recovery from heart transplant surgery. Sports training is a good, diversified form of therapy, and at the same time plays an additional role in social integration and relief of psychological stress. Material and method. The effectiveness of “sports training” was evaluated in a natural clinical experiment involving 34 patients undergoing rehabilitation in the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. The patients were divided into a control group (K), including 17 patients (15 men and 2 women) who underwent rehabilitation before the implementation of “sports training”, using the traditional form of rehabilitation, and an experimental group (E), also including 17 patients matched by age and sex, who received “sports training”. Results. An analysis of the results obtained demonstrated no statistically significant difference between the outcome under traditional rehabilitation and in “sports training”, including respiratory parameters. Nothing in the results pointed to increased risks associated with sports training. Conclusion. Sports’ training is a good alternative to traditional forms of exercises for patients who are well advanced in recovery from heart transplant surgery.

Key words:
Heart Transplant, sport training, rehabilitation

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Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz – Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm. Fizjoterapia Polska 2001; 1(3); 292-296

Abstract

The purpose of this article is to present the case of a patient with the Marfan syndrome who underwent surgery to repair an aortal aneurysm and his early rehabilitation, with particular emphasis on respiratory therapy. A 32-year-old patient with the Marfan syndrome was admitten to the Cardiovascular Surgery and Transplantology Clinic at the Jagiellonian University’s Collegium Medicum in Cracow, Poland, with suspected delamination of an aneurysm in the ascending aorta. Computer tomography revealed supravalvular dilatation of the ascending aorta along a 5-6 cm segment. Emergency surgery was performed using the Bental de Bono Composite Graft St. Jude Medical 25A method and ingrafting a venous bypass to the RCA. After surgery the patient was “suppressed” for 7 days in a drug-induced coma (low arterial blood pressure must be maintained initially in a patient with a surgically implanted prosthesis to prevent damage to the graft site). On the 8th day an attempt was made to extubate the patient. After ca. 14 hours of spontaneous respirator the patient was reintubed due to respiratory and circulatory insufficiency. On the 13th day when it proved impossible to terminate mechanical ventilation of the patient, a tracheotomy was performed. On the 19th day a successful effort was made to disconnect the patient from the respirator. At present the patient is breathing independently and is undergoing rehabilitation in the Department of Surgery. The article describes the program of early rehabilitation for this patient. The significance of the case for physiotherapy practice will be discussed.

Key words:
mechanical ventilation, Rehabilitation, Marfan Syndrome
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