Effect of early mobilization on functional recovery in ICU patients with post-COVID ARDS

Saravankumar J, Rathna Paramaswamy, Buvanesh Annadurai, Iswarya S, Santhana Lakshmi S, Surya Vishnuram, Jeslin G N, Shenbaga Sundaram Subramanian, Senthilkumar N

Saravankumar J et al. – Effect of early mobilization on functional recovery in ICU patients with post-COVID ARDS –  Fizjoterapia Polska 2024; 24(4); 402-406

DOI: https://doi.org/10.56984/8ZG01A8B5C1

Abstract
Background. The COVID-19 pandemic has significantly increased the number of patients requiring intensive care unit (ICU) admissions due to severe complications such as acute respiratory distress syndrome (ARDS). Prolonged ICU stays, often associated with immobility, lead to muscle weakness, ICU-acquired weakness (ICU-AW), and reduced functional status, which impede recovery. Early mobilization in the ICU has been proposed as a beneficial intervention to mitigate these effects, but its impact on patients with post-COVID ARDS remains underexplored. Objective. This study aimed to evaluate the effect of early mobilization on functional recovery in ICU patients with post-COVID ARDS. Methods. A prospective, randomized controlled trial was conducted at Saveetha Medical College and Hospital, Chennai, from August 2021 to August 2024. Two hundred patients with post-COVID ARDS were randomly assigned to either an early mobilization or standard care group. The early mobilization group received structured physical therapy interventions within 48 hours of ICU admission. Functional status was measured using the ICU Mobility Scale (IMS) and Functional Status Scale ICU (FSS ICU) at baseline, weekly, and discharge. Secondary outcomes included the duration of ICU stay, mechanical ventilation, and incidence of ICU-AW. Results. Patients in the early mobilization group demonstrated significantly higher functional recovery, with a mean IMS score of 7.8 ± 1.2 compared to 4.3 ± 1.5 in the standard care group (p < 0.001). The FSS ICU score was also significantly higher in the early mobilization group (90.6 ± 8.3) than in the standard care group (65.4 ± 10.7; p < 0.001). Additionally, early mobilization reduced the mean ICU stay (14.5 ± 3.2 vs. 19.8 ± 4.1 days, p < 0.001), shortened the duration of mechanical ventilation (10.1 ± 2.9 vs. 13.7 ± 3.6 days, p < 0.001), and decreased the incidence of ICU-AW (20% vs. 45%, p = 0.002). Conclusion. Early mobilization significantly improves functional recovery, reduces ICU stay and mechanical ventilation duration, and lowers ICU-AW risk in post-COVID ARDS patients. These findings highlight the importance of integrating early mobility into standard ICU care to enhance patient outcomes.
Keywords
Early Mobilization, Functional Recovery, Post-COVID ARDS, Intensive Care Unit (ICU), COVID-19
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Early mobilization and its impact on recovery in ICU patients with severe COVID-19: A randomized controlled trial

Saravankumar J, Rathna Paramaswamy, Buvanesh Annadurai, Iswarya S, Santhana Lakshmi S, Surya Vishnuram, Jeslin G N, Shenbaga Sundaram Subramanian, Senthilkumar N

Saravankumar J et al. – Early mobilization and its impact on recovery in ICU patients with severe COVID-19: A randomized controlled trial –  Fizjoterapia Polska 2024; 24(4); 222-225

DOI: https://doi.org/10.56984/8ZG01A8W1X6

Abstract
Introduction. The COVID-19 pandemic has severely impacted critically ill patients, often leading to prolonged immobilization in intensive care units (ICUs), which can result in ICU-acquired weakness (ICUAW) and delayed recovery. Early mobilization has emerged as a promising intervention to counter these effects by promoting faster recovery and reducing complications. This study aims to investigate the effects of early mobilization on physical function, muscle strength, and recovery outcomes in ICU patients with severe COVID-19. Methods. This randomized controlled trial (RCT) included 100 ICU patients (50 in the early mobilization group, 50 in the control group) with severe COVID-19. Early mobilization began within 48 to 72 hours of ICU admission and followed a stepwise progression through four mobility levels. Outcome measures included the Physical Function ICU Test (PFIT), Medical Research Council (MRC) sum score, incidence of delirium, ICU and hospital stay length, ventilator-free days, mortality, and readmission rates. Statistical analysis used intention-to-treat methods, with continuous and categorical variables tested accordingly. Results. The early mobilization group had a significantly shorter time to first mobilization (2.3 days vs. 5.8 days, p < 0.001), higher PFIT scores at ICU discharge (25.4 vs. 18.2, p < 0.001), and improved MRC sum scores (48.6 vs. 35.4, p < 0.001) compared to the control group. The incidence of delirium was significantly lower in the early mobilization group (20% vs. 38%, p = 0.03). ICU and hospital stays were shorter in the early mobilization group (10.4 vs. 14.2 days, p < 0.001; 18.5 vs. 24.1 days, p < 0.001). The early mobilization group had more ventilator-free days (20.3 vs. 14.7, p < 0.001). Mortality and readmission rates were similar between groups. Conclusion. Early mobilization significantly improves functional outcomes, reduces ICU and hospital length of stay, and lowers the incidence of delirium in ICU patients with severe COVID-19. These findings support incorporating early mobilization as standard practice in ICUs to enhance recovery outcomes.
Key words
COVID-19, ICU, early mobilization, functional recovery, ICU-acquired weakness
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Life style changes during lock down period of COVID-19 outbreaks in Tamil Nadu, India: A web based survey

Jagadeesan Thanalakshmi, Masilamani Elayaraja, Kaviya Lakshmi, Kuppusamy Maheshkumar, Naima Umar, Mou Pramanik, Rajesh Kumar, Aakash Dhiman, Rakesh Bharati, Dilpreet Kaur, Hemantajit Gogoi, Karuppasamy Govindasamy

Jagadeesan Thanalakshmi, Masilamani Elayaraja, Kaviya Lakshmi, Kuppusamy Maheshkumar, Naima Umar, Mou Pramanik, Rajesh Kumar, Aakash Dhiman, Rakesh Bharati, Dilpreet Kaur, Hemantajit Gogoi, Karuppasamy Govindasamy – Life style changes during lock down period of COVID-19 outbreaks in Tamil Nadu, India: A web based survey – Fizjoterapia Polska 2024; 24(2); 331-336

DOI: https://doi.org/10.56984/8ZG56089LA

Abstract
India has been affected by novel coronavirus disease (COVID-19) since January 2020. It was declared as a pandemic outbreak and a nationwide lock down was implemented to reduce the transmission of infection. As a lack of effective treatment method or vaccine development against the disease, social distancing and home confinement was considered to be the only solution. The COVID-19 has a dangerous effect on the quality of life of the public. The aim of the present study was to assess the life style changes among the public in tamilnadu during the outbreak. This web based survey was initiated to asses and compare the life style changes during lockdown period of COVID-19 outbreak in Tamil Nadu. By July 10, 2020 a total of 236 participants submitted the responses and the collected data were included for the analysis. The study contained a planned questionnaire that finds out demographic, dietary habits information, screen exposure, sleep time and lifestyle habits information through online survey. The present study findings suggest that significant influences of COVID-19 pandemic lockdown on the majority of employed individuals with history of no comorbidity by decreasing Physical activity (60.16%), increase in screen time (52.9%) and sleep per day (43.2%), decrease consumption of vegetables (36.4%) and variation in fruits and meat consumption. This study elicits the importance of various factors to be considered before the commencement and policy about the Lockdown and its durations. These findings need to be further confirmed with studies of larger population size to gain higher insight towards healthy lockdown against COVID-19 pandemic.
Keywords
COVID-19, Tamil Nadu, life style, sleep, screen time, questionnaire
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A national survey of physiotherapists’ assessment and management practices for patients with COVID-19 in acute and rehabilitation care in the United Arab Emirates

Neda Mohammad Ali, Gopala Krishna Alaparthi, Arthur de Sá Ferreira, Ashokan Arumugam, Kalyana Chakravarthy Bairapareddy

Neda Mohammad Ali, Gopala Krishna Alaparthi, Arthur de Sá Ferreira, Ashokan Arumugam, Kalyana Chakravarthy Bairapareddy – A national survey of physiotherapists’ assessment and management practices for patients with COVID-19 in acute and rehabilitation care in the United Arab Emirates – Fizjoterapia Polska 2024; 24(2); 309-317

DOI: https://doi.org/10.56984/8ZG5608SR5

Abstract
Background. Physiotherapists have a significant role in the treatment and care of individuals with COVID-19, who suffer from a range of symptoms and complications. Treatment for these patients requires a multidisciplinary approach. The study aims to explore the practice patterns of assessment and management adopted by physiotherapists for patients with COVID-19 in critical care and rehabilitation settings in the United Arab Emirates (UAE). Methods. A survey questionnaire was shared with physiotherapists working in the UAE’s private and public hospitals. The questionnaire consisted of 60 questions that were divided into 5 sections: assessment in ICU and wards, treatment in ICU and wards, and patient education. Results. The physiotherapy evaluation of patients was primarily focused on specific impairment measures. Respiratory rate was the highest reported assessment tool in the ICU, with 68% of physiotherapists always using it. More than 78% of ward assessments use physical examination and respiratory rate. Treatment in the ICU was primarily done with chest percussion and suction therapy; over 85% reported using them always or frequently. A total of 89% of respondents used positioning and postural drainage as part of their treatment in wards, and 100% chose walking as their method of mobilization. Conclusion. Both ICU and acute care physiotherapists used similar assessment techniques focused on impairments and dyspnea-quantifying measures, with less emphasis on functional exercise capacity. They, however, used similar approaches to treatment in the ICU and wards, with slight variations in airway clearance and equipment use.
Keywords
COVID-19, pulmonary rehabilitation, chest physiotherapy, physiotherapy in critical care, survey
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Effectiveness of manipulative therapy in improving sleep quality and reducing fatigue levels in post-COVID-19 workers

Sabda Hussain As Shafi, Wara Kushartanti, Novita Intan Arovah, Enggista Hendriko Delano, Wahyu Aji Nugroho, Anggun Saraswati

Sabda Hussain As Shafi, Wara Kushartanti, Novita Intan Arovah, Enggista Hendriko Delano, Wahyu Aji Nugroho, Anggun Saraswati – Effectiveness of manipulative therapy in improving sleep quality and reducing fatigue levels in post-COVID-19 workers – Fizjoterapia Polska 2024; 24(2); 303-308

DOI: https://doi.org/10.56984/8ZG5608CI6

Abstract
This research aims to determine the effectiveness of manipulative therapy in improving sleep quality in post-COVID-19 workers. The research was carried out in the Special Region of Yogyakarta, Indonesia. The research design used a quasi-experimental design with a one-group pretest-posttest design. The research sample was 20 post-COVID-19 workers who had poor sleep quality and experienced fatigue. The treatment was carried out once with a duration of 45 minutes. Sleep quality was measured using the Sleep Quality Questionnaire (KKT) instrument and fatigue levels used the Indonesian version of the Fatigue Severity Scale. The level of sleep quality experienced by the samples before and 24 hours after treatment can be described: 18 (90%) samples had poor sleep quality and 2 (10%) samples had good sleep quality before treatment, and after 24 hours after treatment, 18 (90%) experienced good sleep quality improvement and 2 (10%) samples still had poor sleep quality. Level of fatigue: 20 (100%) samples experienced complaints of fatigue before treatment and 24 hours after treatment, 1 (5%) still experienced fatigue and 19 (95%) other samples did not experience fatigue or decreased fatigue. The criteria for sleep quality and level of fatigue, seen from the total scores on the questionnaire filled in by the sample, are in accordance with the score norms. Data analysis techniques use normality tests and difference tests. The research results show that the traditional massage method improves sleep quality and reduces fatigue levels significantly with a p-value < 0.05.
Keywords
traditional massage, sleep quality, massage, COVID-19, post-COVID workers
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Rehabilitation impact on the work ability and functional status of hospitalized COVID-19 survivors

Michal Macej, Gabriela Škrečková, Lucia Demjanovič Kendrová, Pavol Nechvátal, Jakub Čuj

Michal Macej, Gabriela Škrečková, Lucia Demjanovič Kendrová, Pavol Nechvátal, Jakub Čuj – Rehabilitation impact on the work ability and functional status of hospitalized COVID-19 survivors – Fizjoterapia Polska 2024; 24(2); 298-302

DOI: https://doi.org/10.56984/8ZG56088XJ

Abstract
Aim. The aim of the work is to determine the rehabilitation impact on the work ability and functional status of the hospitalized COVID-19 survivors. Materials and methods. The study covered 163 probands (101 women; 62 men) from the Prešov Region (Slovakia) that were hospitalized with COVID-19 disease. Age of the subjects ranged from 32 to 62 years. The experimental group contained 87 patients (55 women; 32 men) and underwent inpatient rehabilitation treatment during their stay in the hospital. The control group consisted of 76 patients (46 women; 30 men), who were not provided with the rehabilitation treatment. In all probands we assessed the work ability index (WAI) and a Patient self-report methods for the Post-Covid-19 Functional Status Scale (PCFS). Results. The experimental group of patients after returning to work showed significantly higher work ability (p = 0.005) and functional status (p = 0.001) compared to the control group. Patients with psychologically demanding type of work that underwent rehabilitation treatment had also significantly higher work ability (p = 0.022) and functional status (p = 0.042) compared with the other group. Similar results were recorded among the probands with a combination of both types of work – physically and psychologically demanding (p < 0.001). In the physically demanding type of work the result was not statistically significant between the groups. Conclusions. The inpatient form of rehabilitation for the patients hospitalized with COVID-19 has a beneficial effect on the work ability and functional status after discharge from the hospital.
Keywords
COVID-19, functional status, rehabilitation, work ability
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Assessing health promotion in high school and university students during COVID-19: A systematic review

Danny Eka Wahyu Saputra, Wawan Sundawan Suherman, Sigit Nugroho, Sunaryo, Yanuar Rachman Sadewa, Inas Gita Amalia, Agung Wahyu Nugroho, Putriana Damayanty, Puji Asmawati

Danny Eka Wahyu Saputra, Wawan Sundawan Suherman, Sigit Nugroho, Sunaryo, Yanuar Rachman Sadewa, Inas Gita Amalia, Agung Wahyu Nugroho, Putriana Damayanty, Puji Asmawati – Assessing health promotion in high school and university students during COVID-19: A systematic review – Fizjoterapia Polska 2024; 24(2); 190-196

DOI: https://doi.org/10.56984/8ZG5608AH6

Abstract
High schools and universities play vital roles as educational hubs for health promotion, contributing to pandemic preparedness and fostering informed and resilient communities. This study aims to comprehensively investigate, drawing on existing literature, health promotion strategies, and activities within the context of high school and college students during the COVID-19 pandemic. This study was a systematic review that conforms to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes [PRISMA] on PubMed, Science Direct, and Semantic Scholar databases [2018-2023]. From an initial 22,633 articles, 5 were selected based on inclusion/exclusion criteria and title/abstract matching. The selected studies informed distinct health promotion patterns. High school students rely on peers and social media, exhibiting varied preventive measures, while university students prioritize digital health literacy through extensive search engine and social media use. The included studies highlight the integration of social media into online education, identifying gaps in COVID-19 knowledge and emphasizing the influential role of social media in shaping behaviors and reinforcing public health defenses. The studies collectively suggest adopting social media strategies for health promotion in high schools and universities. In conclusion, this systematic review provides concise insights into health promotion efforts among high school and university students during the COVID-19 pandemic. Tailored strategies for each educational level, integrating credible social media into education, emerge as key recommendations to enhance health promotion activities and interventions.
Keywords
health promotion, higher education, COVID-19, word of mouth, social media
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Post-Covid-19 health promotion in universities: mental health and social media promotion

Danny Eka Wahyu Saputra, Wawan Sundawan Suherman, Sigit Nugroho, Panut Sumardi, Puji Asmawati

Danny Eka Wahyu Saputra, Wawan Sundawan Suherman, Sigit Nugroho, Panut Sumardi, Puji Asmawati – Post-Covid-19 health promotion in universities: mental health and social media promotion. Fizjoterapia Polska 2023; 23(5); 85-94

DOI: https://doi.org/10.56984/8ZG20B900

Abstract
The crisis due to the Covid-19 pandemic has impacted the way of life, work, and learning processes. The government has issued a policy of adopting a new custom order to suppress the transmission of Covid-19 and continue to move people’s habits. Universities as educational centers have interdisciplinary, multidisciplinary, and transdisciplinary roles and contributions through health promotion research and outreach activities by taking a role in overcoming the Covid-19 pandemic. Universities have an innovative role in preparing for the Covid-19 endemic through their work in education, research, and counseling. With the pandemic and post-Covid-19 preparations, universities are intensifying support in terms of providing health services for the academic community, one of which is sustainable health promotion services. Health promotion on campus after the Covid-19 pandemic can be done by adopting general health promotion strategies, including 1) cross-sectoral coordination, 2) importance and sustainability, 3) empowerment and involvement of the academic community, and 4) equity. Mental health for students and teachers after online teaching is very important. Social media has great potential to promote health and other health interventions as it overcomes some of the limitations of traditional health communication by increasing accessibility, interaction, engagement, empowerment, and adaptation. Health promotion in universities by utilizing social media has several advantages, namely accessibility, convenience, low cost, interaction with end-users, flexibility, status, and visibility. With the good momentum of social media engagement coupled with the new need to focus on health promotion, offering digital media-based online health promotion services is one of the possible actions. Digital media has significant promise for health promotion and other health intervention activities.

Keywords
health promotion, college, Covid-19, social media

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Revitalizing student physical fitness: The vital role of post-pandemic physical activity programs

Bafirman HB, Asep Sujana Wahyuri, Fiky Zarya, Muhamad Ichsan Sabillah, Faza Annasai

 

Bafirman HB, Asep Sujana Wahyuri, Fiky Zarya, Muhamad Ichsan Sabillah, Faza Annasai. Fizjoterapia Polska 2023; 23(4); 226-232

DOI: https://doi.org/10.56984/8ZG20A4D3

Abstract
In post-COVID-19 pandemic conditions, students are not engaging in physical activity both at school and at home, leading to a decline in the quality of students’ physical fitness. The objective of this study is to enhance the physical fitness of students by implementing a well-structured, accurate, consistent, and quantifiable physical exercise program, while also monitoring sports activities undertaken by students. This research employs a pseudo-experimental pre-test post-test design. The study sample consisted of 117 students. The selection technique utilized is purposive sampling. The instrument for assessing physical fitness is the Indonesian Physical Freshness Test (TKJI). The data analysis technique employs paired sample t-tests. The findings reveal a significant effect of the sports activity program on students’ physical fitness, with an average physical fitness score increase of 13% for Junior High School 01, 11% for Junior High School 39, 9% for Junior High School 14, and 5% for Junior High School 24. This is corroborated by t-test results using a paired sample t-test, with a t-value of −3.754 and a significance value of p = 0.001 (p < 0.05). Based on these results, it can be concluded that the implementation of sports activity programs in various junior high schools in the city of Padang significantly improves students’ physical fitness in the post-COVID-19 pandemic era.
Keywords
Physical Fitness, Sports Activities, COVID-19
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Assessment of dyspnoea and physical activity levels among Poles living in Poland and the United Kingdom in the third year of the COVID-19 pandemic – a pilot study

Monika Gałczyk, Anna Zalewska, Aneta Mierzejewska

 

Monika Gałczyk, Anna Zalewska, Aneta Mierzejewska – Assessment of dyspnoea and physical activity levels among Poles living in Poland and the United Kingdom in the third year of the COVID-19 pandemic – a pilot study. Fizjoterapia Polska 2023; 23(4); 6-17

DOI: https://doi.org/10.56984/8ZG20A753

Abstract
Objectives. The aim of this study was to assess the extent of dyspnoea and the relationship between dyspnoea and physical activity among Poles living in Poland and the United Kingdom (UK) in the third year of the COVID-19 pandemic. Methods. The pilot study was conducted in January 2023. The study authors received 200 questionnaires from respondents aged 18-69 years (104 from Poland and 96 from the UK). The level of dyspnoea was assessed using the Medical Research Council Dyspnoea Scale (MRC) questionnaire. Level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ). Results. In the majority of cases, dyspnoea occurred only during heavy physical exertion and increased with age and more cases of COVID-19. A trend towards increasing dyspnoea with decreasing MET scores for moderate physical activity was observed. Respondents’ country of residence was not correlated with dyspnoea level. Conclusions. The introduction of regular physical activity may have an impact on reducing dyspnoea. Dyspnoea is a factor that influences the reduction of physical activity and leads to a change to a sedentary lifestyle.
Key words:
COVID-19, dyspnoea, physical activity
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