Tag: Surya Vishnuram

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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Effectiveness of biopsychosocial approach for subacute neck pain among geriatrics

N.Sathiyaseelan, Shenbaga Sundaram Subramanian, Kumaresan A, Surya Vishnuram, K.C.Gayathri, Madhanraj Sekar, A.K.Keerthana

N.Sathiyaseelan et al. – Effectiveness of biopsychosocial approach for subacute neck pain among geriatrics –  Fizjoterapia Polska 2024; 24(4); 147-152

 

DOI: https://doi.org/10.56984/8ZG01A8N3P5

Abstract
Background: The geriatric Population faces common health challenges such as Frailty and neck Pain, which increases the risk for adverse ADL. It leads to a greater level of disability & Headache risk, lower physical functioning and reduced quality of life. A Biopsychosocial Approach centred on activities, emphasizing the enhancement of Biological factors, Psychological factors and Social functional performance to achieve the goals of the Biopsychosocial Approach. This involves intensifying exercise training by leveraging the environment, conducting thorough task analysis, providing feedback and consistently repeating training sessions. Objective: To determine the effects of the Biopsychosocial Approach on Subacute Neck Pain in the geriatric population, focusing on pain, neck-specific disability and work status. Methods: 64 samples were randomly allocated into two groups. The experimental group received the Biopsychosocial Approach, which integrated biological, psychological and social aspects activity-centred, emphasizing repeated training sessions over 8 weeks. The control group underwent Conservative Management 3 days/week for the same duration. Pre and post-test assessments were conducted using the PCS, NDI and AQoL-8D. Results: The significant improvements in the experimental group compared to the control group were demonstrated by the Wilcoxon Signed Rank Test and Mann-Whitney Rank scores (p < 0.001). Specifically, participants in the experimental group experienced reduced neck pain, enhanced neck function, and improved quality outcomes. The results suggest that the Biopsychosocial Approach effectively addressed the multifaceted nature of pain. Conclusion: The study provides compelling evidence supporting Biopsychosocial in reducing neck pain and improving overall quality of life among geriatric populations.
Keywords
biopsychosocial approach, cervical pain, posterior cervical pains, youngest old adults
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Effectiveness of joint mobilization on heel fat pad syndrome among obese patient in geriatric population

N.Sathiyaseelan, Shenbaga Sundaram Subramanian, Kumaresan A, Surya Vishnuram, K.C.Gayathri, Madhanraj Sekar, A.K.Keerthana

 

N.Sathiyaseelan et al. – Effectiveness of joint mobilization on heel fat pad syndrome among obese patient in geriatric population –  Fizjoterapia Polska 2024; 24(4); 71-76

DOI: https://doi.org/10.56984/8ZG01A8J6K2

Abstract
Objective. To determine the effect of joint mobilization on Heel Fat Pad Syndrome among obese geriatrics. Methods. The randomized controlled study was performed at the Saveetha Physiotherapy OPD, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamilnadu, India. 202 samples aged above 60 years were collected based on the criterion for inclusion and exclusion. Interventions. The experimental Group (101Subjects) was treated with Ultrasound and Joint Mobilization. The Control Group (101 Subjects) was treated with Ultrasound and conventional Exercises. The lifestyle and Balance Assessment used the Foot Function Index and Berg balance scale. A numeric Pain Rating Scale was used to measure Pain. Results. The Wilcoxon Signed Rank Test revealed a significant difference (p < 0.001) in the experimental Group between the pre-test and post-test values of NPRS, FFI, and BBS. Similarly, the Control Group showed a significant difference (p < 0.001) in the pre-test and post-test values of NPRS, FFI, and BBS. The comparison of post-test scores between the Experimental Group and the Control Group also showed a significant difference (p < 0.001), indicating significant improvements in the experimental group. As a result, the effects of Joint Mobilization on Heel Pad Syndrome minimize the symptoms of heel fat pad syndrome, Improve Foot Function and balance and reduce pain. Conclusion. The study provided evidence that ultrasound and joint mobilization used in this study show a significant reduction in pain and balance with non-specific heel pain.
Keywords
heel fat pad syndrome, joint mobilization, obese, geriatrics
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