Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes?

Abstract

A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.

First results from post-COVID inpatient rehabilitation

“…The intensity individualized and well monitored includes Aerobic exercise on a cyclo-ergometer, strengthening exercises with weight machines, free weights and/or elastic bands and at the end of the monitored training session respiratory exercises including pursed-lip abdominal breathing exercise and inspiratory muscle training ( 51 ). Another study shows that aquatic exercises technique seemed to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern ( 52 ).…”

Intensive care unit-acquired weakness: A review from molecular mechanisms to its impact in COVID-2019

“…116 A detailed neurological and muscular evaluation is also essential because many ICU-AW patients with COVID-19 may have early deficits. 146 If the long-term physical consequences of COVID-19 on skeletal muscle are added to the effects of ICU-AW, [147][148][149][150][151][152][153][154][155][156] recovery is complex, along with the high health care costs that this entails. 117 It is crucial to start a nutritional intervention and preventive physical and respiratory therapy to delay the accelerated loss of skeletal muscle mass and maintain respiratory function during the ICU stay.…”

COVID-19 management in Iran and international sanctions

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