Early rehabilitation with dedicated use of belt-type electrical muscle stimulation for severe COVID-19 patients

Early rehabilitation in ICU for COVID-19: what about FES-cycling?

“…Therefore, although we truly think that the method described by Nakamura et al [ 1 ] might be of great interest, we suggest that the use of FES-cycling would induce greater benefits both at short and long term. Sharing this protocol might allow to establish if FES-cycling has a role to play regarding the burden induced by ICUAW in COVID-19 patients.…”

“…We read with great interest the article by Nakamura et al [ 1 ] discussing the use of belt-type electrical muscle stimulation (EMS) for early rehabilitation in severe COVID-19. Authors suggested that among the various possibilities of EMS (i.e., application of a series of stimuli to skeletal muscle to trigger muscle contractions), belt-type EMS could be effective for critical care because it can induce whole lower extremity exercise.…”

“…Although the method presented by Nakamura et al [ 1 ] is interesting, it is essential that early rehabilitation following COVID-19 also targets cardiovascular, cognitive, functional, and mobility reconditioning [ 2 ]. Such benefits require exercise intensities that might not be reachable with belt-type EMS.…”

COVID-19-induced sarcopenia and physical deconditioning may require reassessment of surgical risk for patients with cancer

“…Functional outcome scales such as those proposed by Klok et al may compliment standard assessment tools such as WHO performance status in assessing global functional recovery from the illness but remain unvalidated [28]. Pragmatic approaches to keep physically active prior to cancer surgery, such as home-based exercise programs, will become increasingly important as well as novel rehabilitation techniques for those worse effected by COVID-19 [29]. Going forward, we need a better understanding on how, and to what degree, COVID-19 causes physical deconditioning in mild, moderate, and severe cases alike.…”

Chest physiotherapy: An important adjuvant in critically ill mechanically ventilated patients with COVID-19

“…The ARIR position paper ( Lazzeri et al, 2020 ) suggests careful planning of protocols for early mobilization in COVID-19 patients, rather than random application of these techniques. Inspiratory muscle training, electrical muscle stimulation, and early mobilization could be considered as key strategies in the prevention of ICU-acquired weakness ( Shang et al, 2020 ; Nakamura et al, 2020 ), and should be used rationally to help ensure rapid recovery of those who can benefit. A systematic review and meta-analysis concluded that inspiratory muscle training is able to improve maximal inspiratory pressure and weaning success ( Elkins and Dentice, 2015 ).…”