Frühe Rehabilitation bei COVID-19 – Best Practice
                    Empfehlungen für die frühe Rehabilitation von
                    Patient/innen mit COVID-19

Liebl, Max Emanuel; Gütenbrunner, Christoph; Glaesener, J. J.; Schwarzkopf, S. R.; Best, Norman; Lichti, Gabriele; Kraft, Eduard; Krischak, Gert; Reißhauer, Anett

doi:10.1055/a-1162-4919

Cited by 25 publications

(33 citation statements)

References 9 publications

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“…There are currently some published studies with different levels of evidence, mostly review of investigations about PPT and other cases of viral pneumonia such as influenza, expert opinions, and consensus statements recommended how and when to use PPT for patients with different stages of COVID-19 pneumonia. Some researchers, physiotherapy, and rehabilitation experts have recommended PPT as an effective rehabilitative intervention for patients with all stages of COVID-19 pneumonia [4,5,9,10]. Other researchers believed that only ACT should be applied in the presence of EPS to patients with the severe stage under special conditions; However, they have not suggested utilizing other PPT techniques like diaphragmatic breathing, respiratory muscle training, incentive spirometers, manual mobilization, and exercise training [1,[6][7][8]11].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of Pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID Study): A prospective, randomised, single-blind, controlled trial

Javaherian

Shadmehr

Keshtkar

et al. 2021

Preprint

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Background: Pulmonary physiotherapy (PPT) is an important therapeutic tool in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia. Methods: In this randomised, single-blind, controlled trial, we enrolled hospitalized, non-intubated patients (18 to 75 years with oxygen saturation(Spo2) in free-air breathing ≤90%) with COVID-19 pneumonia at a referral hospital. Participants were randomly assigned(1:1) to receive PPT (six sessions PPT with breathing exercises and airway clearance techniques) or basic care. The primary outcomes were venous blood O2(pO2) and CO2(pCO2) pressures, Spo2, and three-minute walking test(3MWT) that were assessed before and end of sixth session. Secondary outcomes included level of dyspnea, venous blood PH, one-month mortality, three-month mortality and short form-36 (SF-36) after one and three months. The assessor was blinded to the assignment. This trial is registered with ClinicalTrials.gov(NCT04357340). Findings: In April and May 2020, 40 participants were randomly assigned to PPT or basic care groups. At the end of intervention, pO2(adjusted mean difference to baseline measure (AMD) 6⸱43 mmHg [95%CI 2⸱8, 10⸱07], P<0.0001), pCO2(AMD -2⸱1 mmHg [95%CI-6⸱36, 2⸱21], P=0.0011), Spo2(AMD 4⸱43% [95%CI 2⸱04, 6⸱83], P=0.0011), and 3MTW (AMD 91⸱44 m [95%CI 68⸱88, 113⸱99], P<0.0001) were improved higher in PPT group and basic care group. While the mortality rate was not different at one month, at three months it was 25% lower in the PPT group (P=.05). There were no significant differences in most SF-36 domains scores between groups after one and three months. No serious adverse event was observed during PPT sessions. Conclusion: Early PPT can be considered as a safe and effective therapeutic choice for patients with severe COVID-19.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of Pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID Study): A prospective, randomised, single-blind, controlled trial

Javaherian

Shadmehr

Keshtkar

et al. 2021

Preprint

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“…Die Notwendigkeit frührehabilitativer Behandlungsangebote besteht insbesondere bei Patienten nach Langzeitbeatmung oder mit fortbestehender ventilatorischer Insuffizienz und stark reduziertem Allgemeinzustand 32 . In Abgrenzung zur AHB sind pneumologische Frühreha-Patienten bei den Alltagsverrichtungen wie der Körperpflege, dem Aufstehen und der Mobilität noch auf fremde Hilfe angewiesen.…”

Section: Empfehlungen Zur Rehabilitation Bei Covid-19unclassified

DGP-Empfehlungen zur pneumologischen Rehabilitation bei COVID-19

et al. 2020

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ZusammenfassungVor dem Hintergrund der Pandemie durch Infektionen mit dem SARS-CoV-2 hat die Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP e. V.) die Sektion 12 „Rehabilitation, Prävention und Tabakkontrolle“ beauftragt, Empfehlungen zur Umsetzung pneumologischer Rehabilitation bei Patienten nach COVID-19 zu erstellen. Dieses Positionspapier basiert auf dem momentanen aktuellen Wissen, das sich täglich weiterentwickelt. Neben einer Beschreibung der gesundheitlichen Folgen von COVID-19 wird die Indikationsstellung aufgezeigt. Rehabilitative Therapien bei COVID-19 sind bereits auf der Normalstation bzw. Intensivstation indiziert, setzen sich fort als pneumologische Frührehabilitation im Akutkrankenhaus und als Anschlussheilbehandlung oder Reha-Heilverfahren in pneumologischen Rehabilitationskliniken. Im Fokus dieses Positionspapiers stehen Empfehlungen zur inhaltlichen Durchführung einer multimodalen, interdisziplinären pneumologischen Rehabilitation bei COVID-19.

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“…These examples show that Long-COVID may be an indication for rehabilitation interventions (13). This includes acute, post-acute and long-term rehabilitation (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Long-COVID on Functioning – Results from a Community Survey in Patients After Mild and Moderate SARS-CoV-2-Infection in Germany

Lemhöfer

Sturm

Loudovici-Krug

et al. 2021

Preprint

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BackgroundIn COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptom (now called long-COVID) may have an impact on functioning and my hinder affected people to participate in social life. However, little is known if and to what extent patients with mild and moderate COVID-19 who did not need hospitalization or intensive care develop such a syndrome.MethodsA cross-sectional study in 1027 patients with mild or moderate COVID-19 has been performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) that includes Short Form 36 health questionnaire (SF-36) on health-related quality of life, was performed. Descriptive statistics were calculated. Results97.5 % of patients reported one symptom in infection phase such as fatigue, respiratory problems, limitations of the sense of taste and smell, as well as fear and anxiety and other symptoms. In this phase 84.1% of participants experienced activity limitations and participation restrictions such as carrying out daily routine, handling stress, getting household tasks done, care/support for others, and relaxing and leisure.61.9% of participants reported persisting symptoms after more than 3 months after infection. These were among others fatigue, sleep disturbances, respiratory problems pain, fears and anxiety, and restrictions in movement. 49% of the participants reported on activity limitations and participation restrictions. Predominately these were handling stress, carrying out daily routine, looking after one’s health, relaxing and leisure activities as well as doing house work.The impact on quality of life and vocational performance were rather low.ConclusionThe results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not very severe and do not lead to frequent or severe issues with quality of live or work ability.

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Frühe Rehabilitation bei COVID-19 – Best Practice Empfehlungen für die frühe Rehabilitation von Patient/innen mit COVID-19

Cited by 25 publications

References 9 publications

Safety and efficacy of Pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID Study): A prospective, randomised, single-blind, controlled trial

Safety and efficacy of Pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID Study): A prospective, randomised, single-blind, controlled trial

DGP-Empfehlungen zur pneumologischen Rehabilitation bei COVID-19

The Impact of Long-COVID on Functioning – Results from a Community Survey in Patients After Mild and Moderate SARS-CoV-2-Infection in Germany

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