Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Abstract

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients’ reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients’ musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.

Impact of Rehabilitation on Physical and Neuropsychological Health of Patients Who Acquired COVID-19 in the Workplace

“…While current studies confirm the improvement of quadriceps strength after rehabilitation [ 36 , 91 ], the results of the change of hand force after rehabilitation are inconsistent. Significant improvements were observed in some studies [ 34 , 36 ], whereas other studies [ 91 , 92 ] demonstrated only trends comparable with our results. Muscle fatigue of handgrip is part of fatigability.…”

Tackling Post-COVID-19 Rehabilitation Challenges: A Pilot Clinical Trial Investigating the Role of Robotic-Assisted Hand Rehabilitation

“…Their findings demonstrated notable enhancements in the FIM total score from admission to discharge. Cevei et al [ 26 ] conducted a clinical trial with six elderly patients (all over 80 years old) using LOKOMAT for gait robotic rehabilitation over a span of 4 weeks. With an average hospital stay of 17 days and no ICU admissions, significant improvements were observed in the FIM total score but not in the BI, attributing the results to the limited sample size and the advanced age of the participants.…”

“…To our knowledge, only three studies have examined the effectiveness of robotic rehabilitation therapies in COVID-19 patients. These studies targeted lower limb robotic rehabilitation using LOKOMAT (Hocoma, Volketswil, Switzerland) [ 26 ], ANDAGO (Hocoma, Volketswil, Switzerland) [ 27 ], and LUNA EMG (EGZOTech, Gliwice, Poland) [ 28 ], thereby neglecting hand rehabilitation as a specific focus. Thus, our research aims to fill this knowledge gap by offering novel insights into the effectiveness of exoskeleton-based hand-assisted rehabilitation for COVID-19 patients and its potential impact on their quality of life.…”

Secondary Sarcopenia and Spinal Cord Injury: Clinical Associations and Health Outcomes

“…The etiology is multifactorial. Age-related decline, chronic diseases, presbyphagia, qualitative and quantitative muscle tissue impairment, hormonal changes and cellular metabolism (the imbalance between protein synthesis and degradation) are some of the factors involved in the occurrence of sarcopenia [4,5]. The loss of muscle mass and strength associated with the ageing process defines primary sarcopenia, which may contribute to a decrease in mobility, balance, coordination and the ability to perform activities of daily living [6].…”