Role of the Inspiratory Muscles on Functional Performance From Critical Care to Hospital Discharge and Beyond in Patients With COVID-19.

Autor:	Formiga MF; Programa Pós-Graduação em Fisioterapia e Funcionalidade, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil., Dosbaba F; Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic., Hartman M; Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic.; Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic., Batalik L; Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic.; Department of Public Health, Faculty of Medicine, Masaryk University Brno, Brno, South Moravia, Czech Republic., Senkyr V; Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic., Radkovcova I; Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic., Richter S; Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, South Moravia, Czech Republic., Brat K; Department of Respiratory Diseases, University Hospital Brno, Brno South Moravia, Czech Republic., Cahalin LP; Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.
Jazyk:	angličtina
Zdroj:	Physical therapy [Phys Ther] 2023 Aug 01; Vol. 103 (8).
DOI:	10.1093/ptj/pzad051
Abstrakt:	Objective: The role of inspiratory muscle performance in functional performance in patients with coronavirus disease 2019 (COVID-19) is poorly understood. The purpose of this study was to perform a longitudinal examination of inspiratory and functional performance from intensive care unit (ICU) discharge (ICUD) to hospital discharge (HD) and symptoms at HD and 1 month after HD in patients with COVID-19. Methods: Thirty patients (19 men, 11 women) with COVID-19 were included. Examination of inspiratory muscle performance at ICUD and HD was performed with an electronic manometer, which provided the maximal inspiratory pressure (MIP) and several other inspiratory measures. Examination of dyspnea and functional performance was performed at ICUD and HD with the Modified Borg Dyspnea Scale and the 1-minute sit-to-stand test (1MSST), respectively. Results: The mean age was 71 (SD = 11) years, the mean length of ICU stay was 9 (SD = 6) days, and the mean length of hospital stay was 26 (SD = 16) days. Most of the patients were diagnosed with severe COVID-19 (76.7%) and had a mean Charlson Comorbidity Index of 4.4 (SD = 1.9), reflecting high comorbidity. The mean MIP of the entire cohort increased minimally from ICUD to HD (from 36 [SD = 21] to 40 [SD = 20] cm H2O), reflecting predicted values for men and women at ICUD and HD of 46 (25%) to 51 (23%) and 37 (24%) to 37 (20%), respectively. The 1MSTS score increased significantly from ICUD to HD (9.9 [SD = 7.1] vs 17.7 [SD = 11.1]) for the entire cohort but remained far below population-based reference values (2.5th percentile) for the majority of patients at ICUD and HD. At ICUD, MIP was found to be a significant predictor of a favorable change in 1MSTS performance (β = 0.308; odds ratio = 1.36) at HD. Conclusion: A significant reduction in inspiratory and functional performance exists in patients with COVID-19 at both ICUD and HD, with a greater MIP at ICUD being a significant predictor of a greater 1MSTS score at HD. Impact: This study shows that inspiratory muscle training may be an important adjunct after COVID-19. (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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