فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

مقایسه ثبات پاسچرال، عملکرد حرکتی و تنفسی و کیفیت زندگی بیماران مبتلا به سندرم کووید-19 در مراحل تنفسی و التهابی شدید

نوع مقاله : مقاله پژوهشی

نویسندگان
مسعود کریم زاده 1، 2
رضا مهدوی نژاد 3
منصور صاحب الزمانی 4
1 دانشجوی دکتری گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان ، اصفهان، ایران
2 گروه تربیت بدنی، دانشکده علوم انسانی و هنر، دانشگاه ملی مهارت، تهران، ایران
3 دانشیار گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان ، اصفهان، ایران
4 استاد گروه آسیب شناسی ورزشی و حرکات اصالحی، دانشکده علوم ورزشی، دانشگاه شهید باهنر کرمان، کرمان، ایران
10.22038/jpsr.2026.87684.2697
چکیده
هدف:
با افزایش تعداد بیماران کووید-19 در ایران و جهان و ظهور علائم و نشانه ­ها برای ماه­ ها پس از بیماری می­تواند تبدیل به یک بحران پزشکی در جهان شود. هدف مطالعه حاضر مقایسه ثبات پوسچرال، عملکرد حرکتی و تنفسی و کیفیت زندگی بیماران مبتلا به سندرم کووید-19 در مرحله تنفسی و التهابی شدید بود.
روش بررسی:
در این مطالعه علی-مقایسه­ای، جامعه پژوهش شامل تمامی بیماران زن دارای سابقه بیماری کووید-19 که در بیمارستان ­های شهر کرمان بستری بودند، می­ باشد. تعداد 41 زن  به روش هدفمند و در دسترس انتخاب شدند که از این تعداد، 13 بیمار در مرحله تنفسی شدید، 14 بیمار در مرحله التهابی شدید و 14 فرد سالم بودند. ثبات پاسچرال با دستگاه بایودکس، عملکرد حرکتی با آزمون­ های زمان برخاستن و رفتن، عملکرد تنفسی با اسپیرومتری (ظرفیت حیاتی با فشار، ظرفیت حیاتی با فشار در ثانیه اول، نسبت ظرفیت حیاتی پرفشار در ثانیه اول و ظرفیت حیاتی پرفشار) و کیفیت زندگی با پرسشنامه SF-36 اندازه­گیری شد. جهت تحلیل داده ­ها از آزمون تحلیل واریانس (آنوا) استفاده شد.
یافته ­ها:
یافته‌های پژوهش نشان داد که در شاخص‌های ثبات کلی، ثبات قدامی-خلفی، ثبات داخلی-خارجی و آزمون زمان برخاستن و رفتن بین سه گروه تفاوت معناداری وجود داشت (0/05>P). مقادیر ظرفیت حیاتی و ظرفیت حیاتی در ثانیه اول در بیماران در مرحله تنفسی، بیماران با مرحله التهابی شدید و افراد سالم به طور معناداری متفاوت بود (0/05>P). همچنین، کیفیت زندگی در بیماران با مرحله التهابی شدید به طور معناداری پایین‌تر از سایر گروه‌ها گزارش شد (0/05>P).
نتیجه­ گیری:
بر اساس نتایج، با توجه به گذشت چند هفته از ابتلا به بیماری کووید-19، ثبات پاسچرال، عملکرد حرکتی و تنفسی بیماران مرحله التهابی شدید نسبت به سایر بیماران کووید-19 دچار اختلال بیشتری، همچنین این بیماران از کیفیت زندگی پایین­تری نسبت به بیماران با شدت­های عفونی کمتر برخوردار بودند.
کلیدواژه‌ها
کووید-19
عملکرد تنفسی
عملکرد حرکتی
کنترل پاسچر
کیفیت زندگی
  1. Organization WH. Report of the WHO-Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: WHO; 2020; 2020.
  2. Khalagi K, Gharibzadeh S, Khalili D, Mansournia MA, et al. Prevalence of COVID-19 in Iran: results of the first survey of the Iranian COVID-19 Serological Surveillance programme. Clin Microbiol Infect. 2021; 27(11): 1666-1671.
  3. Organization WH. Report of the WHO-Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: WHO; 2020; 2020.
  4. Khalagi K, Gharibzadeh S, Khalili D, Mansournia MA, et al. Prevalence of COVID-19 in Iran: results of the first survey of the Iranian COVID-19 Serological Surveillance programme. Clin Microbiol Infect 2021; 27(11): 1666-1671.
  5. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020; 55(3): 105924.
  6. Talebi S, Nematshahi M, Tajabadi A, Khosrogerdi A. Comparison of clinical and epidemiological characteristics of deceased and recovered patients with COVID-19 in Sabzevar, Iran. Journal Mil Med 2020; 22(6):509-516.
  7. People with certain medical conditions. Center for Disease Control and Prevention Washington DC; 2020.
  8. Lew HL, Oh-Park M, Cifu DX. The war on COVID-19 pandemic: role of rehabilitation professionals and hospitals. American journal of physical medicine & rehabilitation 2020; 99(7): 571-572.
  9. Grasselli G, Zangrillo A, Zanella A, Antonelli M, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323(16): 1574-1581.
  10. Kakodkar P, Kaka N, Baig M. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus 2020;12(4): e7560.
  11. Carda S, Invernizzi M, Bavikatte G, Bensmaïl D, Bianchi F, Deltombe T, et al. The role of physical and rehabilitation medicine in the COVID-19 pandemic: the clinician's view. Annals of physical and rehabilitation medicine 2020; 63(6): 554-556.
  12. Borg K, Stam H. Covid-19 and Physical and Rehabilitation Medicine. J Rehabil Med 2020; 52(4): jrm00045.
  13. Liu J-Y, Hu X-X, Guo L-Z. Effect of ultrasound-guided acupoint electrical stimulation on diaphragmatic dysfunction associated with mechanical ventilation. Zhongguo Zhen Jiu 2019; 39(9): 913-917.
  14. Amiri M, Hasanalifard M, Delphi M. Impact of COVID-19 on the auditory and vestibular system. Auditory and Vestibular Research 2021; 30(3): 152-159.
  15. Karimizadeh Ardakani M, Mansori MH, Moghadas Tabrizi Y, Mohammadkhani K, Mohammadi M. Comparison of musculoskeletal pain balance and quality of life between healthy and Covid-19 disease individuals. The Scientific Journal of Rehabilitation Medicine 2021; 10(4): 668-679.
  16. Negarestani S, Amirseyfaddini M, Daneshjoo A, Karimzadeh M, Shourabadi S. Comparison of static, dynamic balance and knee joint position sense between women with a coronavirus (covid-19) and healthy. The Scientific Journal of Rehabilitation Medicine 2021; 10(5): 1066-1079.
  17. Batawi S, Tarazan N, Al-Raddadi R, Al Qasim E, et al. Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS). Health Qual Life Outcomes 2019; 17(1): 1-7.
  18. Gomersall C, Chan D, Leung P, Joynt G, Hui D. Long term outcome of acute respiratory distress syndrome caused by severe acute respiratory syndrome (SARS): an observational study. Crit Care Resusc 2006;8(4):302-308.
  19. Ricks E. Critical illness polyneuropathy and myopathy: a review of evidence and the implications for weaning from mechanical ventilation and rehabilitation. Physiotherapy 2007; 93(2): 151-156.
  20. Kim J-E, Heo J-H, Kim H-o, Song S-h, et al. Neurological complications during treatment of Middle East respiratory syndrome. J Clin Neurol 2017; 13(3): 227-233.
  21. Scordo KA, Richmond MM, Munro N. Post–COVID-19 syndrome: theoretical basis, identification, and management. AACN Adv Crit Care 2021; 32(2): 188-194.
  22. Hamed SA, ElHadad AF, Oseily AM. Vestibular Function in Children with Type 1 Diabetes: Videonystagmography Testing. Audiol Neurotol 2021; 26(6): 470-478.
  23. Tonković S. Measurement of human locomotion. Kinesiology 2001; 33(2): 228.
  24. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 2006; 35(suppl_2): ii7–ii11.
  25. Tsai L-C, Yu B, Mercer VS, Gross MT. Comparison of different structural foot types for measures of standing postural control. J Orthop Sports Physical Ther 2006; 36(12): 942–953.
  26. Davidson BS, Madigan ML, Nussbaum MA. Effects of lumbar extensor fatigue and fatigue rate on postural sway. Eur j appl physiol 2004; 93(1): 183–189.
  27. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice: Lippincott Williams & Wilkins; 2007.
  28. Peterka RJ. Sensorimotor integration in human postural control. Journal of neurophysiology 2002; 88(3):1097–118.
  29. Ferrè ER, Walther LE, Haggard P. Multisensory interactions between vestibular, visual and somatosensory signals. PLoS One 2015; 10(4): e0124573.
  30. Herridge MS, Tansey CM, Matté A, Tomlinson G, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364(14): 1293–1304.
  31. Curci C, Pis-ano F, Bonacci E, Camozzi DM, et al. Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 Rehabilitation Unit and proposal of a treatment protocol. Eur J Phy Rehabil Med 2020; 56(5): 633-641.
  32. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100(2): 126-131.
  33. Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA 2020; 324(6): 603-605.
  34. Huang C, Huang L, Wang Y, Li X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397(10270): 220-232.
  35. Tenforde MW, Kim SS, Lindsell CJ, Rose EB, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March–June 2020. Morbidity and mortality weekly report 2020; 69(30): 993-998.
  36. Ye Y, Xiong C, Dai Y, Wang Y, et al. Assessment of post-COVID-19 fatigue among female survivors 2 years after hospital discharge: a nested case–control study. BMC Public Health 2023; 23(1): 2455.
  37. Joli J, Buck P, Zipfel S, Stengel A. Post-COVID-19 fatigue: A systematic review. Front Psychiatry 2022; 13: 947973.
  38. Khateri S, Mohammadi H, Khateri R, Moradi Y. The prevalence of underlying diseases and comorbidities in COVID-19 patients; an updated systematic review and meta-analysis. Archives of academic emergency medicine 2020;8(1): e72.
  39. Justino DCP, Silva DFO, da Silva Costa KT, de Morais TNB, de Andrade FB. Prevalence of comorbidities in deceased patients with COVID-19: A systematic review. Medicine 2022; 101(38): e30246.
  40. Flaherty GT, Hession P, Liew CH, Lim BCW, et al. COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations. Trop Dis Travel Med Vaccines 2020; 6: 1-13.
  41. Spielmanns M, Pekacka-Egli A-M, Schoendorf S, Windisch W, Hermann M. Effects of a comprehensive pulmonary rehabilitation in severe post-COVID-19 patients. Int J Environ Res Public Health 2021; 18(5): 2695.
  42. Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38: 101019.
  43. Tan S, Pryor AJ, Melville GW, Fischer O, et al. The lingering symptoms of post‐COVID‐19 condition (long‐COVID): a prospective cohort study. Intern Med J 2024; 54(2): 224-233.
  44. Operation B. Service Manual. New York, NY: Biodex Medical Systems. Inc; 2013.
  45. Cachupe WJ, Shifflett B, Kahanov L, Wughalter EH. Reliability of biodex balance system measures. Measurement in physical education and exercise science 2001; 5(2): 97–108.
  46. Bugajski A, Szalacha L, Rechenberg K, Johnson A, et al. Psychometric evaluation of the self-care in chronic obstructive pulmonary disease inventory in the United States. Heart Lung 2022; 51:1–8.
  47. Kowal M, Morgiel E, Winiarski S, Gieysztor E, et al. Effect of COVID-19 on musculoskeletal performance in gait and the timed-up and go test. J Clin Med 2023; 12(13): 4184.
  48. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am geriatr Soc 1991; 39(2): 142–148.
  49. Kim H-S, Cho S-H, editors. Correlation between lung function and functional movement in healthy adults. Healthcare; 2020; 8(3): 276.
  50. Miller M, Hankinson J, Brusasco V, Burgos F, et al. Standardisation of spirometry. Eur Respir J 2005; 26(2): 319-338.
  51. Ware J, Kosinski M, Keller S. SF-36 physical and mental health summary scales. A user's manual. 2001; 1994.
  52. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of life research 2005; 14: 875-882.
  53. Guzik A, Wolan-Nieroda A, Kochman M, Perenc L, Drużbicki M. Impact of mild COVID-19 on balance function in young adults, a prospective observational study. Sci Rep 2022; 12(1): 12181.
  54. Yılmaz O, Mutlu BÖ, Yaman H, Bayazıt D, et al. Assessment of balance after recovery from Covid-19 disease. Auris Nasus Larynx 2022; 49(2): 291–298.
  55. Tuzun S, Keles A, Yildiran T, Palamar D. Assessment of musculoskeletal pain, fatigue and grip strength in hospitalized patients with COVID-19. Eur J Phys Rehabil Med 2020; 57(4): 653-662.
  56. Huang Y, Tan C, Wu J, Chen M, et al. Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Respir Res 2020; 21(1): 163.
  57. Eksombatchai D, Wongsinin T, Phongnarudech T, Thammavaranucupt K, et al. Pulmonary function and six-minute-walk test in patients after recovery from COVID-19: A prospective cohort study PloS One 2021; 16(9): e0257040.
  58. Neufeld KJ, Leoutsakos J-MS, Yan H, Lin S, , et al. Fatigue symptoms during the first year following ARDS. Chest 2020; 158(3): 999-1007.
  59. van Gassel RJ, Baggerman MR, van de Poll MC. Metabolic aspects of muscle wasting during critical illness. Curr Opin Clin Nut Metab Care 2020; 23(2): 96-101.
  60. Morley JE, Kalantar-Zadeh K, Anker SD. COVID-19: a major cause of cachexia and sarcopenia? J Cachexia, Sarcopenia Muscle 2020; 11(4): 863–865.
  61. Van Aerde N, Van den Berghe G, Wilmer A, Gosselink R, Hermans G. Intensive care unit acquired muscle weakness in COVID-19 patients. Intensive Care Med 2020; 46(11): 2083–2085.
  62. Roosma E, Van Gemert JP, De Zwart AE, van Leer-Buter CC, et al. The effect of COVID-19 on transplant function and development of CLAD in lung transplant patients: A multicenter experience. J Heart Lung Transplantat 2022; 41(9): 1237-1247.
  63. Li X, Wang C, Kou S, Luo P, et al. Lung ventilation function characteristics of survivors from severe COVID-19: a prospective study. Crit Care. 2020; 24(1): 300
  64. Zhou F, Tao M, Shang L, Liu Y, et al. Assessment of sequelae of COVID-19 nearly 1 year after diagnosis. Front med 2021; 8:717194.
  65. Zhang P, Li J, Liu H, Han N, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study. Bone Res 2020; 8(1):8.
  66. Lewis KL, Helgeson SA, Tatari MM, Mallea JM, et al. COVID-19 and the effects on pulmonary function following infection: a retrospective analysis. EClinicalMedicine 2021; 39:101079.
  67. Livermore N, Butler JE, Sharpe L, McBain RA, et al. Panic attacks and perception of inspiratory resistive loads in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2008; 178(1): 7–12.
  68. von Leupoldt A, Sommer T, Kegat S, Baumann HJr, et al. The unpleasantness of perceived dyspnea is processed in the anterior insula and amygdala. Am J Respir Crit Care Med 2008; 177(9): 1026–1032.
  69. sSpathis A, Booth S, Moffat C, Hurst R, et al. The Breathing, Thinking, functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease. NPJ Prim Care Respir Med 2017; 27(1): 27.
  70. Lam M. Wing YK Yu MW-M, et al. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up Arch Intern Med 2009;169:2142–7.
  71. Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host–virus interaction, and proposed neurotropic mechanisms ACS Chem Neurosci 2020; 11(7): 995-998.
  72. Liu K, Chen Y, Wu D, Lin R, et al. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complement Ther Clin Pract 2020; 39: 101132.
فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی
دوره 14، شماره 4
زمستان 1404
صفحه 41-55