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Vol. 23, Art. 1 (pp. 1-19)    |    2022       

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Medical rehabilitation of patients with covid-19-associated lung disease

Yu.B.Goverdovsky, G.A.Tsepkova, Yu.E. Rubtsov, D.A.Sinichkin, A.A.Mikhailov

Military Medical Academy named after S.M. Kirov

Brief summary

A summary of the experience and results of currently available studies is presented in order to determine the possibilities and prospects of rehabilitation measures within the framework of a multidisciplinary approach to the treatment of Covid-19. The goal of pulmonary rehabilitation in patients with Covid-19 associated lung damage is to reduce the symptoms of shortness of breath and anxiety, minimize complications and disability, prevent progressive decline in lung function, and improve the quality of life. Pulmonary rehabilitation during the acute period of Covid-19 treatment should be carried out as soon as it becomes possible due to the severity of the condition, it should include nutritional support, adequate ventilation and oxygenation, sufficient drainage of the bronchial tree, breathing exercises, manual therapy and physical activity. Taking into account the possibility of disability after discharge from the hospital to the outpatient stage, rehabilitation measures should be carrсied out in all patients without exception who have suffered Covid-19 associated lung lesions.


Key words

pulmonary rehabilitation, viral lung disease, Covid-19, quality of life.

Reference list

1. Spruit MA, Singh SJ, Garvey C, et al: An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013;188:e13-64.


2. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Feb 28.


3. Chinese Association of Rehabilitation Medicine; Respiratory rehabilitation committee of Chinese Association of Rehabilitation Medicine; Cardiopulmonary rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation: Recommendations for respiratory rehabilitation of coronavirus disease 2019 in adult [in Chinese]. Zhonghua Jie He He Hu Xi Za Zhi 2020;43:308-14.


4. Janssens JP, Chappuis-Gisin É, Maragkoudakis C, et al: Pulmonary rehabilitation in respiratory disorders other than COPD: an individualized approach [in French]. Rev Med Suisse 2018;14:2054-7.


5. Lim PA, Ng YS, Tay BK: Impact of a viral respiratory epidemic on the practice of medicine and rehabilitation: severe acute respiratory syndrome. Arch Phys Med Rehabil 2004;85:1365-70.


6. Guo YR, Cao QD, Hong ZS, et al: The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res 2020;7:11.


7. Alison JA, McKeough ZJ, Johnston K, et al, Lung Foundation Australia and the Thoracic Society of Australia and New Zealand: Australian and New Zealand pulmonary rehabilitation guidelines. Respirology 2017;22:800-19.


8. Elad D, Wolf M, Keck T: Air-conditioning in the human nasal cavity. Respir Physiol Neurobiol 2008;163(1-3):121-7.


9. Casciari RJ, Fairshter RD, Harrison A, et al: Effects of breathing retraining in patients with chronic obstructive pulmonary disease. Chest 1981;79:393-8.


10. Gosselink R: Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chron Respir Dis 2004;1:163-72


11. Lin L, Li TS: Interpretation of ?Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection by the National Health Commission (Trial Version 5)? [in Chinese]. Zhonghua Yi Xue Za Zhi 2020;100:E001.


12. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al, Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19): Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis 2020;34:101623


13. Ngai SP, Jones AY, Tam WW: Tai chi for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev 2016:CD009953.


14. Vedenie pacientov s COVID-19: vremennie rekomendacii. 27 maya 2020 // VOZ, 2020. ? 78 s. ? URL: https://www.euro.who.int/ru/health-topics/ health-emergencies/coronavirus-covid19/technicalguidance/2020/clinical-management-of-covid-19- interim-guidance,-27-m ay-2020. (Data obrasheniya: 29.05.2020).


15. Jones SE, Barker RE, Nolan CM, et al: Pulmonary rehabilitation in patients with an acute exacerbation of chronic obstructive pulmonary disease. J Thorac Dis 2018;10(S12):S1390-9.


16. Puhan MA, Gimeno-Santos E, Cates CJ, et al: Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2016;12:CD005305.


17. Yang F, Liu N, Hu JY, et al: Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV) [in Chinese]. Zhonghua Jie He He Hu Xi Za Zhi 2020;43:180-2.


18. Liu W, Mu X, Wang X, et al: Effects of comprehensive pulmonary rehabilitation therapy on pulmonary functions and blood gas indexes of patients with severe pneumonia. Exp Ther Med 2018;16:1953-7.


19. Wax RS, Christian MD: Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020;67:568-76.


20. Bissett B, Gosselink R, van Haren FMP: Respiratory muscle rehabilitation in patients with prolonged mechanical ventilation: a targeted approach. Crit Care 2020;24:103.


21. Paiva DN, Assmann LB, Bordin DF, et al: Inspiratory muscle training with threshold or incentive spirometry: which is the most effective? Rev Port Pneumol (2006) 2015;21:76-81.


22. Mayer AF, Karloh M, Dos Santos K, et al: Effects of acute use of pursed-lips breathing during exercise in patients with COPD: a systematic review and meta-analysis. Physiotherapy 2018;104:9-17.


23. Cullen DL, Rodak B: Clinical utility of measures of breathlessness. Respir Care 2002;47:986-93.


24. McKoy NA, Saldanha IJ, Odelola OA, et al: Active cycle of breathing technique for cystic fibrosis. Cochrane Database Syst Rev 2012;12:CD007862.


25. Wilson LM, Morrison L, Robinson KA: Airway clearance techniques for cystic fibrosis: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2019;1:CD011231.


26. McCormack P, Burnham P, Southern KW: Autogenic drainage for airway clearance in cystic fibrosis. Cochrane Database Syst Rev 2017;10:CD009595.


27. Kang SW, Bach JR: Maximum insufflation capacity: vital capacity and cough flows in neuromuscular disease. Am J Phys Med Rehabil 2000;79:222-7


28. Maltais F: Glossopharyngeal breathing. Am J Respir Crit Care Med 2011;184:381.


29. Crawford AB, Cotton DJ, Paiva M, et al: Effect of airway closure on ventilation distribution. J Appl Physiol 1989;66:2511-5.


30. FGAOY VO RNIMY im. N.I. Pirogova Minzdrava Rossii. Metodicheskie rekomendacii: provedenie legochnoi reabilitacii y pacientov s novoi koronavirysnoi infekciei (COVID-19) pri vnebolnichnoi dvyhstoronnei pnevmonii: https://spulmo.ru/upload/metodichka_po_reabilitacii_covid.pdf.


31. Vremennie metodicheskie rekomendacii medicinskaya reabilitaciya pri novoi koronavirysnoi infekcii (COVID 19) https://rehabrus.ru/Docs/2020/vmr-po-mr-19062020.pdf.


32. McIlwaine M, Bradley J, Elborn JS, et al: Personalising airway clearance in chronic lung disease. Eur Respir Rev 2017;26:160086.


33. Fink JB: Positioning versus postural drainage. Respir Care 2002;47:769-77.


34. Gattinoni L, Coppola S, Cressoni M, et al: Covid-19 does not lead to a ?typical? acute respiratory distress syndrome. Am J Respir Crit Care Med 2020;201:1299-300.


35. Manning F, Dean E, Ross J, et al: Effects of side lying on lung function in older individuals. Phys Ther 1999;79:456-66.


36. Dentice RL, Elkins MR, Dwyer GM, et al: The use of an alternate side lying positioning strategy during inhalation therapy does not prolong nebulisation time in adults with cystic fibrosis: a randomised crossover trial. BMC Pulm Med 2018;18:3.


37. Bailey DL, Farrow CE, Lau EM: V/Q SPECT-normal values for lobar function and comparison with CT volumes. Semin Nucl Med 2019;49:58-61.


38. Katz S, Arish N, Rokach A, et al: The effect of body position on pulmonary function: a systematic review. BMC Pulm Med 2018;18:159.


39. Bhuyan U, Peters AM, Gordon I, et al: Effects of posture on the distribution of pulmonary ventilation and perfusion in children and adults. Thorax 1989;44:480-4.


40. Guérin C, Reignier J, Richard J-C, et al: Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013;368:2159-68


41. Pelosi P, D?Andrea L, Vitale G, et al: Vertical gradient of regional lung inflation in adult respiratory distress syndrome. Am J Respir Crit Care Med 1994;149:8-13.


42. Tang X, Du RH, Wang R, et al: Comparison of hospitalized patients with ARDS caused by COVID-19 and H1N1. Chest 2020;158:195-205.


43. Harmony WN: Segmental breathing. Phys Ther Rev 1956;36:106-7.


44. Intensive Care National Audit & Research Centre: ICNARC Report on COVID-19 in Critical Care. Intensive Care National Audit & Research Centre. Available at: www.icnarc.org. Published April 10, 2020. Accessed April 15, 2020.


45. Chlif M, Temfemo A, Keochkerian D, et al: Advanced mechanical ventilatory constraints during incremental exercise in class III obese male subjects. Respir Care 2015;60: 549-60.


46. AAPM&R Board of Governors: AAPM&R Position Statement on the Necessity and Preservation of Personal Protective Equipment. Available at: https://www.aapmr.org/newspublications/member-news/member-news-details/2020/03/30/aapm-r-position-statement-onthe-necessity-and-preservation-of-personal-protective-equipment#.XoYsMSWqIgQ.email. Published March 30, 2020. Accessed April 15, 2020.


47. Dowman L, Hill CJ, Holland AE: Pulmonary rehabilitation for interstitial lung disease. Cochrane Database Syst Rev 2014;10:CD006322.


48. Burtin C, Saey D, Saglam M, et al: Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J 2012;40:338-44.


49. Hui DS, Joynt GM, Wong KT, et al: Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax 2005;60:401-9.


50. Xie L, Liu Y, Xiao Y, et al: Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge. Chest 2005;127:2119-24.


51. Venkataraman T, Frieman MB: The role of epidermal growth factor receptor (EGFR) signaling in SARS coronavirus-induced pulmonary fibrosis. Antiviral Res 2017;143:142-50.


52. Ngai JC, Ko FW, Ng SS, et al: The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology 2010;15:543-50.


53. Jenkins S, Čečins N: Six-minute walk test: observed adverse events and oxygen desaturation in a large cohort of patients with chronic lung disease. Intern Med J 2011;41:416-22.


54. Boutou AK, Pitsiou GG, Trigonis I, et al: Exercise capacity in idiopathic pulmonary fibrosis: the effect of pulmonary hypertension. Respirology 2011;16:451-8.


55. Lechenie i reabilitaciya voennoslyjashih Vooryjennih sil Rossiiskoi Federacii s postkovidnim sindromom / pod red. D.V. Trishkina. - M., 2021. - 97 s.


56. Medicinskaya reabilitaciya pacientov, perenesshih COVID-19,


v voennih sanatorno-kyrortnih organizaciyah Minoboroni Rossii. Metodicheskie rekomendacii / pod red. D.V. Trishkina - M., 2021. - 104 s.