EXERCISE CAPACITY, MUSCLE FUNCTION, FUNCTIONAL BALANCE, AND COGNITIVE STATUS IN PATIENTS WITH POST COVID-19 SYNDROME COMPARED TO HEALTHY CONTROLS

Year 2024, Volume: 5 Issue: 2, 51 - 56, 23.08.2024

Melike Şura Öksüz Çapanoğlu , Oğuz Abdullah Uyaroğlu , Naciye Vardar Yaglı , Melda Saglam , Deniz İnce , Lale Özışık , Nursel Çalık Başaran , Gülay Sain Güven , Ebru Çalık Kütükcü

https://doi.org/10.52831/kjhs.1471414

Abstract

Objective: There is limited data on the effect of post-COVID-19 syndrome on functional outcomes compared with healthy uninfected individuals. This study aimed to compare the muscle function, exercise capacity, and quality of life of patients with post-COVID-19 syndrome with that of healthy controls.
Method: Twenty patients with post-COVID-19 syndrome and twenty healthy controls participated in the study. The Incremental Shuttle Walk Test (ISWT) was used to measure exercise capacity, and the Timed Up and Go Test (TUG) was used to assess functional balance. Quadriceps muscle strength (QMS) and handgrip strength (HGS) were measured. Assessment tools included the McGill Pain Questionnaire (SF-MPQ) for pain, the Tampa Scale for Kinesiophobia (TSK) for movement fear, the Modified Medical Research Council Dyspnea Scale (mMRC) for dyspnea, the Fatigue Severity Scale (FSS) for fatigue perception, and the Cognitive Failures Questionnaire (CFQ) for cognitive status.
Results: The mMRC dyspnea, TSK, FSS, SF-MPQ total scores, and pain severity of patients with post-COVID-19 syndrome were higher than those of healthy controls (p<.05). Compared to the healthy group, the ISWT and %ISWT distances were significantly lower in the post-COVID-19 group (p<.05).
Conclusion: Exercise capacity is negatively affected; anxiety, pain, fatigue severity, dyspnea, and kinesiophobia levels are increased in patients with post-COVID-19 syndrome compared with healthy groups. However, muscle strength, balance, and cognitive function are preserved in individuals with mild-to-moderate COVID-19 infection. Pulmonary rehabilitation programs should be designed on the basis of these multiple influences with a multidisciplinary approach in the long-term rehabilitation of individuals with COVID-19 infection.

Keywords

COVID-19, Functional status, Pandemics, Exercise test, Post-COVID-19

Ethical Statement

This study was approved by the Hacettepe University Non-Interventional Clinical Research Ethics Committee (Approval date: 02.02.2021, Number: GO 21/178).

Supporting Institution

The author(s) received no financial support for the research.

Project Number

None

Thanks

None

References

• Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144.
• Piotrowicz K, Gasowski J, Michel JP, Veronese N. Post-COVID-19 acute sarcopenia: physiopathology and management. Aging Clin Exp Res. 2021;33(10):2887-2898.
• Evans RA, McAuley H, Harrison EM, et al. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med. 2021;9(11):1275-1287.
• Rinaldo RF, Mondoni M, Parazzini EM, et al. Severity does not impact on exercise capacity in COVID-19 survivors. Respir Med. 2021;187:106577.
• Sirayder U, Inal-Ince D, Kepenek-Varol B, Acik C. Long-Term characteristics of severe COVID-19: respiratory function, functional capacity, and quality of life. Int J Environ Res Public Health. 2022;19(10):6304.
• Yilmaz O, Mutlu BO, Yaman H, Bayazit D, Demirhan H, Bayazıt YA. Assessment of balance after recovery from COVID-19 disease. Auris Nasus Larynx. 2022;49(2):291-298.
• Tanriverdi A, Savci S, Kahraman BO, Ozpelit E. Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality. Ir J Med Sci. 2022;191(3):969-975.
• Belli S, Balbi B, Prince I, et al. Low physical functioning and impaired performance of activities of daily life in COVID-19 patients who survived hospitalisation. Eur Respir J. 2020;56(4):2002096.
• Vasold KL, Parks AC, Phelan DML, Pontifex MB, Pivarnik JM. Reliability and validity of commercially available low-cost bioelectrical impedance analysis. Int J Sport Nutr Exerc Metab. 2019;29(4):406-410.
• Argun Barış S, Boyacı H, Akhan S, et al. Charlson Comorbidity Index in predicting poor clinical outcomes and mortality in patients with COVID-19. Turk Thorac J. 2022;23(2):145-153.
• Sunjaya A, Poulos L, Reddel H, Jenkins C. Qualitative validation of the modified Medical Research Council (mMRC) dyspnoea scale as a patient-reported measure of breathlessness severity. Respir Med. 2022;203:106984.
• Probst VS, Hernandes NA, Teixeira DC, et al. Reference values for the incremental shuttle walking test. Respir Med. 2012;106(2):243-248.
• Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66(2):69-74.
• Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997;78(1):26-32.
• Calik Kutukcu E, Cakmak A, Kinaci E, et al. Reliability and validity of the Turkish version of Post-COVID-19 Functional Status Scale. Turk J Med Sci. 2021;51(5):2304-2310.
• Albarrati AM, Gale NS, Munnery MM, Reid N, Cockcroft JR, Shale DJ. The Timed Up and Go test predicts frailty in patients with COPD. NPJ Prim Care Respir Med. 2022;32(1):24.
• Bicici B, Gunes UY. The validity and reliability of the Turkish version of short-form McGill Pain Questionnaire in patients with leukemia. J Clin Nurs. 2012;21(23-24):3328-3334.
• Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-85.
• Yilmaz O, Yakut Y, Uygur F, Ulug N. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Fizyoter Rehabil. 2011;22(1):44-49.
• Ekici G, Atasavun Uysal S, Altuntas O. The validity and reliability of Cognitive Failures Questionnaire in university students. Turk J Physiother Rehabil. 2016;27(2):55-60.
• Aydemir O. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg. 1997;8(4):280-287.
• Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A. Reliability and Validity of the Turkish Version of Short Form-36 (SF-36). İlaç ve Tedavi Dergisi. 1999;12(2):102-106.
• Watanabe M, Caruso D, Tuccinardi D, et al. Visceral fat shows the strongest association with the need of intensive care in patients with COVID-19. Metabolism. 2020;111:154319.
• Anaya JM, Rojas M, Salinas ML, et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmun Rev. 2021;20(11):102947.
• Pavli A, Theodoridou M, Maltezou HC. Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals. Arch Med Res. 2021;52(6):575-581.
• Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81(6):e4-6.
• Chuang H, Lin CW, Hsiao MY, Wang TG, Liang HW. Long COVID and rehabilitation J Formos Med Assoc. 2024;123(Suppl 1):S61-S69.
• Sanyaolu A, Okorie C, Marinkovic A, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med. 2020;2(8):1069-1076.
• Raman B, Cassar MP, Tunnicliffe EM, et al. Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine. 2021;31:100683.
• Morelli N, Parry SM, Steele A, et al. Patients surviving critical COVID-19 have impairments in dual-task performance related to post-intensive care syndrome. J Intensive Care Med. 2022;37(7):890-898.
• Beyer S, Haufe S, Meike D, et al. Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life. PLoS One. 2023;18(10):e0292928.
• Blokland IJ, Ilbrink S, Houdijk H, et al. Exercise capacity after mechanical ventilation because of COVID-19: Cardiopulmonary exercise tests in clinical rehabilitation. Ned Tijdschr Geneeskd. 2020;164:D5253.
• O'Mahoney LL, Routen A, Gillies C, et al. The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis. EClinicalMedicine. 2023;55:101762.
• Ceban F, Ling S, Lui LMW, et al. Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis. Brain Behav Immun. 2022;101:93-135.
• Holdsworth DA, Chamley R, Barker-Davies R, et al. Comprehensive clinical assessment identifies specific neurocognitive deficits in working-age patients with long-COVID. PLoS One. 2022;17(6):e0267392.
• Green CE, Leeds JS, Leeds CM. Occupational effects in patients with post-COVID-19 syndrome. Occup Med. 2024;74(1):86-92.
• Herrero-Montes M, Fernandez-de-Las-Penas C, Ferrer-Pargada D, et al. Association of kinesiophobia with catastrophism and sensitization-associated symptoms in COVID-19 survivors with post-COVID pain. Diagnostics (Basel). 2023;13(5):847.
• Sepulveda-Loyola W, Gil Panont A, Cordeiro Maluf J, Suziane Probst V, Oliveira Bezerra L, da Rocha Rodrigues L, et al. Clinical, physical, and psychological outcomes among individuals with post COVID-19 syndrome with different functional status: a cross-sectional study. Salud, Ciencia y Tecnología. 2024;4:802.