Physiotherapy in patients with COVID-19 in the acute phase

Yıl 2020, Cilt: 1 Sayı: Covid-19 Özel, 10 - 17, 07.10.2020

İsmail Özsoy Gülşah Özsoy

Öz

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a new coronavirus that emerged in China in December 2019. The number of people infected with coronavirus is increasing all over the world. In 5% of coronavirus cases, acute respiratory distress syndrome (ARDS), septic shock, and/or multi-organ dysfunction/insufficiency, which require mechanical ventilation support, develop. The available information shows that physiotherapy practices should be performed on an individual basis based on the results of the multidisciplinary evaluation in the acute phase of the disease. Accordingly, the main methods of physiotherapy in the acute phase are positioning and mobilization. Some physiotherapy methods (e.g., diaphragmatic breathing, pursed-lip breathing techniques, positive expiratory pressure, and exercise training) are not recommended as they increase respiratory distress and respiratory work in the acute phase. It is essential to apply regular contact and droplet infection protection methods and to use personal protective equipment with high protection during physiotherapy methods that will be performed when clinically necessary.

Anahtar Kelimeler

Coronavirus, Mobilization, Physiotherapy

COVID-19 hastalarında akut fazda fizyoterapi

Öz

Aralık 2019'da Çin'de ortaya çıkan şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2), koronavirüs hastalığına 2019 (COVID-19) neden olur. Koronavirüs bulaşmış insan sayısı tüm dünyada artmaktadır. Koronavirüs vakalarının% 5'inde mekanik ventilasyon desteği gerektiren akut solunum sıkıntısı sendromu (ARDS), septik şok ve / veya çoklu organ disfonksiyon / yetmezlik gelişir. Mevcut bilgiler, fizyoterapi uygulamalarının, hastalığın akut fazındaki multidisipliner değerlendirme sonuçlarına göre bireysel olarak yapılması gerektiğini göstermektedir. Buna göre, akut dönemde fizyoterapinin ana yöntemleri pozisyonlama ve mobilizasyondur. Akut dönemde solunum sıkıntısını ve solunum iş yükünü artırdığı için bazı fizyoterapi yöntemleri (örn. diyafragmatik solunum, pursed-lip solunumu, pozitif ekspiratuar basınç ve egzersiz eğitimi) önerilmemektedir. Standart temas ve damlacık enfeksiyonu koruma yöntemlerini uygulamak ve klinik olarak gerekli olduğunda uygulanacak fizyoterapi yöntemleri sırasında yüksek korumalı kişisel koruyucu ekipman kullanmak çok önemlidir.

Anahtar Kelimeler

Koronavirüs, Mobilizasyon, Fizyoterapi

Kaynakça

• Adler, J., & Malone, D. (2012). Early mobilization in the intensive care unit: a systematic review. Cardiopulm Phys Ther J, 23(1), 5-13
• Arias-Fernández, P., Romero-Martin, M., Gómez-Salgado, J., & Fernández-García, D. (2018). Rehabilitation and early mobilization in the critical patient: systematic review. J Phys Ther Sci, 30(9), 1193-1201. https://doi.org/10.1589/jpts.30.1193
• Conceição, T., Gonzáles, A. I., Figueiredo, F., Vieira, D. S. R., & Bündchen, D. C. (2017). Safety criteria to start early mobilization in intensive care units. Systematic review. Rev Bras Ter Intensiva, 29(4), 509-519. https://doi.org/10.5935/0103-507x.20170076
• Ghelichkhani, P., & Esmaeili, M. (2020). Prone Position in Management of COVID-19 Patients; a Commentary. Arch Acad Emerg Med, 8(1), e48. İnal İnce, D., Vardar Yaglı, N., Saglam, M., & Calık Kütükcü, E. (2020). COVID-19 enfeksiyonunda akut ve post-akut fizyoterapi ve rehabilitasyon. Turk J Physiother RehabilTurk J Physiother Rehabil, 31(1), 81-93.
• Krishnagopalan, S., Johnson, E. W., Low, L. L., & Kaufman, L. J. (2002). Body positioning of intensive care patients: clinical practice versus standards. Crit Care Med, 30(11), 2588-2592. https://doi.org/10.1097/00003246-200211000-00031
• Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J., & Hsueh, P. R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents, 55(3), 105924. https://doi.org/10.1016/j.ijantimicag.2020.105924
• Lazzeri, M., Lanza, A., Bellini, R., Bellofiore, A., Cecchetto, S., Colombo, A., D'Abrosca, F., Del Monaco, C., Gaudiello, G., Paneroni, M., Privitera, E., Retucci, M., Rossi, V., Santambrogio, M., Sommariva, M., & Frigerio, P. (2020). Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis, 90(1). https://doi.org/10.4081/monaldi.2020.1285
• Miranda Rocha, A. R., Martinez, B. P., Maldaner da Silva, V. Z., & Forgiarini Junior, L. A. (2017). Early mobilization: Why, what for and how? Med Intensiva, 41(7), 429-436. https://doi.org/10.1016/j.medin.2016.10.003
• Parry, S. M., Granger, C. L., Berney, S., Jones, J., Beach, L., El-Ansary, D., Koopman, R., & Denehy, L. (2015). Assessment of impairment and activity limitations in the critically ill: a systematic review of measurement instruments and their clinimetric properties. Intensive Care Med, 41(5), 744-762. https://doi.org/10.1007/s00134-015-3672-x
• Scholten, E. L., Beitler, J. R., Prisk, G. K., & Malhotra, A. (2017). Treatment of ARDS With Prone Positioning. Chest, 151(1), 215-224. https://doi.org/10.1016/j.chest.2016.06.032
• Thomas, P., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L., Hodgson, C., Jones, A. Y., Kho, M. E., Moses, R., Ntoumenopoulos, G., Parry, S. M., Patman, S., & van der
• Lee, L. (2020). Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother, 66(2), 73-82. https://doi.org/10.1016/j.jphys.2020.03.011
• Vellingiri, B., Jayaramayya, K., Iyer, M., Narayanasamy, A., Govindasamy, V., Giridharan, B., Ganesan, S., Venugopal, A., Venkatesan, D., Ganesan, H., Rajagopalan, K., Rahman, P., Cho, S. G., Kumar, N. S., & Subramaniam, M. D. (2020). COVID-19: A promising cure for the global panic. Sci Total Environ, 725, 138277. https://doi.org/10.1016/j.scitotenv.2020.138277
• WHO. (2020). Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim Guidance. Retrieved 20.07.2020 from WHO Reference number WHO/2019-nCoV/clinical/2020.4