COVID-19 Sonrasında Ortaya Çıkan Nörolojik Bozukluk Sonucu Uygulanan Telerehabilitasyonun Etkileri: Bir Pediatrik Olgu Sunumu

Öz

COVID-19, hafif semptomlardan yaşamı tehdit edebilecek düzeyde semptomlara kadar insanı etkileyebilmektedir. COVID-19 sonrasında sadece yorgunluk veya halsizlik görülebilirken, bazı hastalarda solunum yetmezliği gibi pulmoner, miyokard enfarktüsü gibi kardiyovasküler veya inme/ansefalit gibi nörolojik komplikasyonlar gelişebilmektedir. Literatürde COVID-19’un neden olduğu nörolojik komplikasyonlara dikkat çekilse de, bu komplikasyonlar ve bunu iyileştirmeye yönelik rehabilitasyon programları hakkında yeterince bilgi bulunmamaktadır. Bu olgu sunumunda COVID-19’a bağlı ortaya çıkan nörolojik etkilenime sahip bir kız çocuğuna uygulanan telerehabilitasyonun 12 haftalık etkisi değerlendirilmiştir. Bir fizyoterapist tarafından denetimli telerehabilitasyon programının hastanın vücut yapı ve fonksiyonlarını iyileştirmesine katkı sunduğu, aktivite ve katılımı değerlendiren ölçütlerde iyileşme sağladığı görüldü. Elde edilen bu kazanımların ne kadar devam edeceğini saptamak için daha uzun süreli takibinin yapılması gereklidir.

Anahtar Kelimeler

• COVID-19
• nörolojik bulgular
• telerehabilitasyon

Effects of Telerehabilitation Applied to Patients with Neurological Disorders Following COVID-19: A Pediatric Case Report

Öz

COVID-19 can affect people from mild symptoms to life-threatening symptoms. While only fatigue or weakness may occur after COVID-19, some patients may develop pulmonary complications such as respiratory failure, cardiovascular complications such as myocardial infarction, or neurological complications such as stroke/encephalitis. Although the literature draws attention to the neurological complications caused by COVID-19, there is not enough information about these complications and rehabilitation programs to improve them. In this case report, the 12-week effect of telerehabilitation applied to a girl with neurological impairment due to COVID-19 was evaluated. It was observed that a telerehabilitation program supervised by a physiotherapist contributed to the improvement of the patient's body structure and functions and provided improvements in criteria evaluating activity and participation. Longer-term follow-up is needed to determine how long these gains will continue.

Anahtar Kelimeler

• COVID-19
• neurologic manifestations
• telerehabilitation

Kaynakça

1. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS coronavirus. Journal of Virology. 2020;94(7):10.1128/jvi. 00127-20.
2. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): A review. JAMA. 2020;324(8):782-93.
3. Vakili K, Fathi M, Pezeshgi A, Mohamadkhani A, Hajiesmaeili M, Rezaei-Tavirani M, Sayehmiri F. Critical complications of COVID-19: A descriptive meta-analysis study. Reviews in Cardiovascular Medicine. 2020;21(3):433-42.
4. Jakubec P, Fišerová K, Genzor S, Kolář M. Pulmonary complications after COVID-19. Life. 2022;12(3):357.
5. Dangayach NS, Newcombe V, Sonneville R. Acute neurologic complications of COVID-19 and postacute sequelae of COVID-19. Critical Care Clinics. 2022;38(3):553-70.
6. Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O, Abu-Rub M. Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. BMC Neurology. 2021;21:1-17.
7. El-Hefnawy SM, Eid HA, Mostafa RG, Soliman SS, Omar TA, Azmy RM. COVID-19 susceptibility, severity, clinical outcome and Toll-like receptor (7) mRNA expression driven by TLR7 gene polymorphism (rs3853839) in middle-aged individuals without previous comorbidities. Gene Reports. 2022;27:101612.
8. Van Der Made CI, Simons A, Schuurs-Hoeijmakers J, van den Heuvel G, Mantere T, Kersten S, et al. Presence of genetic variants among young men with severe COVID-19. JAMA. 2020;324(7):663-73.

9. Mantovani S, Oliviero B, Varchetta S, Renieri A, Mondelli MU. TLRs: Innate immune sentries against SARS-CoV-2 infection. International Journal of Molecular Sciences. 2023;24(9):8065.
10. Liu Z-M, Yang M-H, Yu K, Lian Z-X, Deng S-L. Toll-like receptor (TLRs) agonists and antagonists for COVID-19 treatments. Frontiers in Pharmacology. 2022;13:989664.
11. World Health Organization. International Classification of Functioning, Disability, and Health: Children & Youth Version: ICF-CY: World Health Organization; 2007.
12. Suso-Martí L, La Touche R, Herranz-Gómez A, Angulo-Díaz-Parreño S, Paris-Alemany A, Cuenca-Martínez F. Effectiveness of telerehabilitation in physical therapist practice: An umbrella and mapping review with meta–meta-analysis. Physical Therapy. 2021;101(5):pzab075.
13. Seron P, Oliveros M-J, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, et al. Effectiveness of telerehabilitation in physical therapy: a rapid overview. Physical Therapy. 2021;101(6):pzab053.
14. Erden A, Acar Arslan E, Dündar B, Topbaş M, Cavlak U. Reliability and validity of Turkish version of pediatric balance scale. Acta Neurologica Belgica. 2021;121(3):669-75.
15. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: Reliability and validity. Archives of Physical Medicine and Rehabilitation. 2010;91(3):407-13.
16. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed ‘up & go’ test in children. Developmental Medicine and Child Neurology. 2005;47(8):518-24.
17. Ottenbacher KJ, Taylor ET, Msall ME, Braun S, Lane SJ, Granger CV, et al. The stability and equivalence reliability of the functional independence measure for children (WeeFIM)®. Developmental Medicine & Child Neurology. 1996;38(10):907-16.
18. Atasavun Uysal S, Dülger E, Bilgin S, Elbasan B, Çetin H, Türkmen C, et al. Çocuk ve Adölesan Katılım Anketi’nin (CASP) Türkçe geçerlik vegüvenirlik çalışması. XVII. Fizyoterapi ve Rehabilitasyonda Gelişmeler Kongresi, vol.29, Turkey, pp.87, 2018.
19. Gebremeskel GG, Tadesse DB, Haile TG. Mortality and morbidity in critically ill COVID-19 patients: A systematic review and meta-Analysis. Journal of Infection and Public Health. 2024:102533.
20. Milani GP, Bottino I, Rocchi A, Marchisio P, Elli S, Agostoni C, Costantino G. Frequency of children vs adults carrying severe acute respiratory syndrome Coronavirus 2 asymptomatically. JAMA pediatrics. 2021;175(2):193-4.
21. Aparicio C, Willis ZI, Nakamura MM, Wolf J, Little C, Maron GM, et al. Risk factors for pediatric critical COVID-19: A systematic review and meta-analysis. Journal of the Pediatric Infectious Diseases Society. 2024;13(7):352-62.
22. Gürkaş E, Yılmaz D, Kurt AN. COVID-19 ve Nörolojik Bulgular. Turkish Journal of Pediatric Disease. 2022;16(1):79-82.
23. Del Lucchese B, Parravicini S, Filogna S, Mangani G, Beani E, Di Lieto MC, et al. The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders – A systematic review. Frontiers in Public Health. 2024;12:1295273.
24. Paz EV, Giacchino M, Leist M, Chirila C, Petracca L, Agosta G. Telerehabilitation of subjects with neurodevelopmental disorders during confinement due to COVID-19. Revista Colombiana de Psiquiatría (English ed). 2024;53(2):149-57.