Eficácia da telereabilitação pulmonar na tolerância ao exercício, fadiga, percepção de esforço, depressão e qualidade de vida em sobreviventes de COVID-19

Autores

DOI:

https://doi.org/10.17267/2238-2704rpf.2024.e5416

Palavras-chave:

COVID-19, Dispneia, Reabilitação Pulmonar, Qualidade de Vida, Telerreabilitação

Resumo

INTRODUÇÃO: A telerreabilitação avançou significativamente com o surgimento da COVID-19 e a recomendação de limitar o tempo de contato entre fisioterapeutas e pacientes sempre que possível. A eficácia da telerreabilitação em pacientes que permaneceram mais tempo no hospital e necessitaram de suporte de oxigênio após a alta ainda está em questão. OBJETIVO: Para avaliar os efeitos após seis semanas de telereabilitação pulmonar na tolerância ao exercício, nível de fadiga, percepção de esforço, sintomas de depressão e qualidade de vida em pacientes sobreviventes de COVID-19. MATERIAIS E MÉTODOS: Foi realizado um estudo quase-experimental com dezesseis pacientes pós-COVID-19 selecionados de um hospital multispecializado. Os participantes foram orientados a preparar equipamentos como concentrador de oxigênio, cilindro de oxigênio tipo B (reserva), tubos de oxigênio longos, oxímetro de pulso, exercitador de pedal estático, espirômetro incentivador, pesos de tornozelo ou garrafas d'água e sacos de areia. Após seis semanas de telereabilitação, os pacientes foram submetidos a avaliações, incluindo saturação inicial de oxigênio (SPO2), frequência cardíaca, demanda máxima de oxigênio durante o exercício para manter a SPO2 basal, frequência cardíaca máxima, queda máxima na SPO2, tempo de recuperação para SPO2 basal medido com um oxímetro de pulso e cronômetro, esforço percebido máximo usando a Escala de Dispneia de Borg, pontuação máxima de fadiga usando a escala analógica visual (VASF), qualidade de vida avaliada com o questionário SF-36 e estado de saúde mental avaliado com a Escala de Depressão de Hamilton (HAMD). RESULTADOS: Melhorias significativas após a intervenção foram observadas na SPO2 inicial (F (2,12, 23,13) = 21,0, p <0,05) e na frequência cardíaca (F (1,839, 20,23) = 43,73, p <0,05), demanda máxima de oxigênio durante o exercício para manter a SPO2 basal (F (1,487, 16,36) = 8,96, p <0,05), esforço percebido máximo (F (5, 55) = 112,51, p <0,05), pontuação máxima de fadiga (F (1,755, 19,30) = 67,44, p <0,05), frequência cardíaca máxima (F (1,798, 19,78) = 50,99, p <0,05), queda máxima na SPO2 (F (2,467, 27,14) = 41,46, p <0,05) e tempo máximo de recuperação para alcançar a SPO2 basal (F (5, 55) = 78,89, p <0,05). A análise de seis semanas pós-intervenção nos sintomas depressivos (diferença média = 11,25, p <0,05) e na qualidade de vida também mostrou melhoria significativa (diferença média = 29,92, p <0,05). CONCLUSÃO: Seis semanas de telerreabilitação pulmonar abrangente com equipamentos simples melhoraram a tolerância ao exercício, a fadiga, a percepção de esforço, os sintomas de depressão e a qualidade de vida em pacientes pós-COVID-19.

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Referências

(1) Jácome C, Marques A, Oliveira A, Rodrigues LV, Sanches I. Pulmonary telerehabilitation: An international call for action. Pulmonology. 2020;26(6):335-7. https://doi.org/10.1016/j.pulmoe.2020.05.018 DOI: https://doi.org/10.1016/j.pulmoe.2020.05.018

(2) El‐Maradny YA, Rubio‐Casillas A, Uversky VN, Redwan EM. Intrinsic factors behind long‐COVID: I. Prevalence of the extracellular vesicles. J Cell Biochem. 2023;124(5):656-73. https://doi.org/10.1002/jcb.30415 DOI: https://doi.org/10.1002/jcb.30415

(3) Scurati R, Papini N, Giussani P, Alberti G, Tringali C. The challenge of long COVID-19 management: from disease molecular hallmarks to the proposal of exercise as therapy. Int J Mol Sci. 2022;23(20):12311. https://doi.org/10.3390/ijms232012311 DOI: https://doi.org/10.3390/ijms232012311

(4) Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Palacios-Ceña M, Rodríguez-Jiménez J, de-la-Llave-Rincón AI, et al. Fatigue and dyspnoea as main persistent post-COVID-19 symptoms in previously hospitalized patients: related functional limitations and disability. Respiration. 2022;101(2):132-41. https://doi.org/10.1159/000518854 DOI: https://doi.org/10.1159/000518854

(5) Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Martínez BJSA, et al. Post-COVID-19 syndrome and the potential benefits of exercise. Int J Environ Res Public Health. 2021;18(10):5329. https://doi.org/10.3390/ijerph18105329 DOI: https://doi.org/10.3390/ijerph18105329

(6) Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester 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(8):e13-64. https://doi.org/10.1164/rccm.201309-1634st DOI: https://doi.org/10.1164/rccm.201309-1634ST

(7) Zhao HM, Xie YX, Wang C. Recommendations for respiratory rehabilitation in adults with coronavirus disease 2019. Chin Med J. 2020;133(13):1595-602. https://doi.org/10.1097/cm9.0000000000000848 DOI: https://doi.org/10.1097/CM9.0000000000000848

(8) Wang TJ, Chau B, Lui M, Lam GT, Lin N, Humbert S. Physical medicine and rehabilitation and pulmonary rehabilitation for COVID-19. Am J Phys Med Rehabil. 2020;99(9):769-74. https://doi.org/10.1097/phm.0000000000001505 DOI: https://doi.org/10.1097/PHM.0000000000001505

(9) Salawu A, Green A, Crooks MG, Brixey N, Ross DH, Sivan M. A proposal for multidisciplinary tele-rehabilitation in the assessment and rehabilitation of COVID-19 survivors. Int J Environ Res Public Health. 2020;17(13):4890. https://doi.org/10.3390%2Fijerph17134890 DOI: https://doi.org/10.3390/ijerph17134890

(10) Gonzalez-Gerez JJ, Bernal-Utrera C, Anarte-Lazo E, Garcia-Vidal JA, Botella-Rico JM, Rodriguez-Blanco C. Therapeutic pulmonary telerehabilitation protocol for patients affected by COVID-19, confined to their homes: Study protocol for a randomized controlled trial. Trials. 2020;21(1):588. https://doi.org/10.1186/s13063-020-04494-w DOI: https://doi.org/10.1186/s13063-020-04494-w

(11) Singh SJ, Bolton C, Nolan C, Harvey-Dunstan T, Connolly B, Man W, et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open 2020;10:e040213. https://doi.org/10.1136/bmjopen-2020-040213 DOI: https://doi.org/10.1136/bmjopen-2020-040213

(12) She J, Nakamura H, Makino K, Ohyama Y, Hashimoto H. Selection of suitable maximum-heart-rate formulas for use with Karvonen formula to calculate exercise intensity. Int J Autom Comput. 2015;12(1):62-9. https://doi.org/10.1007/s11633-014-0824-3 DOI: https://doi.org/10.1007/s11633-014-0824-3

(13) British Thoracic Society. Guidance for pulmonary rehabilitation – Reopening services for the ‘business as usual’ participants [Internet]. 2020. Available from: https://docslib.org/doc/4617286/bts-guidance-for-pulmonary-rehabilitation-reopening-services-for-the-business-as-usual-participants

(14) Bolton CE, Bevan-Smith EF, Blakey JD, Crowe P, Elkin SL, Garrod R, et al. British Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICE. Thorax. 2013;68(suppl 2):ii1-ii30. https://doi.org/10.1136/thoraxjnl-2013-203808 DOI: https://doi.org/10.1136/thoraxjnl-2013-203808

(15) Ghodge S, Tilaye P, Deshpande S, Nerkar S, Kothary K, Manwadkar S. Effect of Pulmonary Telerehabilitation on Functional Capacity in COVID Survivors; An Initial Evidence. Int J Heal Sci Res [Internet]. 2020;10(10):123-9. Available from: https://www.ijhsr.org/IJHSR_Vol.10_Issue.10_Oct2020/IJHSR_Abstract.018.html

(16) Priya N, Isaac BTJ, Thangakunam B, Christopher DJ. Effect of home-based pulmonary rehabilitation on health-related quality of life, lung function, exercise tolerance, and dyspnea in chronic obstructive pulmonary disorder patients in a tertiary care center in South India. Lung India. 2021;38(3):211-5. https://doi.org/10.4103/lungindia.lungindia_895_20 DOI: https://doi.org/10.4103/lungindia.lungindia_895_20

(17) Lee KA, Hicks G, Nino-Murcia G. Validity and reliability of a scale to assess fatigue. Psychiatry Res. 1991;36(3):291-8. https://doi.org/10.1016/0165-1781(91)90027-m DOI: https://doi.org/10.1016/0165-1781(91)90027-M

(18) Rotterdam F-J, Hensley M, Hazelton M. Measuring Change in Health Status Over Time (Responsiveness): A Meta-analysis of the SF-36 in Cardiac and Pulmonary Rehabilitation. Arch Rehabil Res Clin Transl. 2021;3(2):100127. https://doi.org/10.1016/j.arrct.2021.100127 DOI: https://doi.org/10.1016/j.arrct.2021.100127

(19) Duan H, Li P, Wang Z, Chen H, Wang T, Wu W, et al. Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: Study protocol for a single-center randomised controlled trial. BMJ Open. 2020;10(10):e037307. https://doi.org/10.1136%2Fbmjopen-2020-037307 DOI: https://doi.org/10.1136/bmjopen-2020-037307

(20) Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res. 2002;52(2):69-77. https://doi.org/10.1016/s0022-3999(01)00296-3 DOI: https://doi.org/10.1016/S0022-3999(01)00296-3

(21) Shah S, Majmudar K, Stein A, Gupta N, Suppes S, Karamanis M, et al. Novel Use of Home Pulse Oximetry Monitoring in COVID-19 Patients Discharged From the Emergency Department Identifies Need for Hospitalization. Acad Emerg Med. 2020;27(8):681-92. https://doi.org/10.1111/acem.14053 DOI: https://doi.org/10.1111/acem.14053

(22) Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020;39:101166. https://doi.org/10.1016/j.ctcp.2020.101166 DOI: https://doi.org/10.1016/j.ctcp.2020.101166

(23) Debeaumont D, Boujibar F, Ferrand-Devouge E, Artaud-Macari E, Tamion F, Gravier F-E, et al. Cardiopulmonary Exercise Testing to Assess Persistent Symptoms at 6 Months in People With COVID-19 Who Survived Hospitalization: A Pilot Study. Phys Ther. 2021;101(6):pzab099. https://doi.org/10.1093/ptj/pzab099 DOI: https://doi.org/10.1093/ptj/pzab099

(24) Goërtz YMJ, Van Herck M, Delbressine JM, Vaes AW, Meys R, Machado FVC, et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome? ERJ Open Res. 2020;6(4):00542-2020. https://doi.org/10.1183/23120541.00542-2020 DOI: https://doi.org/10.1183/23120541.00542-2020

(25) Yang LL, Yang T. Pulmonary rehabilitation for patients with coronavirus disease 2019 (COVID-19). Chronic Dis Transl Med. 2020;6(2):79-86. https://doi.org/10.1016/j.cdtm.2020.05.002 DOI: https://doi.org/10.1016/j.cdtm.2020.05.002

(26) He ZF, Zhong NS, Guan WJ. The benefits of pulmonary rehabilitation in patients with COVID-19. ERJ Open Res. 2021;7(2):00212-2021. http://dx.doi.org/10.1183/23120541.00212-2021 DOI: https://doi.org/10.1183/23120541.00212-2021

(27) Capin JJ, Jolley SE, Morrow M, Connors M, Hare K, MaWhinney S, et al. Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study. BMJ Open. 2022;12(7):e061285. https://doi.org/10.1136/bmjopen-2022-061285 DOI: https://doi.org/10.1136/bmjopen-2022-061285

(28) Gloeckl R, Leitl D, Jarosch I, Schneeberger T, Nell C, Stenzel N, et al. Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study. ERJ Open Res. 2021;7(2):00108-2021. http://dx.doi.org/10.1183/23120541.00108-2021 DOI: https://doi.org/10.1183/23120541.00108-2021

(29) Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID‐19 infection: A cross‐sectional evaluation. J Med Virol. 2021;93(2):1013-22. https://doi.org/10.1002/jmv.26368 DOI: https://doi.org/10.1002/jmv.26368

(30) Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324(6):603-5. https://doi.org/10.1001/jama.2020.12603 DOI: https://doi.org/10.1001/jama.2020.12603

(31) Wang C, Pan R, Wan X, Tan Y, Xu L, Ho RC, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5):1729. https://doi.org/10.3390%2Fijerph17051729 DOI: https://doi.org/10.3390/ijerph17051729

(32) Hameed F, Palatulan E, Jaywant A, Said R, Lau C, Sood V, et al. Outcomes of a COVID-19 recovery program for patients hospitalized with SARS-CoV-2 infection in New York City: A prospective cohort study. PM R. 2021;13(6):609-17. https://doi.org/10.1002/pmrj.12578 DOI: https://doi.org/10.1002/pmrj.12578

(33) Tsutsui M, Gerayeli F, Sin DD. Pulmonary rehabilitation in a post-COVID-19 world: Telerehabilitation as a new standard in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2021;16:379-91. https://doi.org/10.2147/copd.s263031 DOI: https://doi.org/10.2147/COPD.S263031

Publicado

25.04.2024

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1.
Palaniappan R, Muthusamy S, Subramaniam A, Krishnan A, Jagannathan KK, Rajagopal A. Eficácia da telereabilitação pulmonar na tolerância ao exercício, fadiga, percepção de esforço, depressão e qualidade de vida em sobreviventes de COVID-19. Rev Pesq Fisio [Internet]. 25º de abril de 2024 [citado 23º de dezembro de 2024];14:e5416. Disponível em: https://journals.bahiana.edu.br/index.php/fisioterapia/article/view/5416

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