Effect of cardiopulmonary and metabolic rehabilitation in patients with exercise-induced oxyhemoglobin desaturation after hospital discharge from COVID-19: case series
DOI:
https://doi.org/10.17267/2238-2704rpf.2023.e4887Keywords:
COVID-19, Hypoxemia, Rehabilitation, Physical Exercise, Quality of Life, PhysiotherapyAbstract
INTRODUCTION: Exercise-induced oxyhemoglobin desaturation in post-COVID-19 patients appears to be associated with reduced diffusion and lung volumes, greater dyspnea and low functional capacity, being related to higher mortality and worse prognosis. Cardiopulmonary and metabolic rehabilitation (CPMR) is relevant, as it aims to restore functionality, exercise tolerance and quality of life (QoL). OBJECTIVE: To verify the effects of CPMR in patients who presented exercise-induced oxyhemoglobin desaturation after hospital discharge due to COVID-19 and also to observe the difference between moderate-intensity continuous training (MICT) and high intensity interval training (HIIT) on effort tolerance, symptoms and QoL. METHODS: This is the report of a series of 4 cases who were hospitalized for COVID-19 and who, after hospital discharge, presented exertion-induced oxyhemoglobin desaturation during the 6-minute step test (6MST). Patients were assessed using spirometry at rest, measurement of inspiratory muscle strength, 6MST, 6-minute walk test (6MWT), quadriceps and biceps brachii maximum repetitions test, and answered the SF-36 QoL questionnaire. Submitted to a training protocol containing training of the inspiratory muscles and resistance training for large muscle groups, additionally, 2 patients underwent CMIT (with 60-80% of heart rate reserve) and 2 HIIT (with 40% of HR reserve in the off, for 4 minutes and 80 to 100%, in the on phase, for 2 minutes) on a treadmill for 30 minutes, finally, after 3 months, they were reassessed. RESULTS: There was an increase in effort tolerance, inspiratory and peripheral muscle strength, in addition to an improvement in QoL and a reduction in symptoms in all patients after CPMR, but there were greater increments in patients submitted to HIIT compared to CMIT in the distance covered in meters (case 1 - 156 (23% increment); case 3 - 168 (40%)) versus (case 2 and 4 - 60 meters, with increments of 9% and 14%, respectively) and greater number of steps (case 1 - 28 (23% increase); case 3- 37 (34%)) versus (case 2 – 2 (2% increment); case 4 - 15 (21%)). CONCLUSION: CPMR had positive effects, with an increase in functional capacity and improvement in QoL, in addition to a reduction in symptoms during exertion, particularly in patients undergoing HIIT.
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Copyright (c) 2023 Aline Soares de Souza, Juliana Bueno Macedo, Thiago Fernandes Pinto, Laion Rodrigo do Amaral Gonzaga, Marco Aurélio Nunes Pereira, Márcia Isabel Bittencourt
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
