著者

Tomoko Sakai Chisato Hoshino Masanobu Hirao Reiko Yamaguchi Rui Nakahara Atsushi Okawa

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.6, pp.20210013, 2021 (Released:2021-03-04)

参考文献数

18

被引用文献数

10

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Objectives: The aim of the study was to describe the characteristics and efficiency of rehabilitation for patients diagnosed with moderate-to-severe coronavirus disease (COVID-19).Methods: We retrospectively assessed the medical records of patients with COVID-19 who underwent rehabilitation for early mobilization and to maintain activities of daily living at our hospital between April 21 and August 20, 2020. The following patient data were evaluated: age, sex, diseases, and the total number of sessions completed by patients with severe COVID-19 in the intensive care unit (ICU) and by patients with moderate disease in the general COVID-19 wards. The number of daily sessions performed by physiotherapists was also evaluated.Results: Of 161 patients with COVID-19 admitted during the study period, 95 underwent rehabilitation (78 in the general COVID-19 wards and 17 in the ICU). These 95 COVID-19 patients completed 1035 rehabilitation sessions in total (882 in the general ward and 153 in the ICU). Polymerase chain reaction test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were positive for 79 patients on the initiation of rehabilitation. Moreover, 86 sessions were supervised remotely, thereby reducing the duration of the medical staff’s stay in the SARS-CoV-2 isolation area. Patients with COVID-19 in the ICU received significantly more daily physiotherapy sessions than general ward patients (P<0.001). Each physiotherapist performed, on average, 4.6 sessions daily, with 4.3 daily sessions being performed wearing personal protective equipment (PPE).Conclusions: COVID-19 rehabilitation required more efforts as wearing PPE was necessary for most cases although tried with remote rehabilitation in some cases. Overall, a longer rehabilitation period was needed for ICU patients.

著者

Tomoko Sakai Chisato Hoshino Atsushi Okawa Kenji Wakabayashi Hidenobu Shigemitsu

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.5, pp.20200016, 2020 (Released:2020-07-29)

参考文献数

26

被引用文献数

2

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Objective: The aim of this study was to investigate the effect and risk management of early mobilization in the intensive care unit (ICU) with multidisciplinary collaboration and daily goal planning.Methods: Rehabilitation of ICU patients in our hospital between April 1, 2019, and September 30, 2019, was investigated retrospectively. The following factors were evaluated: age and sex of the subjects; diseases; the total number of early mobilization therapy sessions done at a lowered goal level; the clinical course of the step-down sessions; reasons for lowering goal levels that corresponded to the cancellation criteria from the officially issued guidelines of the Japanese Association of Rehabilitation Medicine, the expert consensus on ICU, or other reasons for step down; and the rate of planned goals that were achieved.Results: Of the 1908 overall rehabilitation sessions carried out during the period of investigation, 9.6% had the planned level lowered; changes in vital signs accounted for 54.6% of the reasons for lowering the level. Of the step-down sessions, 92.3% corresponded with the cancellation criteria of rehabilitation. Early mobilization in the ICU in accordance with daily goal planning via collaboration within the multidisciplinary team during rounds was accomplished in 90.4% of sessions. No serious mobilization-related adverse events were noted during the study period.Conclusion: Early mobilization should be performed with daily goal planning by a multidisciplinary team during rounds and should be governed by the cancellation criteria of rehabilitation.

著者

Emily Suzuki Tomoko Sakai Chisato Hoshino Masanobu Hirao Reiko Yamaguchi Rui Nakahara

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.5, pp.20200018, 2020 (Released:2020-08-13)

参考文献数

24

被引用文献数

4

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Objective: The aim of this study was to describe the clinical characteristics of coronavirus disease (COVID-19) patients, including risk factors for deep vein thrombosis and pulmonary embolism, and to evaluate the need for rehabilitation to prevent pulmonary embolism.Methods: A retrospective medical record review was conducted of patients admitted to the study hospital with COVID-19 between April 2 and April 23, 2020. The clinical characteristics and blood test results of patients with no history on admission of oral anticoagulant use were evaluated to assess the importance of inflammation and clotting function as risk factors for pulmonary embolism.Results: A total of 51 patients with COVID-19 were admitted during the study period. Their median age was 54.0 years (range: 41–63 years) and 38 of 51 (74.5%) were men. The most common comorbidities in men were diabetes (9/38, 23.7%) and hypertension (13/38, 34.2%). On admission, white blood cell counts were normal in both sexes, whereas C-reactive protein and hemostatic marker levels, except for the activated partial thromboplastin time, were significantly higher in men. Moreover, C-reactive protein and hemostatic marker levels were significantly higher in patients that required invasive ventilation. Two patients were diagnosed with acute pulmonary embolism, neither of whom required invasive ventilation.Conclusions: Hypercoagulability and hyperinflammation were observed in COVID-19 patients, especially in men with high oxygen demand. We recommend anticoagulant therapy and early rehabilitation intervention to prevent pulmonary embolism in COVID-19 patients.

著者

Tomoko Sakai Chisato Hoshino Megumi Nakano Yu Fujiwara Atsushi Okawa

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220015, 2022 (Released:2022-03-31)

参考文献数

20

被引用文献数

2

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Objectives: This study aimed to describe the rehabilitation characteristics of patients with acute stage coronavirus disease managed with extracorporeal membrane oxygenation (ECMO) in the intensive care unit.Methods: This retrospective study enrolled coronavirus disease patients who underwent rehabilitation following ECMO between April 21, 2020, and August 20, 2021. The following patient data were evaluated: age, sex, weaning, peak C-reactive protein, lowest albumin level, white blood cell count, use of steroids and muscle relaxants, duration of respiratory management, ECMO management and rehabilitation, Medical Research Council (MRC) score, and Barthel index after sedation and at discharge.Results: ECMO was performed in 20 patients, and 16 were weaned successfully. The median durations of ECMO and respiratory management in survivors were 14.5 and 38 days, respectively. The median MRC scores after sedation and after rehabilitation therapy were 18 and 45, respectively. The median rehabilitation duration after sedation was 14 days. The MRC score after sedation showed significant correlations with the durations of ECMO and intubation. The median Barthel index values after sedation and at discharge were 0 and 30, respectively.Conclusions: Rehabilitation was important for patients with severe coronavirus disease because muscle weakness advanced in proportion with the durations of ECMO and ventilation management in the intensive care unit.

著者

Tomoko Sakai Chisato Hoshino Masanobu Hirao Megumi Nakano Yusuke Takashina Atsushi Okawa

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230017, 2023 (Released:2023-06-14)

参考文献数

39

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Objectives : We aimed to review the most recent articles on the rehabilitation of patients after coronavirus disease 2019 (COVID-19) and to identify the methods and effects of rehabilitation on such patients.Methods : A literature search was conducted using PubMed and Web of Science from study inception to October 2022 using the following search terms to identify meta-analyses and randomized controlled studies with abstracts written in English: [“COVID-19” or “COVID 19” or “2019-nCoV” or “SARS-CoV” or “novel coronavirus” or “SARS-CoV-2”] and [“rehabilitation”]. Publications investigating the effects of pulmonary and physical rehabilitation on patients with COVID-19 were extracted.Results: The extraction process selected four meta-analyses, two systematic reviews, two literature reviews, and two randomized controlled trials. Pulmonary rehabilitation recovered forced vital capacity (FVC), 6-min walk distance (6MWD), health-related quality of life (HRQOL), and dyspnea. Pulmonary rehabilitation increased predicted FVC, distance in the 6MWD test, and HRQOL score compared with baseline values. Physical rehabilitation, comprising aerobic exercises and resistance training, effectively improved fatigue, functional capacity, and quality of life with no adverse events. Telerehabilitation was an effective tool to provide rehabilitation for patients with COVID-19.Conclusions: Our study suggests that rehabilitation after COVID-19 should be considered an effective therapeutic strategy to improve the functional capacity and quality of life of patients with COVID-19.