Issue 2-21, 2022

Original article

https://doi.org/10.38025/2078-1962-2022-21-2-6-16

Сlinical Efficacy of Individually Dosed Intermittent Hypoxia-Hyperoxic Therapy in Osteoarthritis Patients with Post-Covid Syndrome

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1 ORCIDEvgeniya V. Orlova, 1 ORCIDNadezhda P. Lyamina, 1 ORCIDNatalya V. Skorobogatyth, 1 ORCIDIrena V. Pogonchenkova

1 Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russian Federation


ABSTRACT

Aim. To evaluate the clinical efficiency of the individually dosed interval hypoxia-hyperoxic therapy in the medical rehabilitation ofpatients with osteoarthritis (OA), having post-COVID syndrome.Material and methods. 50 patients with OA (84% females, age of 43 to 68 years) where included in the randomized placebo-controlledstudy. Coronavirus infection COVID-19 were diagnosed from 12 to 26 weeks before the study. Patients had at least 6 symptoms ofpost-COVID syndrome. All patients were randomized into 3 groups. 18 patients of the study group received 10 hypoxia-hyperoxictherapy procedures, 15 comparison group patients – 10 placebo procedures, 14 control group patients – only standard rehabilitation.The study group patients were breathing hypoxic (FiO2 13–15%) and hyperoxic (FiO2 up to 40%) gas mixture through the mask in theinterval mode using device ReOxy. The duration of 1–4 procedures was 30 min, 5–10 procedures – 40 min. The placebo procedureswere performed using the mask with the atmospheric air hole. The standard rehabilitation program in all groups for 2 weeks included:10 group sessions of physical exercises with elements of breathing exercises, 10 procedures of magnetic therapy for joints, 10 sodiumchloride baths. Joint pain and general health on 100-mm visual analog scale, Lequesne and WOMAC indexes, Spielberger-Khaninreactive anxiety test, Beck depression inventory and breathlessness on Modified Borg scale were evaluated at baseline (control pointT0) and at 2 weeks (control point T1).Results and discussion. After 2 weeks (T1) in the study group, pain decreased by 51.4% (p < 0.01), Lequesne index – by 34.8%(p < 0.05), WOMAC – by 44.7% (p < 0.05), reactive anxiety level – by 23.7% (p < 0.05), depression symptoms – by 52.9% (p < 0.01),breathlessness – by 71.2% (p < 0.01), general health improved by 52.1% (р < 0.01). In the study group, there were statistically significantdifferences from the control group in all parameters (р < 0.05) and from the comparison group in most indicators (р < 0.05), excludingthe Lequesne index. These results are consistent with the data of modern studies of efficiency of hypoxic conditioning.Conclusion. 2-week rehabilitation program, including interval hypoxia-hyperoxic therapy, reduces pain, breathlessness, depression andreactive anxiety symptoms, improves general health and functional status in patients with OA, having post-COVID syndrome.


KEYWORDS: osteoarthritis, post-COVID syndrome, rehabilitation, hypoxia-hyperoxic therapy, individually dosed intermittent hypoxia, hypoxic conditioning

FOR CITATION: Orlova E.V., Lyamina N.P., Skorobogatyth N.V., Pogonchenkova I.V. Сlinical Efficacy of Individually Dosed Intermittent Hypoxia-Hyperoxic Therapy in Osteoarthritis Patients with Post-Covid Syndrome. Bulletin of Rehabilitation Medicine. 2022; 21(2): 6-16. https://doi.org/10.38025/2078-1962-2022-21-2-6-16

For correspondence: Evgeniya V. Orlova, e-mail: yevorlova@mail.ru


References:

  1. Nasonov E.L. Rossijskie klinicheskie rekomendacii. Revmatologiya [Russian clinical guidelines. Rheumatology]. Moscow. GEOTAR Media. 2019: 464 p. (In Russ.).
  2. Alekseeva L.I., Taskina E.A., Kashevarova N.G. Osteoartrit: epidemiologiya, klassifikaciya, faktory riska i progressirovaniya, klinika, diagnostika, lech- enie [Osteoarthritis: epidemiology, classification, risk factors and progression, clinical presentation, diagnosis, treatment]. Modern Rheumatology Journal. 2019; 13(2): 9–21. https://doi.org/10.14412/1996-7012-2019-2-9-21 (In Russ.).
  3. Naumov A.V., Alekseeva L.I. Vedenie bol’nyh s osteoartritom i komorbidnost’yu v obshchej vrachebnoj praktike. Klinicheskie rekomendacii [Manage- ment of patients with osteoarthritis and comorbidity in general medical practice. Clinical guidelines]. Moscow. 2016: 40 p. (In Russ.).
  4. Vorobyov P.A. Rekomendacii po vedeniyu bol’nyh s koronavirusnoj infekciej COVID-19 v ostroj faze i pri postkovidnom sindrome v ambulatornyh usloviyah [Guidelines for the management of patients with coronavirus infection COVID-19 in the acute phase and with post-covid syndrome on an outpatient basis]. Problems of Standardization in Health Care. 2021; (7–8): 3–96. https://doi.org/10.26347/1607-2502202107-08003-096 (In Russ.).
  5. Dennis A., Wamil M., Kapur S., Alberts J., Badley A.D., Decker G.A., Rizza S.A., Banerjee R., Banerjee A. Multi-organ impairment in low-risk individuals with long COVID. MedRxiv. 2020. https://doi.org/10.1101/2020.10.14.20212555
  6. Davis H.E., Assaf G.S., McCorkell L., Wei H., Low R.J., Re’em Y., Redfield S., Austin J.P., Akrami A. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. eClinicalMedicine. 2021; 38(2001): 101019 p. https://doi.org/10.1016/j.eclinm.2021.101019
  7. Pugh C.W., Ratcliffe P.J. New horizons in hypoxia signaling pathways. Experimental Cell Research. 2017; 356(2): 116–121. https://doi.org/10.1016/j.yexcr.2017.03.008
  8. Glazachev O.S., Lyamina N.P., Spirina G.K. Interval’noe gipoksicheskoe kondicionirovanie: opyt i perspektivy primeneniya v programmah kardiore- abilitacii [Intermittent hypoxic conditioning: experience and potential in cardiac rehabilitation programs]. Russian Journal of Cardiology. 2021; 26(5): 4426 p. https://doi.org/10.15829/1560-4071-2021-4426 (In Russ.).
  9. Serebrovska T.V., Portnychenko A.G., Drevytska T.I., Portnichenko V.I., Xi L., Egorov E., Gavalko A.V, Naskalova S., Chizhova V., Shatylo V.B. Intermittent hypoxia training in prediabetes patients: Beneficial effects on glucose homeostasis, hypoxia tolerance and gene expression. Experimental Biology and Medicine. 2017; 242(15): 1542–1552. https://doi.org/10.1177/1535370217723578
  10. Chacaroun S., Borowik A., Morrison S.A., Baillieul S., Flore P., Doutreleau S., Verges S. Physiological Responses to Two Hypoxic Conditioning Strategies in Healthy Subjects. Frontiers in Physiology. 2016; (7): 675 p. https://doi.org/10.3389/fphys.2016.00675
  11. Tobin B., Costalat G., Renshaw G.M.C. Intermittent not continuous hypoxia provoked haematological adaptations in healthy seniors: hypoxic pattern may hold the key. European Journal of Applied Physiology. 2020; 120(3): 707–718. https://doi.org/10.1007/s00421-020-04310-y
  12. Kryzhanovskaya S.Yu., Dudnik E.N., Zapara M.A., Samartseva V.G., Glazachev O.S. Procedury gipoksicheskogo kondicionirovaniya ne privodyat k chrezmernoj aktivacii oksidativnogo stressa u prakticheski zdorovyh obsleduemyh [Hypoxic conditioning procedures do not elicit of extreme activation of oxidative stress in almost healthy students]. I.M. Sechenov Russian Journal of Physiology. 2019; 105(1): 89–99. https://doi.org/10.1134/S0869813919010047 (In Russ.).
  13. Serebrovska Z.O, Chong E.Y., Serebrovska T.V., Tumanovska L.V., Xi L. Hypoxia, HIF-1α, and COVID-19: from pathogenic factors to potential therapeu- tic targets. Acta Pharmacologica Sinica. 2020; 41(12): 1539–1546. https://doi.org/10.1038/s41401-020-00554-8
  14. Timon R., Martínez-Guardado I., Camacho-Cardeñosa A., Villa-Andrada J.M., Olcina G., Camacho-Cardeñosa M. Effect of intermittent hypoxic condi- tioning on inflammatory biomarkers in older adults. Experimental Gerontology. 2021; (152): 111478 p. https://doi.org/10.1016/j.exger.2021.111478
  15. Nasonov E.L. Immunopatologiya i immunofarmakoterapiya koronavirusnoj bolezni 2019 (COVID-19): fokus na interlejkin 6 [Immunopathology and immunopharmacotherapy of coronavirus disease 2019 (COVID-19): focus on interleukin-6]. Rheumatology Science and Practice. 2020; 58(3): 245–261 (In Russ.).
  16. Bestavashvili A.A., Glazachev O.S., Bestavashvili A.A., Dhif I., Suvorov A.Yu., Vorontsov N.V., Tuter D.S., Gognieva D.G., Yong Z., Pavlov Ch.S., Glushenkov D.V., Sirkina E.A., Kaloshina I.V., Kopylov P.Yu. The Effects of Intermittent Hypoxic-Hyperoxic Exposures on Lipid Profile and Inflammation in Patients with Metabolic Syndrome. Frontiers in Cardiovascular Medicine. 2021; (8): 700826 p. https://doi.org/10.3389/fcvm.2021.700826
  17. Serebrovska Z.O., Serebrovska T.V., Kholin V.A., Tumanovska L.V., Shysh A.M., Pashevin D.A., Goncharov S.V., Stroy D., Grib O.N., Shatylo V.B., Bachinskaya N.Yu., Egorov E., Xi L., Dosenko Victor E. Intermittent Hypoxia-Hyperoxia Training Improves Cognitive Function and Decreases Circulat- ing Biomarkers of Alzheimer’s Disease in Patients with Mild Cognitive Impairment: A Pilot Study. International Journal of Molecular Sciences. 2019; 20(21): 5405 p. https://doi.org/10.3390/ijms20215405
  18. Timon R., Camacho-Cardeñosa M., González-Custodio A., Olcina G., Gusi N., Camacho-Cardeñosa A. Effect of hypoxic conditioning on functional fit- ness, balance and fear of falling in healthy older adults: a randomized controlled trial. European Review of Aging and Physical Activity. 2021; 18(1): 25 p. https://doi.org/10.1186/s11556-021-00279-5



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