Issue №5-21, 2022

Rehabilitation Programs Effectiveness Model: a Retrospective Comparative Study of Patients with Post-Acute COVID-19 Syndrome



1 ORCIDIrina A. Grishechkina., 1 ORCIDAndrey A. Lobanov.,1 ORCIDSergey V. Andronov.,1 ORCIDAndrey I. Popov.,1 ORCIDMikhail V. Nikitin.,2 ORCIDMarina V. Terentiyeva.

1 National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation
2A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation


ABSTRACT

AIM. To evaluate the expected effectiveness of post-COVID rehabilitation strategies.
MATERIAL AND METHODS. The study was conducted August, 2021 – March, 2022 in the republican and federal rehabilitation centers: Krasnodar Territory (n=25), the Republic of Buryatia (n=25), and Moscow (n= 25). The data were obtained by a retrospective analysis of medical records and by interviewing the study participants who had an indication or had been treated in a rehabilitation centre for post-acute COVID-19 syndrome (U 09.9). The average length of time after the onset of the acute period of the disease was 6.5 ± 2.5 months. A prognostic model was constructed to estimate the expected effectiveness of the rehabilitation programme, as measured by a reduction in the severity of dyspnea. Nonlinear maximum likelihood logit regression was used to build the model.
RESULTS AND DISCUSSION. According to the presented model, the best expected rehabilitation effectiveness was found in the National Medical Research Center (Moscow) (β=-1.788685, p=0.009964604), a slightly lower expected rehabilitation effectiveness was
observed in the resort with a curative climate (Krasnodar Territory) (β=0.9913501, p=0.182944), the lowest expected effectiveness was registered in the regional rehabilitation center (the Republic of Buryatia) (β=1.054594 p=0.2642723). The need for an integrated
approach in the treatment of patients with post-acute COVID-19 syndrome was pointed out by many domestic and foreign researchers, however, the choice and content of treatment strategies is debatable. Our study provides a preliminary answer to this question.
CONCLUSION. The developed model of the expected effectiveness of the rehabilitation of patients suffering from shortness of breath after undergoing COVID-19 has a specificity of 54.54%, sensitivity of 91.3% and an overall accuracy of 84.21%. The best expected rehabilitation effectiveness was found in the National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of the Russian Federation (Moscow) (β=-1.788685, p=0.009964604), somewhat lower in the resort with a curative climate (Krasnodar territory) (β=0.9913501, p=0.182944), the lowest expected efficiency was registered in the regional rehabilitation center (the Republic of Buryatia) (β=1.054594 p=0.2642723).


KEYWORDS: post-acute COVID-19 syndrome, rehabilitation programmes, dyspnea

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Grishechkina I.A., Lobanov A.A., Andronov S.V., Popov A.I., Nikitin M.V., Terentiyeva M.V. Rehabilitation Programs Effectiveness Model: a Retrospective Comparative Study of Patients with Post-Acute COVID-19 Syndrome. Bulletin of Rehabilitation Medicine. 2022; 21 (5): 20-26. https://doi.org/10.38025/2078-1962-2022-21-5-20-26



References:

1. Gilmutdinova I.R., Kolyshenkov V.A., Lapickaya K.A., Trepova A.S., Vasileva V.A., Prosvirnin A.N., Marchenkova L.A., Terentev K.V., Yakovlev M.Y., Rachin A.P., Fesyun A.D., Reverchuk I.V. Telemedicine platform COVIDREHAB for remote rehabilitation of patients after COVID-19. European Journal of Translational Myology. 2021; 31(2): 9783 p. https://doi.org/10.4081/ejtm.2021.9783
2. Ambrazhuk I.I., Fesyun A.D. The main aspects of the development of medical rehabilitation. Russian Journal of Rehabilitation Medicine. 2018; (4): 31-36.
3. Ansokova M.A., Vasil’eva V.A. Rehabilitation of a patient with acute cerebral circulation disturbance due to COVID-19. In the book: Features of the course and diagnosis of a new coronavirus infection COVID-19. Materials of the Russian scientific-practical conference with international participation. Kursk. 2022: 44-45.
4. Marchenkova L.A., Makarova E.V., Yurova O.V. Role of micronutrients in comprehensive rehabilitation of patients with new coronavirus infection COVID-19. Voprosy pitaniia [Problems of Nutrition]. 2021; 90(2): 40-49. https://doi.org/10.33029/0042-8833-2021-90-2-40-49
5. Fesyun A.D., Lobanov A.A., Rachin A.P., Yakovlev M.Yu., Andronov S.V., Konchugova T.V. et al. Challenges and approaches to the medical rehabilitation of patients survived complications of COVID-19. Bulletin оf Rehabilitation Medicine. 2020; 3(97): 3-13. https://doi.org/10.38025/2078-1962-2020-97-3-3-13

6. Vyalkov A.I., Bobrovnitsky I.P., Rakhmanin Yu.A., Razumov A.N. Ways to improve health organization in conditions of growing environmental challenges to life safety and population health. Russian Journal of Rehabilitation Medicine. 2017; (1): 24-41.
7. Cenko E., Badimon L., Bugiardni R., Claeys M.J., De Luca G., De Wit C. et al. Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA). Cardiovascular Research. 2021; 117(14): 2705-2729. https://doi.org/10.1093/cvr/cvab298
8. Bell M., Catalfamo C.J., Farland L.V., Ernst K.C., Jacobs E.T., Klimentidis Y.C. et al. Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT. Public Library of Science. ONE. 2021; 16(8): e0254347. https://doi.org/10.1371/journal.pone.0254347
9. Huang C., Huang L., Wang Y., Li X., Ren L., Gu X. et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet. 2021; 397(10270): 220-232. https://doi.org/10.1016/S0140-6736(20)32656-8
10. Arnold D.T., Hamilton F.W., Milne A., Morley A.J., Viner J., Attwood M. et al. Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax. 2021; 76(4): 399-401. https://doi.org/10.1136/thoraxjnl-2020-216086
11. Cau R., Faa G., Nardi V., Balestrieri A., Puig J., Suri J.S., San Filippo R., Saba L. Long-COVID diagnosis: From diagnostic to advanced AI-driven models. European Journal of Radiology. 2022; (148): 110164. https://doi.org/10.1016/j.ejrad.2022.110164
12. Montani D., Savale L., Noel N., Meyrignac O., Colle R., Gasnieret M. et al. Post-acute COVID-19 syndrome. European Respiratory Review. 2022; (31): 210185. https://doi.org/10.1183/16000617.0185-2021
13. Hodgson C.L., Higgins A.M., Bailey M.J., Mather A.M., Beach L., Bellomo R., Bissett B., Boden I.J., Bradley S., Burrell A., Cooper D.J. et al. & The COVIDRecovery Study Investigators and the ANZICS Clinical Trials Group. The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study. Critical Care. 2021; (25): 382 p. https://doi.org/10.1186/s13054-021-03794-0
14. Di Caudo C.G., Rivas G.M., Fernández-Rodríguez I., Gómez-Jurado G., Garrido M.R., Membrilla-Mesa M. Tratamiento rehabilitador de la infección por COVID: caracterización y seguimiento de pacientes hospitalizados en Granada, Espana. Rehabilitación. 2021 ; 4(56) : 328-336. https://doi.org/10.1016/j.rh.2021.09.001
15. Capin J.J., Wilson M.P., Hare K., Vempati S., Little C.E., McGregor D., Castillo‑Mancilla J., Stevens‑Lapsley J.E., Jolley SE., Erlandson K.M. Prospective telehealth analysis of functional performance, frailty, quality of life, and mental health after COVID-19 hospitalization. BioMed Central. Geriatrics. 2022; (22): 251 p. https://doi.org/10.1186/s12877-022-02854-6
16. Ghosn J., Piroth L., Epaulard O., Le Turnier P., Mentré F., Bachelet D., Laouénan C., the French COVID cohort study and investigators groups. Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort. Clinical Microbiology and Infection. 2021; 27(7): 1041.e1-1041.e4. https://doi.org/10.1016/j.cmi.2021.03.012
17. Wu X., Liu X., Zhou Y., Yu H., Li R., Zhanet Q. et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19- related hospitalisation: a prospective study. The Lancet. Respiratory Medicine. 2021; (9): 747-754. https://doi.org/10.1016/S2213-2600(21)00174-0
18. Belevskij A.S., Meshcheryakova N.N. Pulmonary rehabilitation. Moscow. Atmosphera. 2018: 76 p.
19. Fugazzaro S., Contri A., Esseroukh O., Kaleci S., Croci S., Massari M. et al. Rehabilitation Interventions for Post-Acute COVID-19 Syndrome: A Systematic Review. International Journal of Environmental Research and Public Health. 2022; (19): 5185 p. https://doi.org/10.3390/ijerph19095185
20. Faverio P., Luppi F., Rebora P., D’Andrea G., Stainer A., Busnelli S., Catalano M. et al. One-year pulmonary impairment after severe COVID-19: a prospective, multicenter follow-up study. Respiratory Research. 2022; (23): 65 p. https://doi.org/10.1186/s12931-022-01994-y
21. Bungenberg J., Humkamp K., Hohenfeld Ch., Rust I.M., Ermis U., Dreher M. et al. Long COVID-19: Objectifying most self-reported neurological symptoms. Annals of Clinical and Translational Neurology. 2022; 9(2): 141-154 https://doi.org/10.1002/acn3.51496
22. Schaeffer M.R., Cowan J., Milne K.M., Puyat J.H., Voduc N., Corrales-Medina V. et al. Cardiorespiratory physiology, exertional symptoms, and psychological burden in post-COVID-19 fatigue. Respiratory Physiology & Neurobiology. 2022; (302): 103898 p. https://doi.org/10.1016/j.resp.2022.103898
23. Martínez-Salazar B., Holwerda M., Stüdle C., Piragyte I., Mercader N., Engelhardt B., Rieben R., Döring Y. COVID-19 and the Vasculature: Current Aspects and Long-Term Consequences. Frontiers in Cell and Developmental Biology. 2022; (10): 824851. https://doi.org/10.3389/fcell.2022.824851
24. Gloeck R., Buhr-Schinner H., Koczulla A., Schipmann R., Schultz K., Spielmanns M. et al. DGP-Empfehlungen zur pneumologischen Rehabilitation bei COVID-19. Pneumologie. 2021; 57(2): 189-98.
25. Puchner B., Sahanic S., Kirchmair R., Pizzini A., Sonnweber B., Wöll E. et al. Beneficial effects of multi-disciplinary rehabilitation in Post-acute COVID-19: an observational cohort study. European Journal of Physical and Rehabilitation Medicine. 2021; 57(2): 189-198. https://doi.org/10.23736/S1973-9087.21.06549-7
26. Rutsch M., Frommhold J., Buhr-Schinner H., Djeiranachvili L., Gross Th., Schüller Per O., Katalinic A., Deck R. Study protocol medical rehabilitation after COVID-19 disease: an observational study with a comparison group with obstructive airway disease / Re_Co. BioMed Central Health Services Research. 2021; (21): 373. https://doi.org/10.1186/s12913-021-06378-4
27. Cattadori G., Di Marco S., Baravelli M., Picozzi A., Ambrosio G. Exercise Training in Post-COVID-19 Patients: The Need for a Multifactorial Protocol for a Multifactorial Pathophysiology. Journal of Clinical Medicine. 2022; 11(8): 2228. https://doi.org/10.3390/jcm11082228
28. Fumagalli C., Zocchi Ch., Tassetti L., Silverii M.V., Amato C., Livi L., et al. AOU Careggi COVID-19 Follow-up study Group. Factors associated with persistence of symptoms 1 year after COVID-19: A longitudinal, prospective phone-based interview follow-up cohort study. European Journal of Internal Medicine. 2022; (97): 36-41. https://doi.org/10.1016/j.ejim.2021.11.018
29. Harvey-Dunstan Th.C., Jenkins A.R., Gupta A., Hall I.P. and Bolton Ch.E. Patient-related outcomes in patients referred to a respiratory clinic with persisting symptoms following non-hospitalised COVID-19. Chronic Respiratory Disease. 2022; (19): 1-4. https://doi.org/10.1177/14799731211069391
30. Razumov A.N., Starodubov V.I., Ponomarenko G.N. Sanatorium and resort: national leadership. Мoscow. GEOTAR-Media. 2021: 752 p.
31. Rebrova O.Yu. Statistical analysis of medical data. Application of the application package Statistica. Moscow. Media-Sphere. 2002: 312 p.
32. Bogolyubov V.M. Physiotherapy and balneology. Мoscow. BINOM. 2021: 999p.
33. Understanding of guidance for acupuncture and moxibustion interventions on COVID-19 (Second edition) issued by CAAM. World Journal of Acupuncture – Moxibustion. 2020; 30(1): 1-4. https://doi.org/10.1016/j.wjam.2020.03.005
34. Cen' Yu., Lun Yu. Deep breathing Qigong against diseases. A Modern Guide to Ancient Healing Techniques. Мoscow. Eksmo. 2018: 304p.
35. Meshcheryakova N.N., Belevskij A.S., Kuleshov A.V. Guidelines pulmonary rehabilitation in patients with new coronavirus infection (COVID-19) community-acquired bilateral pneumonia. Moscow. Russia. 2020: 22 p.
36. Lobanov A.A., Grishechkina I.A., Fesyun A.D., Rachin A.P., Yakovlev M.Yu., Andronov S.V., Barashkov G.N., Lebedeva O.D., Popov A.I., Styazhkina E.M., Ansokova M.A., Vasil’eva V.A. Investigation of the Effectiveness and Safety of a Rehabilitation Program for Patients with Long Covid Using Aquatic Training. Bulletin of Rehabilitation Medicine. 2022; 21(3): 45-57. https://doi.org/10.38025/2078-1962-2022-21-3-45-57
37. Delafontaine A., Ditcharlea S., Hussein T., Hoffschir M., Plantefève G., Michon D. Physiotherapy and COVID-19: A major public health role to short, medium and long terms in the patient's rehabilitation process. Kinésithérapie, la Revue. 2020; 20(223): 11-18. https://doi.org/10.1016/j.kine.2020.05.005
38. Frota A.X., Carvalho V.M., Santos S.C.C, da Silva S.P., da Silva S.G.M, de Souza N.S.M.F. et al. Review Article: Functional capacity and rehabilitation strategies in COVID-19 patients: current knowledge and challenges. Revista da Sociedade Brasileira de Medicina Tropical. 2021; (54): e07892020.
https://doi.org/10.1590/0037-8682-0789-2020
39. Meshcheryakova N.N., Belevskij A.S., Kuleshov A. V. Pulmonary rehabilitation of patients with coronavirus infection COVID-19, clinical examples. PULMONOLOGIYA. 2020; 30(5): 712-722. https://doi.org/10.18093/0869-0189-2020-30-5-715-722
40. Mikhaleva K.A., Mikhalev V.S., Eremushkin M.A., Gilmutdinova I.R., Chesnikova E.I. Respiratory exercises for patients with COVID-associated pneumonia. In the book: Modern technologies and equipment for medical rehabilitation, spa treatment and sports medicine. collection of proceedings of the V International Scientific and Practical Congress VITA REHAB WEEK. 2021: 102-104.
41. Moskvin S.V., Agasarov L.G. Laser acupuncture: 35 years of successful application in Russia (narrative review). Journal of Lasers in Medical Sciences. 2020; 11(4): 381-389. https://doi.org/10.34172/jlms.2020.61
42. Bickton F.M., Chisati E., Rylance J., Morton B. An Improvised Pulmonary Telerehabilitation Program for Postacute COVID-19 Patients Would Be Feasible and Acceptable in a Low-Resource Setting. American Journal of Physical Medicine & Rehabilitation. 2021; 100(3): 209-212. https://doi.org/10.1097/PHM.0000000000001666
43. Bouteleux B., Henrot P., Ernst R., Grassion L., Raherison-Semjen Ch., Beaufils F., Zysman M., Delorme M. Respiratory rehabilitation for COVID-19 related persistent dyspnea: A one-year experience. Respiratory Medicine. 2021; (189): 106648. https://doi.org/10.1016/j.rmed.2021.106648
44. Bek L.M., Berentschot J.C., Hellemons M.E., Huijts S.M., Aerts J.G.J.V., van Bommel J. et al. and the CO-FLOW Collaboration Group CO-FLOW: COvid-19 Follow-up care paths and Long-term Outcomes Within the Dutch health care system: study protocol of a multicenter prospective cohort study following patients 2 years after hospital discharge. BioMed Central Health Services Research. 2021; (21): 847. https://doi.org/10.1186/s12913-021-06813-6






Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.

РЕКЛАМА