Influence of Inpatient Physiotherapy Following Recovery from Coronavirus on Physical Function Improvement

Kiyokazu Sekikawa, Yasutaka Umayahara, Ryo Kozu, Tomoya Ogawa, Akira Tamaki
Purpose:

This study aimed to examine the characteristics of physical function and the effects of physical therapy (PT) in individuals who recovered from COVID-19.

Methods:

This was a multicenter, noninterventional, prospective cohort study. The study population comprised individuals who recovered from COVID-19, continued to require hospital management, and underwent PT in a hospital setting. Recovery from the effects of the SARS-CoV-2 virus was defined as a negative result confirmed by a pathogen testing method or by the patient's exit from the designated red zone within the facility. For inpatients, functional assessment was conducted on two occasions: initially at the commencement of PT and subsequently at its conclusion. Functional evaluation was conducted using the Short Physical Performance Battery (SPPB), Clinical Frailty Scale (CFS), and a five-question questionnaire on strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F). This study did not employ a method of supplementing missing values with predicted values. The Wilcoxon signed-rank test was used to ascertain whether any statistically significant differences in functional scores (SPPB, CFS, and SARC-F) existed between the commencement and conclusion of the PT. All analyses were conducted using IBM SPSS Statistics v29, with a significance level of 0.05. Results are presented as median values with interquartile ranges. This study was approved by the Ethics Committee of the Hyogo Medical University (reference number: 20029).

Results:

The maximum number of participants in the study was 226. There was a statistically significant improvement in the SPPB score at the end of the PT program [6.5(7.0)] compared to the baseline score prior to the commencement of PT [9.0(4.0)] (p0.001). At the end of the PT program, the CFS and SARC-F scores decreased significantly compared with the baseline assessment [CFS: 6.0(3.8) vs. 4.0(2.0), p 0.001; SARC-F: 4.5(6.0) vs. 2.0(3.0), p 0.01].

Conclusion(s):

Some community-dwelling individuals who recovered from COVID-19 infection nevertheless continued to experience sarcopenia and frailty, as well as limitations in their ADL. The results demonstrated that PT was effective in ameliorating frailty and sarcopenia as well as ADL limitations and physical function. However, some participants exhibited a high risk of developing frailty and sarcopenia after PT.

Implications:

To improve physical function and frailty and sarcopenia, PT should be provided not just during the hospitalization period, but also continuously after discharge with support care in the home setting.

Funding acknowledgements:
This study was funded by the Grants-in-Aid for Scientific Research and the Japanese Society of Respiratory Physical Therapy.
Keywords:
post-COVID-19
Physical Function
Primary topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethics Committee of the Hyogo Medical University
Provide the ethics approval number:
reference number: 20029
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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