The primary objective of this study was to evaluate and compare the functional recovery of older adults following COVID-19 infection, distinguishing between those who received post-COVID physiotherapy treatment and those who did not. Additionally, the study aimed to investigate how specific characteristics of physiotherapy rehabilitation influenced functional recovery 12 months post-infection.
This retrospective cohort study collected data through an online survey developed in the REDCap database, which was distributed to the population of Sao Paulo, Brazil, using the Municipal Health Department's database. Participants were individuals aged 50 years or older who had COVID-19 between 2020 and 2021, with or without Severe Acute Respiratory Syndrome (SARS), confirmed by PCR+ or positive serological test. Sociodemographic and clinical data were collected from the Municipal Health Department's database and through questionnaires. Functional assessment was conducted using the Katz Index for basic activities and the Lawton Scale for instrumental activities. The characteristics of the physiotherapeutic approach were gathered through an online questionnaire.
The study included 767 participants, of which 44% were male and 56% were female. The group referred for physiotherapy had an average age of 55 years, while the group not referred for physiotherapy had a mean age of 50. Regarding the severity of COVID-19, 90% of those referred for physiotherapy had Severe Acute Respiratory Syndrome (SARS). Among those who had access to physiotherapy, 97% had the severe form of COVID-19. However, 65% of those who did not have access to physiotherapy treatment also had SARS. When comparing the groups referred and those with access, the data showed that 77% also had access. Additionally, the data indicated that individuals identified as brown had the highest percentage of no access to physiotherapy, at 23%.
Regarding the duration of physiotherapy sessions, 32% of participants had sessions lasting 15 to 30 minutes, 37% had sessions lasting 30 to 45 minutes, and 29% had sessions lasting more than 45 minutes. Access to physiotherapy was distributed as follows: 29% through the public network, 12% through the private network, and 76% through health plans.
The primary reasons for referral to physiotherapy included leg weakness (60%), arm weakness (52%), dyspnea (85%), changes in sensitivity (8%), fatigue or tiredness (63%), and pain (17%).
Regarding basic activities of daily living, it was found that participants were independent before COVID-19 but began to exhibit some functional dependence after COVID-19. However, they regained independence after 12 months. Notably, the functional impact was more significant in those who were referred for physiotherapy.
This study highlights the critical role of physiotherapy in rehabilitating older adults following COVID-19 infection. The findings indicate that individuals with access to physiotherapy exhibit better functional outcomes.
The study underscores the significance of tailored physiotherapy interventions, emphasizing that the treatment's duration, frequency, and specificity are crucial factors contributing to the functional improvement of patients.
Functionality
Rehabilitation
