冠状病毒肺炎后呼吸肌力受损患者的综合康复疗效

A. F. Belyaev, B. Geltser, T. S. Kharkovskaya, O. Fotina, A. Dei
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摘要

研究目的本研究旨在评估综合康复计划对冠状病毒肺炎后呼吸肌力下降患者的疗效。这项前瞻性、随机化研究共招募了 55 名从 COVID-19 中康复的患者(平均年龄为 66.1±6.4 岁;男性占 21.8%,女性占 78.2%)。康复方案包括 10 次呼吸练习、10 次胸部按摩治疗和 3 次整骨疗法调整。在开始康复治疗前和康复治疗结束后,都对呼吸功能和呼吸肌力量进行了评估。最初的主诉包括快速疲劳、体力负荷下呼吸困难、眩晕、头痛、呼吸时胸痛以及睡眠模式紊乱。参与者分为两组:男性和女性。与正常值相比,两组患者的呼气肌力均下降了 1.2 倍,吸气肌力下降了 1.6 倍。肺活量测定显示,所有参与者的肺功能均受损。康复后,总体健康状况明显改善,主诉的严重程度也有所减轻。康复路由量表显示,病情严重程度从2-3点下降到1-2点,同时呼吸肌力量、血氧饱和度和肺功能的恢复也有显著的统计学意义。我们提出的综合康复方案结合了整骨疗法、呼吸运动和按摩,成功地将病理呼吸模式转变为生理呼吸模式,增强了呼吸肌的力量,恢复了肺功能。因此,COVID-19 后肺炎患者的运动能力得到改善,焦虑和抑郁程度降低,生活质量提高。
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Effectiveness of comprehensive rehabilitation of patients with impaired respiratory muscle strength after coronavirus pneumonia
Aim. The study aims to evaluate the effectiveness of a comprehensive rehabilitation program for patients experiencing reduced respiratory muscle strength following coronavirus pneumonia.Materials and methods. This prospective, ran-domized study enrolled 55 individuals (average age 66.1±6.4 years; 21.8% males and 78.2% females) who had recovered from COVID-19. The rehabilitation regimen included 10 sessions of respiratory exercises, 10 chest massage treatments, and 3 sessions of osteopathic adjustment. Assessments of respiratory function and respiratory muscle strength were conducted both before the initiation of rehabilitation and upon its completion.Results. Initial complaints included rapid fatigue, dyspnea under physical strain, vertigo, headaches, chest pain during respiration, and disrupted sleep patterns. Participants were categorized into two groups: males and females. Both groups demonstrated a decrease in expiratory muscle strength by a factor of 1.2 and inspiratory muscle strength by 1.6, compared to normative values. Spirometry indicated impaired lung function across all participants. Post-rehabilitation, a marked improvement in overall health and a reduction in complaint severity were observed. Rehabilitation routing scales showed a decrease in condition severity from 2-3 points to 1-2 points, alongside a statistically significant increase in respiratory muscle strength, enhanced oxygen saturation, and restored lung function.Conclusion. Our proposed comprehensive rehabilitation program, incorporating osteopathic manipulation, respiratory exercises, and massage, successfully shifts the pathological breathing pattern to a physiological one, strengthens respiratory muscles, and reinstates lung function. This leads to improved exercise, reduced anxiety and depression levels, and enhanced quality of life for post-COVID-19 pneumonia patients.
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