Preliminary Observations and Experiences of Physiotherapy Practice in Acute Care Setup of COVID 19: A Retrospective Observational Study.
Identifieur interne : 000075 ( Main/Curation ); précédent : 000074; suivant : 000076Preliminary Observations and Experiences of Physiotherapy Practice in Acute Care Setup of COVID 19: A Retrospective Observational Study.
Auteurs : Mariya P. Jiandani ; Santosh B. Salagre ; Shabana Kazi ; Saraswati Iyer ; Poonam Patil ; Wasim Y. Khot ; Ekta Patil ; Mashira SopariwalaSource :
- The Journal of the Association of Physicians of India [ 0004-5772 ] ; 2020.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Humains (MeSH), Infections à coronavirus (MeSH), Jeune adulte (MeSH), Pandémies (MeSH), Pneumopathie virale (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Techniques de physiothérapie (MeSH), Unités de soins intensifs (MeSH), Études rétrospectives (MeSH).
- MESH :
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (MeSH), Humans (MeSH), Intensive Care Units (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Physical Therapy Modalities (MeSH), Pneumonia, Viral (MeSH), Retrospective Studies (MeSH), Young Adult (MeSH).
- MESH :
Abstract
Background
The rapid outbreak of coronavirus disease 2019 (COVID-19), a public health emergency of grave concern, warranted hospital admissions with almost 90,000 cases in June 2020 in city of Mumbai. 3-10% of the patients with moderate to severe involvement required intensive care unit (ICU) admission with respiratory support. Patients admitted in ICU with an acute COVID event present with respiratory dysfunction and are more likely to have critical illness myopathy and neuropathy (CIMN). Physiotherapy services being integral part of non-pharmacological management of any ICU was implemented for patients with COVID 19; a novel viral disease.
Objective
This retrospective study was undertaken to explore the physiotherapy practices that could be implemented in patients admitted with COVID 19 in the ICU and its effect on mobility and oxygen requirement as an outcome.
Methodology
Following ethical permission of institute, the data was extracted from electronic data record sheet in which daily parameters for physiotherapy intervention were recorded. Data from a single ICU and step down unit (SDU) from 5th June to 5th July 2020 was analysed. Records of patients diagnosed with COVID 19 and admitted in ICU or SDU were studied. Those in the age group of 18 to 90 years, of either gender were included. Demographic characteristics, disease severity, oxygen requirement, mobility status, physiotherapy intervention were studied.
Results
278 record sheets (110 ICU and 168 SDU) were retrospectively analysed for demographics. 44.55% of patients improved with side lying position, 37.27% with prone position and 10.91% with quarter prone position. 4.55% of patient maintained oxygenation in propped up sitting. 2.73% could not be positioned. Chest physiotherapy techniques applied were deep breathing, ACBT, paced breathing and diaphragmatic breathing. Deep intercostal pressure on NIV along with vibrations was given to 12.72% of patients in the ICU. Group therapy sessions were conducted in SDU where 50.59% patients participated. ICU mobility score showed significant improvement on Wilcoxon Signed Ranks test status on day 7 in the ICU (z=-5.99, p=0.00) and SDU (z= 7.676, p=0.00) compared to day 1. Descriptive analysis showed a definitive reduction in oxygen support requirement.
Conclusion
Most common form of physiotherapy interventions in patients with Covid 19 were therapeutic positioning, early mobilization and breathing exercises. Physiotherapy intervention appears promising in facilitating early patient ambulation and discharge. This study shows that it is safe and feasible to provide early physiotherapy treatment techniques in patients with COVID-19 using appropriate measures of infection prevention and cross contamination.
PubMed: 32978920
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Mariya P. Jiandani<affiliation><nlm:affiliation>Associate Professor, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Professor and In-charge Covid ICU, Department of Medicine, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Junior Physiotherapist, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Prof. and Head, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Assistant Physiotherapist, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Assistant Professor, Department of Medicine, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Postgraduate Student, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Postgraduate Student, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</nlm:affiliation>
<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
</affiliation>
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<author><name sortKey="Salagre, Santosh B" sort="Salagre, Santosh B" uniqKey="Salagre S" first="Santosh B" last="Salagre">Santosh B. Salagre</name>
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<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
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<author><name sortKey="Kazi, Shabana" sort="Kazi, Shabana" uniqKey="Kazi S" first="Shabana" last="Kazi">Shabana Kazi</name>
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<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
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<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
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<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
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<wicri:noCountry code="subField">Maharashtra</wicri:noCountry>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Coronavirus Infections (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Physical Therapy Modalities (MeSH)</term>
<term>Pneumonia, Viral (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Techniques de physiothérapie (MeSH)</term>
<term>Unités de soins intensifs (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Betacoronavirus</term>
<term>Coronavirus Infections</term>
<term>Humans</term>
<term>Intensive Care Units</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Physical Therapy Modalities</term>
<term>Pneumonia, Viral</term>
<term>Retrospective Studies</term>
<term>Young Adult</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Betacoronavirus</term>
<term>Humains</term>
<term>Infections à coronavirus</term>
<term>Jeune adulte</term>
<term>Pandémies</term>
<term>Pneumopathie virale</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Techniques de physiothérapie</term>
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<front><div type="abstract" xml:lang="en"><p><b>Background</b>
</p>
<p>The rapid outbreak of coronavirus disease 2019 (COVID-19), a public health emergency of grave concern, warranted hospital admissions with almost 90,000 cases in June 2020 in city of Mumbai. 3-10% of the patients with moderate to severe involvement required intensive care unit (ICU) admission with respiratory support. Patients admitted in ICU with an acute COVID event present with respiratory dysfunction and are more likely to have critical illness myopathy and neuropathy (CIMN). Physiotherapy services being integral part of non-pharmacological management of any ICU was implemented for patients with COVID 19; a novel viral disease.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Objective</b>
</p>
<p>This retrospective study was undertaken to explore the physiotherapy practices that could be implemented in patients admitted with COVID 19 in the ICU and its effect on mobility and oxygen requirement as an outcome.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Methodology</b>
</p>
<p>Following ethical permission of institute, the data was extracted from electronic data record sheet in which daily parameters for physiotherapy intervention were recorded. Data from a single ICU and step down unit (SDU) from 5th June to 5th July 2020 was analysed. Records of patients diagnosed with COVID 19 and admitted in ICU or SDU were studied. Those in the age group of 18 to 90 years, of either gender were included. Demographic characteristics, disease severity, oxygen requirement, mobility status, physiotherapy intervention were studied.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Results</b>
</p>
<p>278 record sheets (110 ICU and 168 SDU) were retrospectively analysed for demographics. 44.55% of patients improved with side lying position, 37.27% with prone position and 10.91% with quarter prone position. 4.55% of patient maintained oxygenation in propped up sitting. 2.73% could not be positioned. Chest physiotherapy techniques applied were deep breathing, ACBT, paced breathing and diaphragmatic breathing. Deep intercostal pressure on NIV along with vibrations was given to 12.72% of patients in the ICU. Group therapy sessions were conducted in SDU where 50.59% patients participated. ICU mobility score showed significant improvement on Wilcoxon Signed Ranks test status on day 7 in the ICU (z=-5.99, p=0.00) and SDU (z= 7.676, p=0.00) compared to day 1. Descriptive analysis showed a definitive reduction in oxygen support requirement.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusion</b>
</p>
<p>Most common form of physiotherapy interventions in patients with Covid 19 were therapeutic positioning, early mobilization and breathing exercises. Physiotherapy intervention appears promising in facilitating early patient ambulation and discharge. This study shows that it is safe and feasible to provide early physiotherapy treatment techniques in patients with COVID-19 using appropriate measures of infection prevention and cross contamination.</p>
</div>
</front>
</TEI>
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<Title>The Journal of the Association of Physicians of India</Title>
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<ArticleTitle>Preliminary Observations and Experiences of Physiotherapy Practice in Acute Care Setup of COVID 19: A Retrospective Observational Study.</ArticleTitle>
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<Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">The rapid outbreak of coronavirus disease 2019 (COVID-19), a public health emergency of grave concern, warranted hospital admissions with almost 90,000 cases in June 2020 in city of Mumbai. 3-10% of the patients with moderate to severe involvement required intensive care unit (ICU) admission with respiratory support. Patients admitted in ICU with an acute COVID event present with respiratory dysfunction and are more likely to have critical illness myopathy and neuropathy (CIMN). Physiotherapy services being integral part of non-pharmacological management of any ICU was implemented for patients with COVID 19; a novel viral disease.</AbstractText>
<AbstractText Label="Objective" NlmCategory="UNASSIGNED">This retrospective study was undertaken to explore the physiotherapy practices that could be implemented in patients admitted with COVID 19 in the ICU and its effect on mobility and oxygen requirement as an outcome.</AbstractText>
<AbstractText Label="Methodology" NlmCategory="UNASSIGNED">Following ethical permission of institute, the data was extracted from electronic data record sheet in which daily parameters for physiotherapy intervention were recorded. Data from a single ICU and step down unit (SDU) from 5th June to 5th July 2020 was analysed. Records of patients diagnosed with COVID 19 and admitted in ICU or SDU were studied. Those in the age group of 18 to 90 years, of either gender were included. Demographic characteristics, disease severity, oxygen requirement, mobility status, physiotherapy intervention were studied.</AbstractText>
<AbstractText Label="Results" NlmCategory="UNASSIGNED">278 record sheets (110 ICU and 168 SDU) were retrospectively analysed for demographics. 44.55% of patients improved with side lying position, 37.27% with prone position and 10.91% with quarter prone position. 4.55% of patient maintained oxygenation in propped up sitting. 2.73% could not be positioned. Chest physiotherapy techniques applied were deep breathing, ACBT, paced breathing and diaphragmatic breathing. Deep intercostal pressure on NIV along with vibrations was given to 12.72% of patients in the ICU. Group therapy sessions were conducted in SDU where 50.59% patients participated. ICU mobility score showed significant improvement on Wilcoxon Signed Ranks test status on day 7 in the ICU (z=-5.99, p=0.00) and SDU (z= 7.676, p=0.00) compared to day 1. Descriptive analysis showed a definitive reduction in oxygen support requirement.</AbstractText>
<AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">Most common form of physiotherapy interventions in patients with Covid 19 were therapeutic positioning, early mobilization and breathing exercises. Physiotherapy intervention appears promising in facilitating early patient ambulation and discharge. This study shows that it is safe and feasible to provide early physiotherapy treatment techniques in patients with COVID-19 using appropriate measures of infection prevention and cross contamination.</AbstractText>
<CopyrightInformation>© Journal of the Association of Physicians of India 2011.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jiandani</LastName>
<ForeName>Mariya P</ForeName>
<Initials>MP</Initials>
<AffiliationInfo><Affiliation>Associate Professor, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Salagre</LastName>
<ForeName>Santosh B</ForeName>
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<AffiliationInfo><Affiliation>Professor and In-charge Covid ICU, Department of Medicine, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Kazi</LastName>
<ForeName>Shabana</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Junior Physiotherapist, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Iyer</LastName>
<ForeName>Saraswati</ForeName>
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<AffiliationInfo><Affiliation>Prof. and Head, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
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<ForeName>Poonam</ForeName>
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</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Khot</LastName>
<ForeName>Wasim Y</ForeName>
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<AffiliationInfo><Affiliation>Assistant Professor, Department of Medicine, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Patil</LastName>
<ForeName>Ekta</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Postgraduate Student, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sopariwala</LastName>
<ForeName>Mashira</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Postgraduate Student, Department of Physiotherapy, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.</Affiliation>
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<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
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