IJPR.2022.125

Type of Article:  Original Research

Volume 10; Issue 3 (June 2022)

Page No.: 4269-4279

DOI: https://dx.doi.org/10.16965/ijpr.2022.125

Assessment of Balance and Fatigue In COVID-19 Patients Admitted to a Tertiary Care Center: A Retrospective Analysis

Lakshmiprabha Deviprasad *,  Bhagyashree Hajare, Krishna Sukhadev Rathod, Ankita Bhanushali, Ashwini Mundhe, Shreya Chury, Rutu Parikh, Saraswati Iyer.

P.T. School and Centre, Seth G.S.M.C and KEM Hospital, Mumbai, Maharashtra, India.

Corresponding author: Lakshmiprabha Deviprasad, Institutional Address- P.T. School and Centre, Seth G.S.M.C and KEM Hospital, Mumbai, Maharashtra, India. Contact no- 9870487879 E-Mail: laps2204@gmail.com

ABSTRACT

Background: COVID-19 predominantly affects the respiratory system; however, evidence indicates a multisystem disease, with some patients presenting with neuromuscular and psychological sequelae.  Impaired balance, and fatigue are frequently found in the patients with respiratory illness and is associated with functional impairments in daily life.

 Objectives: A Retrospective analysis of balance and fatigue in COVID-19 disease and identifying any influence of comorbidities on balance and fatigue with different disease severities will help us understand and widen the scope of physiotherapy interventions during COVID-19 and Post-COVID-19 rehabilitation

Procedure: The Medical and Physiotherapy records of 67 patients, in the age group of 18 – 75 Years, admitted in a Tertiary care hospital with COVID-19 were considered from the period of September 2020 to March 2021. Data consisting of sex, severity of COVID-19, Oxygen status, comorbidities, SLS time for Static balance, FRT distance for dynamic balance and NRS score for fatigue, were considered for analysis while those on HFNC or Ventilator, unconscious patients or with altered sensorium, or musculoskeletal and neurological conditions were excluded.

Results: FRT distance, SLS time and NRS scores were significantly reduced in those who were on oxygen supplementation as compared to those not on oxygen supplementation.

There was a moderate negative correlation between age and FRT, SLS values of those who were on oxygen supplementation but not in those without oxygen supplementation.  There was no significant difference in FRT, SLS & NRS values with or without comorbidities.

Conclusion: Balance performances were significantly reduced and fatigue significantly increased in COVID-19 patients who were on supplemental oxygen. Age is also an important factor influencing balance in them. Comorbidities did not have any effect on balance and fatigue in different disease severities. Assessment of static balance, dynamic balance and fatigue should be considered as an important part of Physiotherapy routine assessments in patients with COVID-19.

KEY WORDS: Static balance, Dynamic balance, Fatigue.

REFERENCES

[1]. Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020 Aug;56(2):106054.
[2]. Garg RK. Spectrum of Neurological Manifestations in Covid-19: A Review. Neurol India. 2020 May-Jun;68(3):560-572.
[3]. Pergolizzi JV Jr, Raffa RB, Varrassi G, Magnusson P, LeQuang JA, Paladini A, Taylor R, Wollmuth C, Breve F, Chopra M, Nalamasu R, Christo PJ. Potential neurological manifestations of COVID-19: a narrative review. Postgrad Med. 2021 Jan 11;1-11.
[4]. Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant. 2020 May;39(5):405-407.
[5]. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, Hosein Z, Padda I, Mangat J, Altaf M. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med. 2020;2(8):1069-1076.
[6]. Demeco A, Marotta N, Barletta M, Pino I, Marinaro C, Petraroli A, Moggio L, Ammendolia A. Rehabilitation of patients post-COVID-19 infection: a literature review. J Int Med Res. 2020 Aug;48(8):300060520948382.
[7]. Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil. 2020 Nov 9;66(4):480-494.
[8]. Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020 Aug;56(2):106054.
[9]. Goodwin VA, Allan L, Bethel A, Cowley A, Cross JL, Day J, Drummond A, Hall AJ, Howard M, Morley N, Thompson Coon J, Lamb SE. Rehabilitation to enable recovery from COVID-19: a rapid systematic review. Physiotherapy. 2021 Jun;111:4-22.
[10]. Krishna Sukhadev Rathod, Lakshmiprabha Deviprasad, Bhagyashree R Hajare, Shreya M Chury, Saraswati K. Iyer. COVID and Post COVID Physical Therapy of a 63 year old male with affection of Balance: A Case Report. Int J Physiother Res 2021;9(6):4079-4086.
[11]. Hunt MA, McManus FJ, Hinman RS, Bennell KL. Predictors of single-leg standing balance in individuals with medial knee osteoarthritis. Arthritis Care Res (Hoboken). 2010 Apr;62(4):496-500.
[12]. Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15.
[13]. Chuang LL, Lin KC, Hsu AL, Wu CY, Chang KC, Li YC, Chen YL. Reliability and validity of a vertical numerical rating scale supplemented with a faces rating scale in measuring fatigue after stroke. Health Qual Life Outcomes. 2015 Jun 30;13:91.
[14]. Ni W, Yang X, Yang D, Bao J, Li R, Xiao Y, Hou C, Wang H, Liu J, Yang D, Xu Y, Cao Z, Gao Z. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care. 2020 Jul 13;24(1):422.
[15]. Melo AKG, Milby KM, Caparroz ALMA, Pinto ACPN, Santos RRP, Rocha AP, Ferreira GA, Souza VA, Valadares LDA, Vieira RMRA, Pileggi GS, Trevisani VFM. Biomarkers of cytokine storm as red flags for severe and fatal COVID-19 cases: A living systematic review and meta-analysis. PLoS One. 2021 Jun 29;16(6):e0253894.
[16]. Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020 Jul;39(7):2085-2094.
[17]. Park JK, Deutz NEP, Cruthirds CL, Kirschner SK, Park H, Madigan ML, Engelen MPKJ. Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease. J Clin Med. 2020 Feb 24;9(2):609.
[18]. Wostyn P. COVID-19 and chronic fatigue syndrome: Is the worst yet to come? Med Hypotheses. 2021 Jan;146:110469.
[19]. Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, McKyer ELJ, Ahmed HU, Ma P. Epidemiology of mental health problems in COVID-19: a review. F1000Res. 2020 Jun 23;9:636.
[20]. Zhang C, Talaber A, Truong M, Vargas BB. KD Balance: An objective measure of balance in tandem and double leg stances. Digital Health. 2019 Oct;5:2055207619885573.
[21]. Perez-Cruzado D, González-Sánchez M, Cuesta-Vargas AI. Parameterization and reliability of single-leg balance test assessed with inertial sensors in stroke survivors: a cross-sectional study. Biomedical engineering online. 2014 Dec;13(1):1-2.
[22]. from:http://functionalpathways.com/intranet-files/Standardized_Test_Reference_Card_Template.pdf (last accessed 16.10.2020).
[23]. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance.J Gerontol. 1990;45(6):M192-197.
[24]. Schenkman M, Morey M, Kuchibhatla M. Spinal flexibility and balance control among community-dwelling adults with and without Parkinson’s. J Gerontol A Biol Sci Med Sci. 2000;55(8):M441-445.
[25]. Weiner DK, Duncan PW, Chandler J, Studenski SA. Functional reach: a marker of physical frailty. J Am Geriatr Soc. 1992;40(3):203-207.
[26]. FRT Available from: https://www.sralab.org/sites/default/files/2017-06/5Hgjkv-Functional%20Reach%20Test.pdf (last accessed 16.10.2020)

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