Rehabilitation of patients after COVID-19 in post discharge period: two case study

Background
: SARS-CoV-2 is an acute infectious respiratory disease with a varied clinical presentation. Physiotherapy has a beneficial effect on increasing physical capacity, improving quality of life, and ameliorating the negative effects of the disease in patients after an acute respiratory distress syndrome (ARDS) incident. The first scientific reports are emerging which suggest that this applies equally to patients who have undergone COVID-19.

Aims
To present a proprietary rehabilitation procedure for patients in the post-acute phase of COVID-19. The therapeutic management included four components such as aerobic and resistance training, respiratory therapy in combination with Super Induction Stimulation (SIS).

Report of two cases
Two patients, approximately 50 years old, with SARS-CoV-2 infection were included in the study. Patients were admitted to the rehabilitation department in the post-acute phase and during the qualification for therapy they were examined with standardized tests and questionnaires. The main assessment tools were spirometry, 6-minute walk test (6MWT), and modified Borg scale. They were performed before the start of rehabilitation, after 2 and 4 weeks. Significant improvement in 6MWT scores was observed after therapeutic management. The distance increased at an average of 350%. Subjective feelings of fatigue and dyspnea also improved. Functional performance using the Barthel Index showed a mean improvement of 38%. Spirometry showed improvement in forced expiratory volume in one second / forced vital capacity (FEV1/ FVC) at an average of 25%.

Summary
Patients with COVID-19 infection require intensive rehabilitation especially in the post discharge period. With the therapeutic program used, patients achieved significant improvements in all measured parameters. Moreover, the function of the respiratory system also improved, as demonstrated by spirometry.