Yoğun Bakım Ünitelerinde Mekanik Ventilatöre Bağlı Olan COVID-19 Hastaları İçin Güvenli Rehabilitasyon Uygulamaları

Aralık 2019’da Çin’in Wuhan şehrinde Şiddetli Akut Solunum Sendromu (SARS-Cov-2) adı verilen yeni bir koronavirüs türü ortaya çıktı. Oldukça bulaşıcı doğası nedeniyle, yeni koronavirüs (COVID-19) dünyada 200’den fazla ülkeye yayılmış ve dünya çapında giderek daha fazla insana bulaşmaya devam etmektedir. Dünya Sağlık Örgütüne göre, COVID-19 hastalarının %5’i mekanik ventilatör kullanımına ihtiyaç duymaktadır. COVID-19 hastalarının kırılganlığı nedeniyle, bu hastalara kanıtlarla desteklenen güvenli egzersizlerin uygulanması büyük önem taşımaktadır. Tüm vücut titreşimi, el-ayak ergometresi ve elektriksel kas stimülasyonu bu derlemede araştırılmış ve güvenlik, fizibilite, pratiklik ve ortaya konulan kanıt kalitesi açısından değerlendirilmiştir. Literatürdeki mevcut kanıtlara göre hepsi, hastaların sağlığını tehlikeye atabilecek aktif egzersizlerin yerine,hasta sağlığı açısından güvenli ve uygulanabilir alternatifler olarak uygun görüldü. Fizyoterapistlerin, bu egzersiz programlarının uygulanması konusunda yoğun bakım ünitesi doktorlarıyla çalışması ve COVID-19 hastalarının, program için uygun olup olmadığını belirlemeleri önerilir. Bu derleme, tüm vücut titreşimi, el-ayak ergometresi ve elektriksel kas stimülasyonu yöntemlerinin, COVID-19’lu hastalarda fonksiyonel sonuçları geliştirmek, kas erimesini, deliryumu ve COVID-19’un solunumsal komplikasyonlarını azaltmak amacıyla, tüm dünyadaki fizyoterapistler için güvenli rehabilitasyon uygulamaları olabileceği sonucuna varmıştır.

Safe Rehabilitation Practices For COVID-19 Patients on Mechanical Ventilators in the Intensive Care Units

A new type of coronavirus called Severe Acute Respiratory Syndrome (SARS-Cov-2) emerged in the city of Wuhan of China in December 2019. Due to its highly infectious nature, the new coronavirus (COVID-19) has spread over to more than 200 countries in the world and continues to infect more and more people worldwide. According to the World Health Organization, 5% of COVID-19 patients require the use of mechanical ventilators. Due to the fragile nature of the COVID-19 patients, it is of utmost importance that evidence-based safe exercises be applied to these patients. In this review, whole-body vibration, cycle ergometer, and electrical muscle stimulation were all investigated and evaluated in terms of their safety, feasibility, practicality, and the quality of evidence presented. According to the current evidence in the literature, they were all deemed safe and feasible alternatives to active exercises that could put the patients’ health in jeopardy. Physiotherapists are recommended to work with the intensive care unit physicians regarding the implementation of these exercise programs and determine whether the patients with COVID-19 are suitable for the program. This review concluded that whole-body vibration, cycle ergometer, and electrical muscle stimulation modalities may serve as the safe rehabilitation practices for the physiotherapists worldwide to improve functional outcomes in patients with COVID-19, prevent muscle wasting, delirium, and decrease respiratory complications of COVID-19.

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