Early Mobilization Practices in COVID-19 Patients

Year 2020, Volume: 5 Issue: 2, 83 - 86, 30.06.2020

Müge Kırmızı , Damla Karabay , Sevtap Günay Uçurum , Derya Özer Kaya

Abstract

COVID-19 Hastalarında Erken Dönem Mobilizasyon Uygulamaları

Abstract

Özet

Koronavirus Hastalığı (COVID-19), ilerleyen aşamalarında solunum yetmezliğine yol açabilen solunum sistemi etkileri dışında hastaların kas iskelet sistemi dâhil birçok sistemine de zarar veren oldukça bulaşıcı bir hastalıktır. Bu hastalığın tedavi sürecinde fizyoterapistler, solunum fizyoterapisine ek olarak kas iskelet sisteminin desteklenmesi ve hastaların erken dönem mobilizasyonun sağlanmasında da önemli rol oynarlar. Özellikle solunum fizyoterapisinin önerilmediği kritik dönemde, terapatik pozisyonlamanın ve mobilizasyonun önemi çok daha büyüktür. İmmobilizasyonun yol açtığı fiziksel uygunluk düzeylerindeki kaybı azaltma ve geciktirmedeki rolü kanıtlanmış olan mobilizasyon uygulamaları, hastanın klinik durumuna uygun olarak gerçekleştirilmelidir. Mobilizasyon, öksürme ve sekresyonların ekspektorasyonuna neden olabileceği için aerosol üretici bir prosedür olarak düşünülmeli ve enfeksiyon kontrol prosedürlerine ve önlemlerine sıkı sıkıya bağlı kalınarak uygulanmalıdır.

Anahtar Kelimeler: COVID-19, egzersiz, fizyoterapi, mobilizasyon.

Abstract

Coronovirus disease (COVID-19) is a highly contagious disease which damages many systems of patients, including the musculoskeletal system, in addition to its effects on the respiratory system that can lead to respiratory failure in its later stages. In the treatment process of this disease, physiotherapists play an important role in supporting the musculoskeletal system and providing early mobilization of patients in addition to respiratory physiotherapy. Mobilization and therapeutic positioning are much more important, especially in the critical period when respiratory physiotherapy is not recommended. Mobilization practices that have a proven role in reducing and delaying the loss of physical fitness caused by immobilization should be carried out according to the clinical condition of the patient. Because mobilization can cause coughing and expectoration of secretions, it should be considered as an aerosol-generating procedure, and strict adherence should be applied to infection control procedures and precautions.

Keywords: COVID-19, exercise, physiotherapy, mobilization.

Keywords

COVID-19, egzersiz, fizyoterapi, mobilizasyon

References

• Ajimsha, M., Neeraj Gampawar, M., Surendran, P. J., Jacob, P., Karpouzis, V., Haneef, M. et al. (2020). Acute care physiotherapy management of COVID-19 patients in Qatar: Consensus-based recommendations. Preprints, 2020040417.
• Bott, J., Blumenthal, S., Buxton, M., Ellum, S., Falconer, C., Garrod, R. et al. (2009). Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax, 64(Suppl 1), i1-i52.
• Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y. et al. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395(10223), 507-513.
• Cieloszczyk, A., Lewko, A., Śliwka, A., Włoch, T., & Pyszora, A. (2020) Recommendations for physiotherapy of adult patients with COVID-19. Retrieved May 5, 2020, from https://www.wcpt.org/sites/wcpt. org/files/files/wcptnews/images/Recommendations%20for%20 physiotherapy%20of%20adult%20patients%20with%20COVID-19_ POLISH.pdf.
• Del Rio, C., & Malani P. N. (2019). Novel coronavirus—important information for clinicians. JAMA, 323(11), 1039-1040.
• European Centre for Disease Prevention and Control (2020, March 31). Infection prevention and control for COVID-19 in healthcare settings – Second update. Retrieved May 8, 2020, from https://www.ecdc. europa.eu/sites/default/files/documents/Infection-preventioncontrol-for-the-care-of-patients-with-2019-nCoV-healthcaresettings_update-31-March-2020.pdf
• Imperial College London COVID-19 Response Team (2020, March 11). Report 8: Symptom progression of COVID-19. Retrieved May 3, 2020, from https://www.imperial.ac.uk/media/imperial-college/medicine/ mrc-gida/2020-03-11-COVID19-Report-8.pdf.
• İnal İnce, D., Vardar Yağlı, N., Sağlam, M., & Çalık Kütükcü, E. (2020). Yeni tip koronavirüs (Sars-Cov-2) kaynaklı COVID-19 enfeksiyonunda akut dönem ve postakut dönemde fizyoterapi ve rehabilitasyon. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 31(1), 81-93.
• Kress, J. P., & Hall, J. B. (2014). ICU-acquired weakness and recovery from critical illness. New England Journal of Medicine, 370(17), 1626-1635.
• Lazzeri, M., Lanza, A., Bellini, R., Bellofiore, A., Cecchetto, S., Colombo, A. et al. (2020). Respiratory Physiotherapy in patients with COVID-19 infection in acute setting: a Position paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Archives for Chest Disease, 90(1), 163-168.
• Morris, P. (2007). Moving our critically ill patients: Mobility barriers and benefits. Critical Care Clinics, 23(1), 1-20.
• SIMFER (2020). Recommendations for Respiratory Rehabilitation of COVID-19 in Adult. Retrieved May 7, 2020, from, https://www.simfer.it/ recommendations-for-respiratory-rehabilitation-of-covid-19-in-adult/
• Skinner, E. H., Haines, K. J., Berney, S., Warrillow, S., Harrold, M., & Denehy, L. (2015). Usual care physiotherapy during acute hospitalization in subjects admitted to the ICU: an observational cohort study. Respiratory care, 60(10), 1476-1485.
• Thomas, P., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L., et al. (2020). Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. Journal of Physiotherapy, 66, 73-82.
• Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J. et al. (2020). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA, 323(11), 1061-1069. UK Government (n. d.). COVID-19: Guidance for infection prevention and control in healthcare settings. Version 1.0. Retrieved May 8, 2020, from https://www.rcslt.org/-/media/docs/Infection_prevention_and_ control_guidance_for_pandemic_coronavirus.%20forrespiratoryrehabilitation-of-covid-19-in-adult/
• World Health Organization (2020, March 6). Coronavirus disease 2019 (COVID-19) Situation Report 46. Retrieved May 5, 2020, from https://apps.who.int/iris/bitstream/handle/10665/331443/ nCoVsitrep06Mar2020-eng.pdf?sequence=1&isAllowed=y.
• World Health Organization (2020, March 11). WHO Director-General’s opening remarks at the media briefing on COVID-19. Retrieved May 3, 2020, from https://www.who.int/dg/speeches/detail/whodirectorgeneral-s-opening-remarks-at-themedia-briefing-on-covid-19---11march-2020.
• World Health Organization (2020, March 13). Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance. Retrieved May 7, 2020, from https:// www.who.int/publications-detail/clinical-management-of-severeacute-respiratory-infection-when-novel-coronavirus-(ncov)-infectionis-suspected.
• Zhao, H. M., Xie, Y. X., & Wang, C. (2020). Recommendations for respiratory rehabilitation in adults with COVID-19. Chinese Medical Journal, 43(4), 308-314.