Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Background: Severe COVID-19 infection often leads to impairments requiring pulmonary rehabilitation (PR) following the acute phase. Little is known about the efficacy of PR in these patients. We therefore compared post-COVID-19 patients (PG) referred to PR patients with other lung diseases (LG). Methods: 99 PG were admitted to PR. In a prospective design, the results of PG were collected and compared to the results of LG of 2019 (n = 419) according to Functional Independence Measurement (FIM), Cumulative Illness Rating Scale (CIRS), 6-min walk test (6-MWT), duration of PR, and Feeling Thermometer (FT). Results: According to age, sex, and CIRS, both groups showed no significant differences. The improvements in the 6-MWT in the pre to post comparison were on average 180 (±101) meters for PG and 102 (±89) meters for LG (p < 0.001). FT showed a significant enhancement for PG of 21 (±14) points and for LG of 17 (±16) points (p < 0.039), while FIM significantly increased by 11 (±10) points in PG and 7 (±8) points in LG (p < 0.001). Conclusions: Comprehensive PR in PG is very effective according to the results in FIM, 6-MWT and FT. Therefore, we recommend PR following severe post-COVID-19 infections.

Behavior of the functional independence domains in patients submitted to the revascularization of the myocardium during intensive care unit stay

INTRODUCTION: Functional Independence Measurement (MIF) is used to evaluate the functional status of patients being divided into domains and should be applied in patients undergoing cardiac surgery due to their high potential for deleterious effects. OBJECTIVE: To analyze the behavior of MIF domains in patients submitted to myocardial revascularization. MATERIALS AND METHODS: This is a cohort study. At the time of hospital admission, the functionality was evaluated through the MIF and computed the six domains. After the surgery on the day of discharge from the Intensive Care Unit (ICU), the MIF was again applied for comparison with the preoperative period and correlation with the length of stay in the ICU. RESULTS: A total of 38 patients were analyzed: 21 (55.3%) men, mean age was 57.3 ± 13.3 years. The mean ICU stay was 2.9 ± 1.3 days, with a FIM of 125.7 ± 0.5 and a mean of 87.4 ± 16.8 (p <0.001). In relation to the domains, a reduction was observed in all of them, with the exception of Communication from 14 to 13.1 ± 2.1 (p = 0.24) and Cognition 20.9 ± 0.1 to 19.2 ± 4, 4 (p = 0.24). However, there was a strong correlation between ICU stay time with the communication domains (r -0.76 and p <0.01) and cognition (r -0.77 and p <0.01). CONCLUSION: It is concluded that the functionality is reduced due to cardiac surgery and that the time spent in the ICU is directly related to the worsening of communication and cognition.

Hemiparetic Positioning of Patients With Hemiplegia

Nature and scope of the project: Patients with hemiplegia may develop pain, decreased strength, sensation, and tone impacting functional ability of the affected arm when patients are not positioned correctly. The purpose of this quality improvement (QI) project was to evaluate improvements in the function of patients with hemiplegia in a rehabilitation hospital after implementing a hemiparetic positioning program. Project implementation: Education on hemiparetic positioning developed by an interdisciplinary team was offered to all nursing and therapy staff over a 1-month with follow-up and written materials. Evaluation criteria: The outcome measures for this project were Functional Independence Measurement (FIM) scores. Changes in FIM scores of patients hospitalized 3 months before the project were compared with a sample hospitalized after the project to see if outcomes improved. Outcomes: The sample consisted of 91 (pre-QI = 27, post-QI = 64) hospitalized patients with hemiplegia. All patients had significant improvements in FIM scores from admission to discharge. There were no significant differences observed between the groups on FIM change scores using Mann–Whitney U test: transfers from bed/chair/wheelchair (z = −.822, p = .411), upper body dressing (z = −.104, p = .917), lower body dressing (z = −1.120, p = .263), and toileting (z = −1.259, p = .208).

Functional independence of long-living elderly at hospital admission

The aim of this quantitative cross-sectional study was to assess the functional independence of long-living elderly at the time of hospitalization. The study was conducted in two teaching hospitals, in the period between January and June of 2011, with 116 long-living elderly. The Functional Independence Measure Scale was applied for data collection and data analyses were performed using descriptive statistics. The score of the total Functional Independence Measure varied from 48 to 126, with a mean of 105.9% (±17.9), which represents functional independence. The motor Functional Independence Measurement of 30 to 91 (77.3%; ±14.5) and the social/cognitive Functional Independence Measurement of 18 to 35 (28.6%; ±4.9). At the hospital admission, the long-living elderly appeared to be independent in all of the Functional Independence Measurement domains. Knowing the functional capacity is essential to plan care throughout the entire hospitalization process.