Atividade muscular durante as tarefas de sentar e levantar em individuos na fase subaguda da COVID-19 com quadro funcional leve a moderado: estudo transversal.

Abstract

Introduction: Despite the importance of physical therapy in the treatment of functional impairments caused by COVID-19, there is little evidence available in the literature on postCOVID rehabilitation. In addition, COVID-19 affects the musculoskeletal system causing limitations in carrying out daily tasks. Objective: this master's thesis had two objectives: 1) to map studies that address the use of physical therapy in the rehabilitation of adult and elderly patients after COVID-19 infection; 2) to assess muscle electrical activity during sitting and standing tasks in subjects with and without COVID-19. Methods: For the first objective, a scoping review was carried out based on the Joanna Briggs Institute methodology: participant (P), represented by post-COVID-19 adult and elderly patients; concept (C), physical therapy interventions; and context (C), recovery period after COVID-19 (inpatient or outpatient phase). For the second objective, a cross-sectional study was carried out in individuals with and without COVID-19 in three stages: application of the electronic form, screening of participants and assessment of muscle electrical activity during the sit-to-stand task through electromyography. Results: In the first study, 7,568 studies were identified; however, only 11 were included in the review. Physiotherapeutic interventions included aerobic exercise, respiratory muscle training, muscle strength training, breathing exercises, early mobilization, balance training, bronchial hygiene maneuvers, body positioning management, flexibility training, cognitive training, neuromuscular electrical stimulation, and trunk exercises. In the second study, it was observed that during lifting tasks, there was no difference between the mean RMS in the rectus femoris (RF), tibialis anterior (TA) and medial gastrocnemius (GM) muscles between the groups. During sitting tasks, there was no difference between the mean RMS in the RF, TA and GM muscles between the groups. However, there was a moderate clinical difference (D-Cohen = 0.70) in AT activity between the groups. Conclusion: Our study demonstrated the increasing usefulness of physical therapy interventions, especially in improving quality of life, as well as bodily functions after pulmonary, cardiac, neurological, digestive and musculoskeletal rehabilitation. We also observed that there was no difference in muscle activity in the tasks of sitting and standing in individuals with and without COVID-19, however, the high variability in muscle activation, especially of the tibialis anterior, in the task of sitting in the COVID-19 group stands out.

Introduction: Despite the importance of physical therapy in the treatment of functional impairments caused by COVID-19, there is little evidence available in the literature on post-COVID rehabilitation. In addition, COVID-19 affects the musculoskeletal system causing limitations in carrying out daily tasks. Objectives: Despite the importance of physical therapy in the treatment of functional impairments caused by COVID-19, there is little scientific evidence available in the literature on the specificity, intensity, frequency and type of exercise, which must be clarified. Therefore, this review aims to map studies that address the use of physical therapy in the rehabilitation of adult and elderly patients after COVID-19 infection. Methods: This scoping review was based on the Joanna Briggs Institute methodology: participant (P), represented by post-COVID-19 adult and elderly patients; concept (C), main physical therapy interventions; and context (C), post-COVID-19 recovery period (hospital or outpatient phase). The following sources of information were used: MEDLINE/PubMed, Cochrane, PEDro, Scopus, CINAHL, Web of Science, Science Direct and Springer. The search was performed between December 2019 and November 2021. Rayyan (Qatar Computing Research Institute, QCRI) was used for the study selection and review process. Results: 7,568 studies were identified; however, only 11 were included in this review. The most frequent physical therapy interventions were those associated with pulmonary, cardiac, musculoskeletal, neurological and digestive rehabilitation in post-COVID-19 adult and elderly patients. Physiotherapeutic interventions included aerobic exercise, respiratory muscle training, muscle strength training, breathing exercises, early mobilization, balance training, bronchial hygiene maneuvers, body positioning management, flexibility training, cognitive training, neuromuscular electrical stimulation, and trunk exercises. Conclusion: Our study demonstrated the increasing usefulness of therapeutic interventions, mainly in improving quality of life as well as bodily functions after pulmonary, cardiac, neurological, digestive and musculoskeletal rehabilitation in postCOVID-19 patients.

Introduction: the infection by COVID-19 and the musculoskeletal system implies a reduction in the occurrence of adaptation to physical activity, the realization of the musculoskeletal body in fiber size- and what demonstrates the realization of the human body to physical strength, which demonstrates the realization of the body human to physical strength need to assess muscle electrical activity. Objective: to evaluate muscle electrical activity during sitting and standing tasks in individuals with and without COVID-19. Method: This is a cross-sectional study of individuals with and without COVID-19 in a Biomechanics and Motor Control Laboratory at the Federal University of Triângulo Mineiro. Data collection took place in three stages, namely: application of the electronic form, screening of participants and assessment of muscle electrical activity through electromyography. The Shapiro-Wilk, non-parametric Mann-Whitney, D-Cohen tests, descriptive statistics using the coefficient of variation, Skewness and Kurtosis were used for data analysis. Results: During the lifting tasks, there was no difference between the mean RMS in the RF (p = 0.49), TA (p = 0.78) and GM (p = 0.78) muscles between the groups. During the sitting tasks, there was no difference between the mean RMS in the RF (p = 0.50), TA (p = 0.09) and GM (p = 0.57) muscles between the groups. However, there was a moderate clinical difference (D-Cohen = 0.7) in AT activity between the groups. In addition, there was high variability in all muscles in the RMS in the COVID-19 group during both tasks, and an increase in the ICR of the GM compared to the TA (MD: -0.30; 95%CI -0.51 - -0 .81; p=0.001) during the lifting task in patients with COVID-19. Conclusion: there was no difference in the muscle activity of the RF, TA and GM in the tasks of sitting and standing in individuals with and without COVID19, however, the high variability in muscle activation stands out.

Objetivos: Apesar da importância da fisioterapia no tratamento dos comprometimentos funcionais causados pela COVID-19, há poucas evidências científicas disponíveis na literatura sobre a especificidade, intensidade, frequência e tipo de exercício, que devem ser esclarecidas. Portanto, esta revisão tem como objetivo mapear estudos que abordem o uso da fisioterapia na reabilitação de pacientes adultos e idosos após infecção por COVID-19. Métodos: Esta revisão de escopo foi baseada na metodologia do Joanna Briggs Institute: participante (P), representado por pacientes adultos e idosos pósCOVID-19; conceito (C), principais intervenções fisioterapêuticas; e contexto (C), período de recuperação pós COVID-19 (fase hospitalar ou ambulatorial). Foram utilizadas as seguintes fontes de informação: MEDLINE/PubMed, Cochrane, PEDro, Scopus, CINAHL, Web of Science, Science Direct e Springer. A busca foi realizada entre dezembro de 2019 e novembro de 2021. Rayyan (Qatar Computing Research Institute, QCRI) foi usado para o processo de seleção e análise dos estudos. Resultados: Foram identificados 7.568 estudos; no entanto, apenas 11 foram incluídos nesta revisão. As intervenções fisioterapêuticas mais frequentes foram aquelas associadas à reabilitação pulmonar, cardíaca, musculoesquelética, neurológica e digestiva em pacientes adultos e idosos pós-COVID-19. As intervenções fisioterapêuticas incluíram exercícios aeróbicos, treinamento muscular respiratório, treinamento de força muscular, exercícios respiratórios, mobilização precoce, treinamento de equilíbrio, manobras de higiene brônquica, manejo de posicionamento corporal, treinamento de flexibilidade, treinamento cognitivo, estimulação elétrica neuromuscular e exercícios de tronco. Conclusão: Nosso estudo demonstrou a crescente utilidade das intervenções terapêuticas, principalmente na melhora da qualidade de vida, bem como das funções corporais após reabilitação pulmonar, cardíaca, neurológica, digestiva e musculoesquelética em pacientes pósCOVID-19.

Introdução: a infecção por COVID-19 acomete o sistema musculoesquelético e implica na redução da força muscular em decorrência da adaptação do corpo humano à inatividade física prolongada, diminuindo o tamanho da fibra muscular e causando limitações na realização de tarefas diárias, o que demonstra a necessidade de avaliação da atividade elétrica muscular. Objetivo: avaliar a atividade elétrica muscular durante as tarefas de sentar e levantar em indivíduos com e sem COVID-19. Método: Trata-se de estudo transversal indivíduos com e sem COVID-19 em um Laboratório de Biomecânica e Controle Motor da Universidade Federal do Triângulo Mineiro. A coleta de dados ocorreu em três etapas, a saber: aplicação do formulário eletrônico, triagem dos participantes e avaliação da atividade elétrica muscular por meio da eletromiografia. Utilizou-se para a análise dos dados os testes de Shapiro-Wilk, não-paramétrico de Mann-Whitney, DCohen, estatística descritiva por meio do coeficiente de variação, Skewness e Kurtosis. Resultados: Durante a tarefas de levantar, não houve diferença entre a média do RMS nos músculos RF (p = 0.49), TA (p = 0.78) e GM (p = 0.78) entre os grupos. Durante a tarefas de sentar, não houve diferença entre a média do RMS nos músculos RF (p = 0.50), TA (p = 0.09) e GM (p = 0.57) entre os grupos. Porém, houve diferença clínica moderada (D-Cohen = 0,7) na atividade do TA entre os grupos. Além disso, houve alta variabilidade em todos os músculos no RMS no grupo COVID-19 durante ambas as tarefas, e um aumento da ICR do GM em relação ao TA (MD: -0,30; IC95% -0,51 - -0,81; p= 0,001) durante a tarefa de levantar em pacientes com COVID-19. Conclusão: não houve diferença na atividade muscular do RF, TA e GM nas tarefas de sentar e levantar em indivíduos com e sem COVID-19, entretanto, destaca-se a alta variabilidade na ativação muscular.