Efeitos de um programa de treinamento físico supervisionado após hospitalização por Covid-19

Abstract

COVID-19 has impacted the lives of many people and caused sequelae, especially among those who required hospitalization. Supervised physical training is used in the treatment of chronic respiratory diseases and is indicated to treat sequelae of COVID-19. The aim was to verify the effects of supervised physical training after hospitalization by COVID-19. This is a quasi-experimental study, carried out in a public hospital the Gyn, Goias, Brazil. Seventeen patients were evaluated, who after hospitalization were referred to the physical therapy outpatient clinic for supervised physical training. For evaluation, a form was used with sociodemographic and economic data, six-minute walk test (6MWT), sit and stand test (SWT), post COVID-19 functional status scale (PCFS), manovacuometry (MIP and MEP), Short Form Health Survey (SF-36), London Chest Activity of Daily Living (LCADL), and Modified Medical Research Council (mMRC). The physical training protocol consisted of eighteen sessions, two or three times a week. The revaluation was carried after this period. For continuous variables we used mean and standard deviation or median with 25th and 75% percentiles. For categorical variables absolute and relative frequencies were used. Data distribution was analyzed using the Shapiro Wilk test. The paired t test and Wilcoxon test were used for comparisons. The significance level adopted was 5%. There was an increase in the distance walked in the 6MWT from 392.5 ± 105.9 to 484.7 ± 95.4 meters, p< 0.001. The SWT showed an increase from 16.0 [11.0-19.0] to 21.5 [20.0-22.0] repetitions, p < 0.001. In PCFS there was a decrease in the absolute frequency in the scores of mild, moderate, and severe limitations in the 17 participants to an increase in the frequency in the scores of no limitation and very mild limitation in 16 of them after the training. The MIP increased from 100.0 [60.0- 110.0] to 110.0 [70.0-110.0], p = 0.005. There was improvement in the SF-36 related domains, being: functional capacity from 30.0 (15.0-55.0) to 60.0 (50.0-70.0), physical aspects from 0 (0.0-0.0) to 50.0 (25.00-100.0), emotional aspects from 0 (0-66.7) to 100.0 (33.3-100.0), pain from 41.0 (31.0-64.0) to 62.0 (42.0-74.0), vitality from 40.0 (25.0-60.0) to 65.0 (60.0-80.0), social aspects from 50.0 (25.0-62.5) to 75.0 (62.5-87.5), mental health from 56.0 (32.0-72.0) to 76.0 (68.0-88-0), and general health status from 60.0 (45.0-77.0) to 72.0 (52.0-82.0). The LCADL showed a reduction in dyspnea from 25.8 ± 11.2 to 15.6 ± 4.5 points, p < 0.001. The mMRC, which before training was two, three and four in 10 participants, after training was between zero and one in all 17 participants. Supervised physical training improved functional capacity, inspiratory muscle strength, quality of life, and reduced dyspnea during daily activities. In this sense, this study positively impacts society by evaluating a simple, short duration protocol that has proven to be effective on the limitations left by COVID-19, and may be a stimulus to the creation of government programs to assist society