Natural Course of Muscular Strength, Physical Performance, and Musculoskeletal Symptoms in Hospitalized Patients With COVID-19.

OBJECTIVE: To investigate the course of muscle strength, musculoskeletal symptoms and physical performance over time in hospitalized COVID-19 patients, and their relation with disease severity at admission. DESIGN: Prospective cohort study. SETTING: Pandemic clinic of Gazi University Hospital, Ankara, Turkey. PARTICIPANTS: 76 adult COVID-19 patients (aged >18 years) were enrolled in the study between March 2021 and May 2021 (N=76). The participants were grouped as "mild," "moderate," and "severe" according to clinical and radiological findings. MAIN OUTCOME MEASURES: The fraction of inspired oxygen (FiO2), oxygen saturation (SpO2), hand grip strength (HGS), 5-times sit and stand test (5XSTS), modified Borg scale at rest (mBorg-rest), modified Borg scale during activities of daily living (mBorg-ADL), Barthel index, and visual analog scale for myalgia (myalgia-VAS) values were recorded on the first day of hospitalization and in the first, third, and 12th weeks. Outcome measures were compared between disease severity groups. In addition, the changes in these outcome measures over time were also examined. RESULTS: There were 15 (19.7%) participants in the mild, 20 (26.3%) in the moderate, and 41 (53.9%) in the severe groups. At the baseline evaluation, SpO2 (P<.001), FiO2 (P<.001), 5XSTS (P=.002), mBorg-rest (P=.016), and mBorg-ADL (P<.001) were different in 3 groups, but there were no differences for HGS, Barthel index, and myalgia-VAS score. HGS, 5XSTS, myalgia-VAS, and mBorg-ADL scores improved significantly over time in all the groups (P<.001, P≤.001, and P<.001, respectively). At the end of 12 weeks, only 5XSTS was different between the groups. 5XSTS was significantly longer in the severe group (P=.010). CONCLUSION: Although significant improvement was observed in the muscle strength, physical performance, and musculoskeletal symptoms of patients with COVID-19 over time, the physical performance of these patients did not reach normal standards. We conclude that post-COVID-19 rehabilitation programs are needed to optimize the physical performance of the patients.

Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study.

OBJECTIVE: To investigate the efficacy of Nintendo Wii Fit®-based balance rehabilitation as an adjunc-tive therapy to conventional rehabilitation in stroke patients. METHODS: During the study period, 70 stroke patients were evaluated. Of these, 23 who met the study criteria were randomly assigned to either the experimental group (n = 12) or the control group (n = 11) by block randomization. Primary outcome measures were Berg Balance Scale, Functional Reach Test, Postural Assessment Scale for Stroke Patients, Timed Up and Go Test and Static Balance Index. Secondary outcome measures were postural sway, as assessed with Emed-X, Functional Independence Measure Transfer and Ambulation Scores. An evaluator who was blinded to the groups made assessments immediately before (baseline), immediately after (post-treatment), and 4 weeks after completion of the study (follow-up). RESULTS: Group-time interaction was significant in the Berg Balance Scale, Functional Reach Test, anteroposterior and mediolateral centre of pressure displacement with eyes open, anteroposterior centre of pressure displacement with eyes closed, centre of pressure displacement during weight shifting to affected side, to unaffected side and total centre of pressure displacement during weight shifting. Demonstrating significant group-time interaction in those parameters suggests that, while both groups exhibited significant improvement, the experimental group showed greater improvement than the control group. CONCLUSION: Virtual reality exercises with the Nintendo Wii system could represent a useful adjunctive therapy to traditional treatment to improve static and dynamic balance in stroke patients.