Recent Advance Analysis of Recovery in Hospitalized People with COVID-19: A Systematic Review.

INTRODUCTION: COVID-19 is a public health emergency all around the world. Severe illness occurred in about 14% of patients and 5% of patients developed critical illness, but the prognosis for these patients remains unclear. OBJECTIVE: To describe the prognosis in hospitalized adults with COVID-19. METHODS: The MEDLINE, EMBASE, AMED, and COCHRANE databases were searched for studies published up to 28 June 2021 without language restrictions. Descriptors were related to "COVID-19" and "prognosis". Prospective inception cohort studies that assessed morbidity, mortality and recovery in hospitalized people over 18 years old with COVID-19 were included. Two independent reviewers selected eligible studies and extracted the available data. Acute respiratory distress syndrome (ARDS) and multiple organ failure (MOFS) were considered as outcomes for morbidity and discharge was considered for recovery. The Quality in Prognosis Studies (QUIPS) tool was used to assess risk of bias. Analyses were performed using Comprehensive Meta-Analysis (version 2.2.064). RESULTS: We included 30 inception cohort studies investigating 13,717 people hospitalized with COVID-19 from different countries. The mean (SD) age was 60.90 (21.87) years, and there was high proportion of males (76.19%) and people with comorbidities (e.g., 49.44% with hypertension and 29.75% with diabetes). Findings suggested a high occurrence of morbidity, mainly related to ARDS. Morbidity rates varied across studies from 19% to 36% in hospital wards, and from 13% to 90% in Intensive Care Units-ICU. Mortality rates ranged from 4% to 38% in hospital wards and from 8% to 51% in ICU. Recovery rates ranged up to 94% and 65% in hospital wards and ICU, respectively. The included studies had high risk of bias in the confounding domain. CONCLUSIONS: The prognosis of people hospitalized with COVID-19 is an issue for the public health system worldwide, with high morbidity and mortality rates, mainly in ICU and for patients with comorbidities. Its prognosis emphasizes the need for appropriate prevention and management strategies.

Whole body vibration in the static modified push-up position in untrained healthy women stimulates neuromuscular system potentiating increased handgrip myogenic response.

OBJECTIVE: To investigate the acute effect of whole-body vibration (WBV) on handgrip strength (HS) and electromyographic activity of the flexor digitorum superficialis muscle of healthy women in the static push-up position. METHODS: Twenty-eight women received four experimental tests in a randomized order: A) Control - rest in seating position with feet on the floor and hands in the supine position on the lower limbs. There was no vibration stimulus; B) Placebo - push-up position with their hands on the vibratory platform that remained disconnected, but with a sonorous stimulus mimicking the vibration; C) Low vibration and D) High vibration - push-up position with their hands on the vibratory platform using one of the vibratory stimulus intensity: low vibration: 25 Hz/2 mm/49.30 m s-2; or high vibration: 45 Hz/2 mm/159.73 m s-2. Participants remained 5 min in each situation. HS and electromyography (EMG) were performed at baseline and after all four experimental tests. The index of neural efficiency (i.e. the ratio between EMG and HS) was also calculated to determine the efficiency of muscle contraction. Statistical analysis was performed by ANOVA two-way design mixed test with Tukey's post hoc test, being considered significant p < 0.05. RESULTS: High vibration increased HS compared with all the other experimental tests (p = 0.0006, F = 6.03). There was a reduction of EMG activity of the flexor digitorum superficialis muscle only after high vibration (p = 0.0135, F = 6.22), which was accompanied by lower values of the index of neural efficiency after intervention (between-group difference, p = 0.0002, F = 0.674). CONCLUSION: WBV in the push-up position has an acute positive effect on HS accompanied by a lower index of neural efficiency, providing a better efficiency of muscle contraction.

The Pilates breathing technique increases the electromyographic amplitude level of the deep abdominal muscles in untrained people.

OBJECTIVE: To evaluate the behaviour of the upper rectus abdominis, lower rectus abdominis and transverse abdominis/internal oblique (TrA/IO) by using surface electromyography during trunk flexion with and without the Pilates breathing technique. METHODS: Nineteen female subjects (without experience of the Pilates method) were recruited. The muscles were evaluated while trunk flexion was performed by using the Pilates breathing technique (POW) and Step Barrel device, followed by another contraction without the technique (NORM). Normality was accepted, and the paired t-test was used to determine data differences (p < 0.05). RESULTS: Significant differences were noted in the amplitude level of activation between TrA/IO-POW and TrA/IO-NORM. The activation amplitude level of TrA/IO-POW significantly increased compared with all the other muscles under the NORM condition. CONCLUSION: The breathing technique of the Pilates method associated with trunk flexion increases TrA/IO electrical activity.