Post-COVID-19 physical and cognitive impairments and associations with quality of life: a cross-sectional study.

Background and objective: This study aimed to compare physical and cognitive functions between post-coronavirus disease 2019 (COVID-19) participants and healthy matched controls and investigate associations between physical and cognitive impairments with quality of life. Methods: Twenty-three post-COVID-19 participants and 23 age and sex-matched healthy people without a history of COVID-19 were included. Physical function was assessed using the Medical Research Council Sum Score (MRC-SS), 2 min Step Test, Modified Borg Scale, and Short Physical Performance Battery (SPPB) Test. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Stroop test, and the quality of life was evaluated using the Euro Quality of Life-5 Dimensions-3 Levels (EQ-5D-3l) questionnaire. Assessments were performed by a physical therapist in one session. Results: Mann-Whitney U test showed that in the post-COVID-19 group, compared to the control group, the number of steps in the 2 min Step Test (p < 0.001, ES = 0.57) and the scores of the SPPB (p = 0.03, ES = 0.32), MoCA (p = 0.003, ES = 0.44), Stroop test (p < 0.001, ES = 0.75), and the EQ-5D-3l visual analog scale (p = 0.027, ES = 0.32) were significantly lower. In addition, the Modified Borg Scale score (p < 0.001, ES = 0.6), TMT-A (p = 0.013, ES = 0.36) and TMT-B (p = 0.016, ES = 0.35) times, and the Stroop time (p < 0.001, ES = 0.61) were significantly higher in the post-COVID-19 group. There were no significant between-group differences in the MRC-SS score (p = 0.055, ES = 0.28). Furthermore, there were significant moderate to high associations between physical and cognitive functions and the quality of life in post-COVID-19 participants. Conclusions: On average 4 months after symptomatic COVID-19, post-COVID-19 participants had significant impairments in physical and cognitive functions compared to healthy matched controls that were significantly correlated with the quality of life. These findings highlight the need for a comprehensive assessment to plan appropriate management strategies.

EFFECT OF VISCERAL MANIPULATION ON CHILDREN WITH REFRACTORY CHRONIC FUNCTIONAL CONSTIPATION: A RANDOMIZED CONTROLLED TRIAL.

BACKGROUND: Functional constipation (FC) is a common global high prevalence issue in children. OBJECTIVE: The purpose of the present study is to evaluate the effect of visceral manipulation (VM) on children with chronic interacble FC unresponsive to the standard treatment. METHODS: This study was conducted as a randomized, single-blind controlled trial. Fifty-two children with refractory chronic functional constipation unresponsive to the standard medical treatment were randomly allocated to two groups of 26 control (standard medical care (SMC)) and 26 intervention (SMC with VM) for 4 weeks. Abdominal pain, painful defecation, stool consistency, defecation frequency, and the dose of oral laxative were evaluated before and after the treatment period using the Pain Rating Scale, Bristol stool form scale, and patient/parents report. RESULTS: At the end of treatment, except for the dose of oral laxative in the control group, all of the results showed a significant difference in both groups (P<0.05). The dose of oral laxative in the intervention group decreased significantly (P<0.05), however, no significant change was observed in the control group (P>0.05). In the intervention group comparison, statistically significant differences were found in all va-riables except the Bristol stool form scale (P<0.05). The Bristol stool form scale after treatments was not different when the groups were compared (P=0.32), but the number of subjects who had normal stool consistency was significantly increased in the intervention group than in the control group (P<0.05). CONCLUSION: VM can be considered as a possible treatment without side effects besides SMC for the management of chronic FC. Further studies are needed to investigate the long-term effect of VM.

Efeito da manipulação visceral em crianças com constipação crônica funcional refratária: um ensaio clínico randomizado controlado / Effect of visceral manipulation on children with refractory chronic functional constipation: a randomized controlled trial

ABSTRACT Background: Functional constipation (FC) is a common global high prevalence issue in children. Objective: The purpose of the present study is to evaluate the effect of visceral manipulation (VM) on children with chronic interacble FC unresponsive to the standard treatment. Methods: This study was conducted as a randomized, single-blind controlled trial. Fifty-two children with refractory chronic functional constipation unresponsive to the standard medical treatment were randomly allocated to two groups of 26 control (standard medical care (SMC)) and 26 intervention (SMC with VM) for 4 weeks. Abdominal pain, painful defecation, stool consistency, defecation frequency, and the dose of oral laxative were evaluated before and after the treatment period using the Pain Rating Scale, Bristol stool form scale, and patient/parents report. Results: At the end of treatment, except for the dose of oral laxative in the control group, all of the results showed a significant difference in both groups (P<0.05). The dose of oral laxative in the intervention group decreased significantly (P<0.05), however, no significant change was observed in the control group (P>0.05). In the intervention group comparison, statistically significant differences were found in all va­riables except the Bristol stool form scale (P<0.05). The Bristol stool form scale after treatments was not different when the groups were compared (P=0.32), but the number of subjects who had normal stool consistency was significantly increased in the intervention group than in the control group (P<0.05). Conclusion: VM can be considered as a possible treatment without side effects besides SMC for the management of chronic FC. Further studies are needed to investigate the long-term effect of VM.

RESUMO Contexto: A constipação funcional (CF) é um problema comum de alta prevalência global em crianças. Objetivo: O objetivo do presente estudo é avaliar o efeito da manipulação visceral (MV) em crianças com CF crônica intratável, não responsiva ao tratamento padrão. Métodos: Este estudo foi conduzido como um ensaio clínico randomizado, controlado e cego. Cinquenta e duas crianças com CF crônica refratária, não responsivas ao tratamento médico padrão, foram randomicamente alocadas em dois grupos de 26 controle (cuidados médicos padrão (CMP)) e 26 intervenção (CMP com MV) por 4 semanas. Dor abdominal, defecação dolorosa, consistência das fezes, frequência de defecação e dose de laxante oral foram avaliadas antes e após o período de tratamento usando a Escala de Avaliação da Dor, Escala de Forma das Fezes de Bristol e relato do paciente/pais. Resultados: No final do tratamento, exceto pela dose de laxante oral no grupo controle, todos os resultados mostraram uma diferença significativa em ambos os grupos (P<0,05). A dose de laxante oral no grupo de intervenção diminuiu significativamente (P<0,05), entretanto, nenhuma mudança significativa foi observada no grupo controle (P>0,05). Na comparação do grupo de intervenção, diferenças estatisticamente significativas foram encontradas em todas as variáveis, exceto na Escala de Forma das Fezes de Bristol (P<0,05). A Escala de Forma das Fezes de Bristol após os tratamentos não foi diferente quando os grupos foram comparados (P=0,32), mas o número de indivíduos com consistência fecal normal aumentou significativamente no grupo de intervenção em comparação com o grupo controle (P<0,05). Conclusão: A MV pode ser considerada como um possível tratamento sem efeitos colaterais além dos CMP para o manejo da CF crônica. Mais estudos são necessários para investigar o efeito de longo prazo da MV.