Craniofacial Pain Management in Severe COVID-19 Patients During the Pandemic Peak in Kosovo: A Comprehensive Approach.

Background This cross-sectional study aims to evaluate pain management's success in limiting admissions and assesses remote care's effectiveness for optimal pain relief. By utilizing data from severe COVID-19 inpatients in Prishtina, Kosovo, this study offers insights into the challenges posed by the pandemic and innovative care approaches aimed at improving patient well-being. Methodology This cross-sectional study includes 55 patients with severe COVID-19 after hospital discharge. All study participants completed the questionnaire in the presence of a clinical pharmacologist. The questionnaire of this study consisted of three parts: sociodemographic data (first part), the Intensity and Characteristics of Toothache (IaCofT) and headache (second part), and pharmacological treatment of headache and dental pain (third part). The questionnaire on IaCofT and headache was created with some modifications of the Modified Dental Pain Screening Questionnaire (M-DePaQ). Descriptive statistics were conducted using Prism version 10.0.1 (Windows and Mac). Results According to the study data, 89.1% (n = 49) of the participants experienced pain during hospitalization with COVID-19, while 72.72% (n = 40) of them experienced pain after hospital discharge. Of the participants, 32.7% (n = 18) experienced dental pain, whereas 60% (n = 33) reported having headaches. Regarding the pain scale, more than two-thirds (n = 40, 72.72%) of the participants had moderate to moderately severe pain, and in 70.9% (n = 39) of the cases, the pain occurred episodically. The absolute majority (n = 53, 96.4%) of study participants reported the use of analgesics for pain management. Paracetamol (n = 46, 83.6%) and ibuprofen (n = 14, 25.5%) were the most commonly used analgesics for pain management. Conclusions This study highlighted the prevalence of headache and acute dental pain in these patients. The majority of the study participants were convinced by the healthcare system and were highly dependent on pharmacological treatment for headaches and acute toothache during the COVID-19 peak. The study results showed that the pain was proven to be successfully treated pharmacologically with analgesics such as paracetamol, ibuprofen, and diclofenac. Telemedicine is expected to become an important healthcare practice in the post-COVID-19 era. Therefore, the introduction of this service could be considered.

Functional status and quality of life in post-COVID-19 patients two to three weeks after hospitalization: A cross-sectional study.

Background and Aims: Extended hospitalization due to coronavirus disease 2019 (COVID-19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post-hospitalized patients are promptly assessed. The aim of this study was to identify post-COVID-19 patients' functional status and quality of life, as well as to investigate their inter-relatedness 2-3 weeks after hospital discharge. Methods: The study included 39 post-COVID-19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio-demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6-min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5-Dimension 5-Level (EQ-5D-5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing. Results: The median (interquartile range [IQR]) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0-3), 3 (1-6), 9 (8-10), 30.5 (23.2-43.5) kg, 344.5 (312.7-381.7) m respectively, while the mean (SD) for EQ-5D-5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ-5D-5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = -0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = -0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg-CR10, and 6MWT were found to be strongly predictive of SPPB total score. Conclusion: In post-COVID-19 patients' functional status and quality of life were impaired 2-3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.

Effects of Physiotherapy on Rehabilitation and Quality of Life in Patients Hospitalized for COVID-19: A Review of Findings from Key Studies Published 2020-2022.

The estimated percentage of individuals with COVID-19 due to infection with SARS-CoV-2 in need of hospitalization mostly increases proportionally with age, reaching almost 10% for those older than 60 years. Among hospitalized patients, one-fifth require treatment in the intensive care unit (ICU) due to acute respiratory distress syndrome, multiorgan failure, or hypoxemic respiratory insufficiency. Patients with moderate and severe COVID-19 who were hospitalized during the early stages of the pandemic and who continue to be hospitalized report fatigue, muscle weakness, joint stiffness, reduced mobility, increased risk of falls, and impaired quality of life. Physiotherapy is recognized to be important in the rehabilitation of COVID-19 patients requiring hospitalization. The current physiotherapy guidelines and recommendations for individuals with COVID-19, which include treatment methods and outcome measures for evaluation of the effects on respiratory and physical function and quality of life, are those established from the pre-COVID-19 era. The available extant scientific literature mainly reported the effect of physiotherapy in patients with COVID-19 in the acute, hospitalization courses of the disease, while there is a lack of quality primary, experimental studies on the effects of physiotherapy in rehabilitation of post-COVID-19 patients after hospitalization. This review aims to present an update on the effects of physiotherapy on rehabilitation and quality of life in patients hospitalized for COVID-19 and the findings from key studies published between 2020 and 2022.

Outcome of 24 Weeks of Combined Schroth and Pilates Exercises on Cobb Angle, Angle of Trunk Rotation, Chest Expansion, Flexibility and Quality of Life in Adolescents with Idiopathic Scoliosis.

BACKGROUND This study aimed to quantify the outcomes of combining Schroth and Pilates exercises on the Cobb angle, angle of trunk rotation (ATR), chest expansion, flexibility (trunk flexion), and quality of life (QoL) in adolescents with mild and moderate idiopathic scoliosis. MATERIAL AND METHODS Sixty-nine adolescents with idiopathic scoliosis aged 10-17 years, presenting with a Cobb angle of 10-45º were enrolled in this study. The treatment protocol, including selected exercises from Schroth and Pilates methods, was performed over 24 weeks and consisted of 2 periods of 2-week treatment regimens performed daily for 60 minutes. Each of treatment periods was then followed by the same home program treatment for 10 weeks. Cobb angle (x-rays), ATR (Scoliometer), chest expansion (cm), trunk flexion (cm, distance between C7 to S2 with measuring tape), and QoL (SRS-22r Scoliosis Research Society Questionnaire) were assessed pre-treatment, at 12 week, and at 24 weeks. RESULTS Significant improvements (P<0.05) were found in both groups of patients wearing and not wearing a brace for Cobb angle (from 21.97±4.99° to 18.11±6.39°; from 14.19±3.11° to 11.66±2.73°), angle of trunk rotation (from 7.19±1.36° to 5.36±1.66°; from 4.72±1.04° to 3.58±0.94°), chest expansion (from 2.56±0.84 cm to 3.46±0.72 cm; from 2.57±0.87 cm to 3.52±0.72 cm), trunk flexion (from 9.55±1.95 cm to 14.33±2.40 cm; from 9.82±2.61 cm to 13.98±2.18 cm) and QoL (from 3.50±0.27 to 3.82±0.2; from 3.42±0.24 to 3.78±0.23) respectively. CONCLUSIONS This study showed that combined exercises provided benefit on the Cobb angle, ATR, chest expansion, trunk flexion and QoL in adolescents with mild and moderate idiopathic scoliosis.

Contribution of Physical and Motor Characteristics to Functional Performance in Children and Adolescents with Down Syndrome: A Preliminary Study.

BACKGROUND Down syndrome (DS) is the most frequent genetic mental disability. Individuals with DS experience a variety of physical, motor, and functional challenges throughout the lifespan. However, the inter-relatedness between these domains is relatively unexplored in children with DS. This study aimed to determine which physical and motor characteristics contribute to functional performance in children and adolescents with DS. It also investigated the relationship between physical, motor, and functional domains. MATERIAL AND METHODS We enrolled 44 children and adolescents with DS, ages 3-18 years, in this cross-sectional study. The participants were assessed for functional skills (PEDI-CAT), gross motor skills (GMFM-88), balance (PBS), fine motor skills (Nine-hole peg test), grip strength (hand-held Jamar dynamometer), and body mass index (BMI). Descriptive statistics, Pearson's correlation, and stepwise linear regression were employed for statistical analysis. RESULTS Fine motor skills and grip strength were found to be significant predictors of functional performance. All measures, except BMI, were significantly correlated with each other. The participants scored below standard values in all 4 domains of PEDI-CAT, with the social/cognitive skills being most impaired, while mobility proficiency was found to be participants' strongest asset. CONCLUSIONS This study demonstrated fine motor skills and grip strength to be predictors of functional performance in children and adolescents with DS. It also showed a high level of inter-relatedness between the variables of physical, motor, and functional domains in this population.

Attainment of gross motor milestones in children with Down syndrome in Kosovo - developmental perspective.

Aim To investigate the age (in months) at which motor skills are developed in children with Down syndrome (DS), and compare it to the age of the development of the same skills in both, children with typical development (TD), and children with DS reported by four other studies. Methods Sixteen children (7 girls and 9 boys) were monthly assessed for the development of nineteen motor skills between 2008 and 2011. The mean ages when the skills were accomplished were presented using descriptive statistics. Independent T-samples test (significance < 0.05) was used to compare the mean developmental ages from our study with those seen in children with TD (Comparison 1) and also in children with DS reported by four other authors (Comparison 2a-2d). Results Children with DS developed at a significantly slower pace compared to children with TD (p=0.005). Generally, delay and variance of developmental age in children with DS increased chronologically with the complexity of the skills. No significant difference was found between developmental age in children from the present study and children with DS from other studies. Conclusion The rate of attainment of motor skills is delayed in children with DS in comparison to children with TD, however, the developmental sequence is the same. The delayed development is more prominent in more complex skills.