Reabilitação ambulatorial da COVID longa: uma chamada à ação

Autores

  • Marta Imamura Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina da Universidade de São Paulo https://orcid.org/0000-0003-0355-9697
  • Gilson Tanaka Shinzato Instituto de Medicina Física e Reabilitação, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo
  • Sabrina Saemy Tome Uchiyama Instituto de Medicina Física e Reabilitação, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo
  • Lucas Ramos De Pretto Centro de Lasers e Aplicações, Instituto de Pesquisas Energéticas e Nucleares
  • Denise Vianna Machado Ayres Instituto de Medicina Física e Reabilitação, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo
  • Simone Hitomi Oshiro Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Valéria Dini Leite Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Daniela Aguilera Moura Antonio Rossi Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Harumi Nemoto Kaihami Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Rosana Aparecida de Freitas Lopes Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Denise Rodrigues Tsukimoto Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Gabriella Souza Naves Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Denise Matheus Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Artur César Aquino dos Santos Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Margarida Harumi Miyazaki Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Linamara Rizzo Battistella Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina da Universidade de São Paulo

DOI:

https://doi.org/10.11606/issn.2317-0190.v28i4a192649

Palavras-chave:

COVID-19, Reabilitação, Resultado do Tratamento, Equipe de Assistência ao Paciente, Centros de Reabilitação

Resumo

A COVID-19 tem consequências sensório motoras, cognitivas, psíquicas e nutricionais que necessitam de reabilitação. Objetivo: Descrever o programa de reabilitação ambulatorial desenvolvido no Instituto de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, otimizado, intensivo e de curta duração. Método: Obtivemos informações sociodemográficas e clínicas de 12 adultos com diagnóstico laboratorial de COVID-19, grave e crítica, que necessitaram de hospitalização na fase aguda. Avaliações funcionais: Escala de Medida de Independência Funcional (MIF), EQ-5D-5L, World Health Organization Disability Assessment Schedule (WHODAS 2.0), Post-COVID-19 Functional Status scale, Medical Research Council (MRC) dyspnea scale, escala visual analógica (EVA) para dor, DN-4 (Douleur Neuropathique 4), escala de sonolência de Epworth, Índice de Gravidade da Insônia, Montreal Ontario Cognitive Assessment (MoCA), escala de Depressão, ansiedade e estresse (DASS-21), avaliação nutricional, Timed Up and Go, teste de caminhada de 10 metros, teste de preensão palmar, MRC sum score, ultrassonografia musculoesquelética da coxa antes, durante e após programa de reabilitação ambulatorial. Este incluiu estimulação magnética indutiva e elétrica musculoesquelética, tratamento por ondas de choque extracorpóreas, exercícios isocinéticos, abordagem emocional, estimulação cognitiva, estimulação do desempenho ocupacional, orientação nutricional e programa educacional por aplicativo COMVC. O tratamento foi realizado duas vezes por semana até atingir os critérios de alta pré-estabelecidos. Resultados: VAS e TUG proporcionaram melhora estatisticamente significante (p <0,001). PCFS, MIF, Handgrip, 10 MWT e DASS-21 domínio ansiedade apresentam tendências de melhora. Conclusão: O programa melhora a dor, mobilidade e ansiedade em pacientes com COVID longa.

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2021-12-31

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Imamura M, Shinzato GT, Uchiyama SST, De Pretto LR, Ayres DVM, Oshiro SH, Leite VD, Rossi DAMA, Kaihami HN, Lopes RA de F, Tsukimoto DR, Naves GS, Matheus D, Santos ACA dos, Miyazaki MH, Battistella LR. Reabilitação ambulatorial da COVID longa: uma chamada à ação. Acta Fisiátr. [Internet]. 31 de dezembro de 2021 [citado 26 de setembro de 2022];28(4):221-37. Disponível em: https://www.revistas.usp.br/actafisiatrica/article/view/192649

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