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, et al. Reabilitação ambulatorial da COVID longa: uma chamada à ação. Acta Fisiátr. [Internet]. 31º de dezembro de 2021 [citado 22º de novembro de 2024];28(4):221-37. Disponível em: https://revistas.usp.br/actafisiatrica/article/view/192649