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European Journal of Physical and Rehabilitation Medicine 2020 Apr 15

DOI: 10.23736/S1973-9087.20.06305-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Rehabilitation and respiratory management in the acute and early post-acute phase. “Instant paper from the field” on rehabilitation answers to the Covid-19 emergency

Carlotte KIEKENS 1, Paolo BOLDRINI 2, Arnaldo ANDREOLI 3, Renato AVESANI 4, Federica GAMNA 5, Maurizio GRANDI 6, Francesco LOMBARDI 7, Mirco LUSUARDI 8, Franco MOLTENI 6, Alberto PERBONI 9, Stefano NEGRINI 10, 11

1 Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy; 2 Past-President Italian Society of Physical and Rehabilitation Medicine (SIMFER), General Secretary European Society of Physical and Rehabilitation Medicine (ESPRM); 3 Unità Operativa Complessa di Riabilitazione Specialistica, ASST FBF Sacco, Milan, Italy; 4 IRCCS Sacro Cuore Don Calabria, Negrar (VR), Italy; 5 Medicina Fisica e Neuroriabilitazione, AOU San Luigi Gonzaga, Orbassano, Torino, Italy; 6 H.Valduce Villa Beretta, Costa Masnaga, Lecco,Como, Italy; 7 Neurorehabilitation Unit. Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia. S. Sebastiano Hospital, Correggio, Reggio Emilia, Italy; 8 Respiratory Rehabilitation and Neuromuscular-Rehabilitation Department, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia. S. Sebastiano Hospital, Correggio, Reggio Emilia, Italy; 9 Pneumologia, AOU San Luigi Gonzaga, Orbassano, Torino, Italy; 10 Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, Milan, Italy; 11 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy


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Covid-19 is a respiratory infectious disease that can cause respiratory, physical and psychological long-term dysfunctions in patients. First recommendations on respiratory management were published, but they were not based on the specific needs due to Covid-19. In this paper we share the early experiences from the clinical field in Northern Italy, where the epidemic started in February. This paper summarizes the second webinar on Covid-19 (230 live attendees, 11,600 viewers of the recorded version) organized by the Italian Society of Physical and Rehabilitation Medicine about rehabilitation and in particular respiratory management in the acute (Intensive Care Unit - ICU) and immediate post-acute phases. There is the need to prepare for the post-acute phase. ICU length of stay is relatively long, with immobilisation in prone position. Some specific problems are described, including severe muscle weakness and fatigue, joint stiffness, dysphagia, (neuro)psychological problems, impaired functioning concerning mobility, activities of daily life and work. A lot is yet unknown and patients can experience long-term consequences as we know from the literature on the post-intensive care syndrome, but Covid-19 has unique features to be investigated and understood. As one colleague stated during the Covinar: this is a marathon, not a sprint….


KEY WORDS: Rehabilitation; Covid-19; Pneumonia

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