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Title 重症COVID-19患者に対する急性期リハビリテーション治療の効果
Subtitle 原著
Authors 広田桂介*1, 神谷俊次*1, 福島竜也*1, 杉本幸広*1, 松瀬博夫*1, 橋田竜騎*2, 岩永壮平*1, 松岡昌信*3, 高須修*4, 星野友昭*3, 志波直人*2
Authors (kana)
Organization *1久留米大学病院リハビリテーション部, *2久留米大学医学部整形外科学講座, *3久留米大学医学部内科学講座呼吸器・神経・膠原病内科部門, *4久留米大学医学部救急医学講座
Journal The Japanese Journal of Rehabilitation Medicine
Volume 59
Number 10
Page 1045-1055
Year/Month 2022 / 10
Article 原著
Publisher 日本リハビリテーション医学会
Abstract 「要旨」 重症Coronavirus disease 2019(COVID-19)患者は治療困難例も多く, 集中治療室滞在が長期化した患者に神経学的合併症を引き起こした報告が多数みられる. 重症COVID-19患者に対するリハビリテーション医療は重要とされているが, その有効性を示すプログラムはない. そこで, 当院で作成し使用した重症COVID-19患者に対する発症後の急性期から開始するリハビリテーションプログラムの有効性について検討した. 対象は, 当院重症COVID-19病棟に入院となり, リハビリテーション治療を施行した重症COVID-19患者28人. 年齢中央値61歳, 男女比67.9%:32.1%(19:9), BMI中央値25.0kg/m2. COVID-19重症病棟退出後でCOVID-19中等症病棟入室および退出時におけるMedical Research Council Scoring(MRC)を評価し比較検討した. MRCは, COVID-19中等症病棟入室時の中央値43点であり, 退出時は50点で有意に改善した(p<.001). さらにBarthel Indexにおいても同様に有意な改善が認められた(32.5点 vs. 77.5点, p<.001). 重症COVID-19患者に対する発症後の急性期から開始するリハビリテーション治療は, 筋力や日常生活を改善させる可能性がある.
Practice 医療技術
Keywords リハビリテーションプログラム(rehabilitation program), 骨格筋量(muscle mass), 筋力(muscle strength), コロナウイルス感染症(coronavirus disease 2019), 急性期リハビリテーション治療(acute rehabilitation treatment)

English

Title Effect of Acute Rehabilitation Treatment for Patients with Severe COVID-19
Subtitle
Authors Keisuke Hirota*1, Shunji Koya*1, Tatsuya Fukushima*1, Takahiro Sugimoto*1, Hiroo Matsuse*1, Ryuki Hashida*2, Souhei Iwanaga*1, Masanobu Matsuoka*3, Osamu Takasu*4, Tomoaki Hoshino*3, Naoto Shiba*2
Authors (kana)
Organization *1Division of Rehabilitation, Kurume University Hospital, *2Department of Orthopedics, Kurume University School of Medicine, *3Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, *4Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
Journal The Japanese Journal of Rehabilitation Medicine
Volume 59
Number 10
Page 1045-1055
Year/Month 2022 / 10
Article Original article
Publisher The Japanese Association of Rehabilitation Medicine
Abstract [Abstract] Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important ; however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61 [23-88] years ; female/male, 9/19, body mass index, 25.0 [18.0-33.6]kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points ; P<.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P<.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.
Practice Medical technology
Keywords rehabilitation program, muscle mass, muscle strength, coronavirus disease 2019, acute rehabilitation treatment
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