Management of persistent sinus tachycardia during post-acute rehabilitation in a critical patient with COVID-19: a single-case study

2021 ◽  
Vol 28 (9) ◽  
pp. 1-10
Author(s):  
Matthew Rong Jie Tay ◽  
Jocelyn Mei Lin Thio ◽  
Yee Hong Low ◽  
Simon Wing Tai Lau ◽  
Wai Lim William Chan
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Sinus Tachycardia ◽  
Inpatient Rehabilitation ◽  
Step Test ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Acute Rehabilitation ◽  
Minute Walk

Background Sinus tachycardia is a common arrhythmia in patients with COVID-19, and may pose challenges during rehabilitation. Case description This is a case report of a 39-year-old critically ill patient with COVID-19 with no premorbid conditions, who presented with intensive care unit-acquired weakness and persistent sinus tachycardia after their stay in an intensive care unit. The sinus tachycardia and exertional symptoms contributed to a severely limited exercise capacity (assessed through the 6-Minute Walk Test and 2-Minute Step Test), which impaired the progress of inpatient rehabilitation. This was addressed through the use of bisoprolol for heart rate control and a rehabilitation programme based on cardiac rehabilitation principles. Results The patient's intensive care unit-acquired weakness improved with exercise-based rehabilitation, and the Functional Independence Measure motor subscore improved from 54/91 to 91/91 on discharge after 6 weeks of inpatient rehabilitation. After bisoprolol was started for sinus tachycardia, the patient's resting heart rate improved from 106 beats per minute to less than 90 beats per minute during this period of inpatient rehabilitation. During the same period, the patient exhibited concurrent improvement in exercise capacity on weekly 6-Minute Walk Test measurements. Improvements in the 2-Minute Step Test were also documented. Conclusions Patient assessment using submaximal exercise testing with serial 6-Minute Walk Tests and 2-Minute Step Tests, along with using beta-blockers and cardiac rehabilitation principles, can be useful in the post-acute rehabilitation of patients recovering from COVID-19 with persistent sinus tachycardia.

scholarly journals The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Regis Goulart Rosa ◽  
Camila Dietrich ◽  
Enio Luiz Tschiedel do Valle ◽  
Denise Souza ◽  
Luciana Tagliari ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Complex approach to assessment of functional status of patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 9 (4) ◽  
pp. 553-558
Author(s):  
Aleksey V. Kosyakov ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Functional Status ◽  
Pulmonary Disease ◽  
Clinical Diagnostics ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Obstructive Pulmonary Disease ◽  
6 Minute Walk Test ◽  
Minute Walk

BACKGROUND: Considering the economic costs of managing patients with chronic obstructive pulmonary disease (COPD), as well as the high mortality and disability rate, it is necessary to improve the diagnosis of the disease, to look for new approaches to assessing the functional status of patients. AIM: Is to study the functional status of patients with COPD. MATERIALS AND METHODS: A comprehensive approach was applied to assess the functional status of patients: the data of the 6-minute walk test (6MWT), heart rate variability (HRV) was studied, ergoreflex was assessed according to HRV data. 64 patients with COPD and 41 male volunteers without respiratory diseases older than 40 years were examined. Statistical processing of the obtained results was carried out using the licensed package of applied statistical programs Excel 2010 and Statistica 10. RESULTS: The group of patients with COPD and the respondents of the control group were comparable in terms of body mass index, heart rate, respiratory rate, index of indicators of activity of regulatory systems (p > 0.05). As expected, during the 6MWT, differences were obtained between the studied groups in terms of the distance covered (p < 0.01). Similarly, the results of the study of the function of external respiration showed a statistically significant difference in all the studied parameters (p < 0.01). The results obtained confirmed the presence of impaired respiratory function in the group of patients with COPD. Analysis of HRV values, when conducting a test with external peripheral vascular occlusion, confirmed ergoreflex hyperactivity in patients with COPD. CONCLUSION: The integration of methods for routine clinical diagnostics of patients condition (spirometry, 6-minute walk test, assessment of autonomic status) and the introduction of the study of ergoreflex activity made it possible to expand the understanding of the functional state of patients with COPD and is of great interest for further research.

scholarly journals AB0986 NT-PROBNP LEVEL IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1786.2-1787
Author(s):  
T. Holovko ◽  
L. Bohmat ◽  
N. Shevchenko ◽  
A. U. Afighi
Keyword(s):  
Heart Rate ◽  
Juvenile Idiopathic Arthritis ◽  
Myocardial Contractility ◽  
Exercise Tolerance ◽  
Disease Duration ◽  
Control Group ◽  
Healthy Children ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

Background:The defeat of the cardiovascular system is considered a proven comorbid state in rheumatic diseases, including rheumatoid arthritis in adults. One of the markers of the cardiovascular failure formation is BNP, namely, its N-terminal inactive fragment (NT-proBNP76), which accumulates in specific granules of cardiomyocytes. Its diagnostic value increases with the appearance of minimally expressed symptoms. The long-term course of JIA is also characterized by changes in the state of the cardiovascular system, and there may be no visible clinical manifestations. For their diagnosis a 6-minute walk test is widely used, including in children.Objectives:To study the content of NT-proBNP in patients with juvenile idiopathic arthritis and compare with the level of exercise tolerance.Methods:10 patients with JIA (9 girls, 1 boy), average age 12.78 ± 0.95 years, were examined. All children had a polyarticular RF negative subtype of JIA with a disease duration of more than three years (average disease duration 69.56 ± 17.07 months), received basic methotrexate therapy and did not have dysfunction of the lower extremities joints. The control group included 7 healthy children, comparable by sex, average age 14.25±0.73 years. An ECG, an ultrasound scan of the heart, and a 6-minute walk test (6MTX) were carried out with determining the distance traveled (6MWD) and the increase in heart rate. The level of the N-terminal polypeptide of cerebral natriuretic hormone (B-type) (NT-proBNP) was determined in the morning, after waking up, and studied by competitive immunoassay on an IMMULITE 2000 analyzer (“Siemens”).Results:In children with JIA a decrease in myocardial contractility was not detected. Left ventricular ejection fraction (62.17±0.83% (60.02 – 64.02) versus 69.84 ± 0.85% (62.3 – 80.3), p <0.05) in children with JIA were within normal limits, but significantly lower than in the control group. According to the results 6MTX indicator 6MWD in JIA-patients was 490.51 ± 11.40 m and in the control group 516.85 ± 8.84 m (p <0.05) and heart rate growth was 27.75 ± 2.30% versus in the control group (37.38 ± 3.86%), p <0.05. A negative correlation between the increase in heart rate and the duration of the disease was found (r = -0.7, p = 0.05). The level of NT-proBNP in patients with JIA was within physiological values and amounted to 47.5 ± 14.09 pg / ml (20 – 128 pg/ml), but this was higher than in children of the control group (20.29 ± 0.29 pg / ml (20-22 pg/ml), p <0.05). A high correlation was found between 6 MWD and NT-proBNP level (r = 0.8, p <0.03).Conclusion:In children with JIA there is a decrease of the exercise tolerance that increases with the duration of JIA on the background of preserved myocardial contractility. This is accompanied by a higher basal NT-proBNP level than in healthy children.Disclosure of Interests:None declared

scholarly journals ROLE OF PHYSIOTHERAPY IN IMPROVING QUALITY OF LIFE IN LIVER TRANSPLANT PATIENTS

2019 ◽  
Vol 3 (2) ◽  
pp. 126-130
Author(s):  
Tausif Aamir ◽  
◽  
Sundas Iftikhar ◽  
Rehan Ramzan Khan ◽  
Muhammad Kashif Khan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Liver Transplantation ◽  
Muscle Power ◽  
Walk Test ◽  
Sf 36 ◽  
6 Minute Walk Test ◽  
The Impact ◽  
Minute Walk

Objective: To evaluate the impact of pre and early post operative physical therapy on quality of life (QOL) in patients of liver transplantation. Methods and materials: A Single group pre and post experimental study design was conducted in Shifa International Hospital in which 20 patients with cirrhotic liver waiting for transplant participated. Non probability Convenience Sampling technique was used. Data was collected over a period of six months using a standard questionnaire 36-Item Short Form Survey (SF-36)and a General demographic questionnaire which included age, gender, BMI, along with diabetes, hypertension, ECOG level, tidal volume, muscle power, 6 minute walk test(heart rate, SpO2, distance covered, exertion level measurement). Results: The mean ± SD age & Body Mass Index of the participants (N=20) were 47.20 ± 11.49 years and 24.83 ± 2.1 respectively. 6 Minute Walk Test Heart Rate, 6 Minute Walk Test Distance, , ECOG, 6 Minute Walk Test Exertion Level and Muscle power were shown significantly improved throughout the treatment duration (p<0.001). While 6 Minute Walk Test Oxygen Saturation showed significant improvement only in initial two weeks (p=0.01), but at the end of 2nd week and overall improvement was not significant (p≥0.05). The results of the study also showed significant improvement (p<0.001) in all domains of quality of life (SF-36) at the end of study. Conclusion: The study indicated that early pre and post physiotherapy interventions can improve the overall health-related quality of life including the aerobic physical fitness and muscle strength in patients having liver transplantation Keywords: 6 minute walk test, ECOG, Incentive spirometry, Liver transplantation, Muscle power, Physiotherapy, Quality of life.

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