1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for 'CFS'.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 29th April 2024 is here.
    Dismiss Notice
  3. Welcome! Read the Core Purpose and Values of our forum.
    Dismiss Notice

Decline in Mobility and Balance in Persons with Post–COVID-19 Condition, 2024, Feldman et al.

Discussion in 'Long Covid research' started by SNT Gatchaman, Mar 20, 2024.

Tags:
  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

    Messages:
    4,515
    Location:
    Aotearoa New Zealand
    Decline in Mobility and Balance in Persons with Post–COVID-19 Condition
    Feldman, Debbie Ehrmann; Guillemette, Albert; Sanzari, Juliana; Youkheang, Stéphane; Mazer, Barbara

    OBJECTIVES
    Post–COVID-19 condition (PCC) may impact mobility and balance and affect physical function. The objectives of the study were to estimate the prevalence of decline in balance and mobility in individuals with PCC; explore the association between comorbidities and sociodemographic characteristics with decline in balance and mobility; and evaluate correlations between decline in mobility and balance with change in performance of usual activities, personal care, and global health perception.

    METHODS
    The design was a cross sectional study of persons with a COVID-19 diagnosis that was confirmed at least 3 months before the study. Those with PCC, defined as those still troubled by symptoms, were evaluated for decline in mobility and balance and with associated clinical and demographic factors using bivariate analysis and multivariable logistic regression. Correlations between decline in mobility and balance were also examined with change in ability to perform usual activities, personal care, and global health perception.

    RESULTS
    In 1031 persons with PCC, mobility deteriorated in 44.9% and balance deteriorated in 37.1%. Older age, hospitalization, comorbidities, and obesity were associated with decline in mobility, while decline in balance was associated with older age and comorbidities. Reduced mobility was associated with changes in ability to carry out usual activities (rp = 0.6), conduct personal care (rp = 0.6), and global health status (rp = 0.5). Correlations between decline in balance and these same outcomes were 0.5, 0.5, and 0.45, respectively.

    CONCLUSIONS
    Almost half the participants with PCC had reduced mobility and over a third reported deterioration in balance, with associated difficulties with daily functioning. Factors associated with greater decline help identify those most at risk.

    IMPACT
    Many people with PCC experience changes in mobility and balance, which can affect functional capacities and lead to physical therapist consultations. Further study should assess specific needs of these patients and determine effective physical therapist interventions to meet these needs.

    Link | PDF (Physical Therapy)
     
    SNT Gatchaman, Mar 20, 2024
    #1
    EzzieD, Sean and Hutan like this.
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    27,121
    Location:
    Aotearoa New Zealand
    I experienced this decline in my balance.

    Relatively soon after I became ill with ME/CFS but before I had a diagnosis, I thought I just needed to be more fit. I signed up for individual pilates classes. I think I started with twice a week, just 30 minutes per session, although dropped that back to once a week quite quickly as it was knocking out too much of my week in recovery time.

    Anyway, this particular pilates studio offered a free evaluation session before the exercises started, and so they had a record of my ability to stand, with eyes shut, on one leg, muscle strength and so on. I can't recall how long it was before they repeated the assessment, and I was good about turning up for each session and I would certainly do my best during them, to the point where extreme muscle tremors would start indicating muscle exhaustion.

    So, the time came when they did the 'after' evaluation, where the dutiful exerciser is supposed to be rewarded with objective improvements, and encouraged on to achieve further physical excellence. And of course, for me, everything, including balance was worse. The instructors couldn't understand it and neither could I. It got to the point where just the 15 minute walk to the studio was too much. I'd get there and be so exhausted, I'd just sit there for a bit and then walk dejectedly home.

    I remember receiving, soon after the followup assessment, an emailed newsletter from the pilates studio where they wrote about their 'star of the month' or something, a woman who had turned up with poor fitness and how she had been diligent and put the work in and how wonderfully fit she was now.

    So yeah, I don't know if these authors are considering PEM in their assessment of 'the specific needs of these patients', but, from the abstract, they seem to be assuming that 'effective physical therapist interventions' will meet all needs. In which case I have some 'physical therapist interventions' of my own that I would like to suggest.
     
    Hutan, Mar 20, 2024
    #2
    alktipping, Starlight, EzzieD and 4 others like this.
  3. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

    Messages:
    4,515
    Location:
    Aotearoa New Zealand
    No mention of PEM. Here is the recommendation, which of course assumes rehabilitation will solve all —

    Totally agree we need specialised assessment and treatment. Rehab ain't it though. The relevant helpful interventions will flow from understanding the mechanisms being uncovered by Systrom, Wüst et al (plus the upstream findings per Scheibenbogen, Hanson etc).
     
    SNT Gatchaman, Mar 20, 2024
    #3
    alktipping, rvallee, Starlight and 4 others like this.

Share This Page