Letter to the Editor
10.25176/RFMH.v24i4.6336
Importance of physiotherapy in sequelae of post-COVID-19 patients
Importancia de la fisioterapia en secuelas de pacientes post COVID-19
1 Universidad de Huánuco. Huánuco, Perú.
aEstudiante de Enfermería
1 Universidad de Huánuco. Huánuco, Perú.
aEstudiante de Enfermería
Sr editor
As nursing students, we have read with great interest the article titled "Functionality before and after physiotherapy in post-COVID-19 patients"
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1. Siete ML, Carmona MH, Manzano MS, Montiel BVM, Castro EG, Galicia AG, et al. Funcionalidad antes y después de fisioterapia en pacientes post COVID-19. Rev Fac Med Hum [Internet]. 6 de diciembre de 2023 [citado 15 de enero de 2024];23(3):73-8. Disponible en: https://revistas.urp.edu.pe/index.php/RFMH/article/view/5532
, published in volume 23, issue 3 (2023) of the Revista de la Facultad de Medicina Humana. This study highlights the importance of functional physical therapy in patients with post-COVID-19 sequelae. We consider it relevant to express our concern regarding the increase in these sequelae in our country, which aligns with the findings of Goicochea et al.
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2. Goicochea Ríos E del S, Córdova Paz Soldán OM, Gómez Goicochea NI, Vicuña Villacorta J. Secuelas post infección por COVID 19 en pacientes del Hospital I Florencia de Mora. Trujillo - Perú. Rev Fac Med Hum [Internet]. octubre de 2022 [citado 20 de enero de 2024];22(4):754-64. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_abstract&pid=S2308-05312022000400754&lng=es&nrm=iso&tlng=es
, who report that 28.8% of post-COVID patients experienced sequelae, predominantly respiratory, musculoskeletal, and neurological, as shown in Table 1. This increase may be related to the large percentage of unvaccinated individuals. The objective of that article was to highlight the physical and respiratory functional effects in post-COVID-19 patients, with the goal of improving and alleviating the symptoms associated with this condition.
In relation to the study’s approach, we emphasize the importance of a multidisciplinary intervention and the involvement of rehabilitation and post-acute care teams in managing the sequelae of the disease. We suggest that when addressing the long-term effects in post-COVID-19 patients, different health professionals should be involved to achieve more comprehensive results
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3. Febré N, Mondaca Gómez K, Méndez Celis P, Badilla Morales V, Soto-Parada P, Ivanovic P, et al. Calidad en Enfermería: Su gestión, implementación y medición. Rev Med Cli Cond [Internet]. 1 de mayo de 2018 [citado 16 de enero de 2024];29(3):278-87. Disponible en: https://www.sciencedirect.com/science/article/pii/S0716864018300567
. The inclusion of specific scales and tests to evaluate functionality before and after the intervention provides a solid basis for measuring outcomes and understanding the effectiveness of the proposed therapy.
A study conducted in Peru reports similar findings, emphasizing the importance of respiratory physiotherapy in post-COVID-19 patients, with positive effects on functionality, quality of life, and reduction of respiratory symptoms
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4. García Moreno JJ. Eficacia de la fisioterapia respiratoria en la mejora de la capacidad respiratoria y calidad de vida en adultos post-COVID-19 [Internet] [Tesis para optar el título profesional de médico cirujano]. [Trujillo - Perú]: Universidad Cesar Vallejo; 2021 [citado 16 de enero de 2023]. Disponible en: https://repositorio.ucv.edu.pe/bitstream/handle/20.500.12692/87355/Garc%c3%ada_MJJ-SD.pdf?sequence=1&isAllowed=y
. Both studies demonstrate improvements in respiratory capacity and quality of life following the application of therapies.
We would also like to point out some concerns and suggestions regarding the article. The authors mention that there was no control group and that the sample size was relatively small
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5. Miller L, Marín Rodríguez I. Estrategias experimentales para el análisis y evaluación de políticas públicas. Gestión y Análisis de Políticas Públicas [Internet]. 1 de marzo de 2023 [citado 16 de enero de 2024];(31):56-70. Disponible en: https://revistasonline.inap.es/index.php/GAPP/article/view/11133
. Additionally, the absence of long-term follow-up limits a full understanding of patient outcomes after treatment.
Regarding the results, significant improvements were observed in muscle strength, mobility, and functional capacity of the patients after receiving physical and occupational therapy. These findings are promising and reinforce the importance of implementing comprehensive rehabilitation programs to address the long-term sequelae of COVID-19. In 2021, Huerta, a representative of the Pan American Health Organization (PAHO) in Honduras, emphasized the importance of identifying the rehabilitation needs of patients and conducting hospital follow-up, noting that rehabilitation programs should be personalized according to each patient’s short- or long-term needs
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6. Organización Panamericana de la Salud. Acceso a servicios de rehabilitación despues de un año de pandemia de COVID-19. 2021 [citado 16 de enero de 2024]. Acceso a servicios de rehabilitación despues de un año de pandemia de COVID-19 - OPS/OMS | Organización Panamericana de la Salud. Disponible en: https://www.paho.org/es/noticias/23-9-2021-acceso-servicios-rehabilitacion-despues-ano-pandemia-covid-19
.
We suggest that the discussion on the study’s limitations be expanded to include aspects such as sample size, lack of a control group, and the absence of long-term follow-up. Including these reflections would strengthen the validity and applicability of the results.
We appreciate the comprehensive approach of the study and the application of various scales to assess patient functionality. This type of research significantly contributes to scientific knowledge and the improvement of medical care. Despite the aforementioned limitations, the results suggest considerable benefits. We urge the scientific community to continue researching this area to improve the understanding and treatment of COVID-19 sequelae.
We hope that our suggestions will be considered for future research and that this work will inspire further studies that benefit the medical community and affected patients.
Population diagnosed with COVID-19 by type of sequelae and sex. Hospital I Florencia de Mora, December 2021
| Sex | Total | ||||||
|---|---|---|---|---|---|---|---|
| Female | Male | ||||||
| Respiratory | Dysphagia | 2 | 33.33% | 4 | 66.7% | 6 | 100.0% |
| Dyspnea | 26 | 53.0% | 23 | 47.0% | 49 | 100.0% | |
| Dysphagia and dysphonia, dyspnea | 0 | 0.0% | 2 | 100.0% | 2 | 100.0% | |
| Odynophagia | 1 | 100.0% | 0 | 0.0% | 1 | 100.0% | |
| Total | 29 | 50.0% | 29 | 50.0% | 58 | 100.0% | |
| Neurological | Headache | 4 | 50.0% | 4 | 50.0% | 8 | 100.0% |
| Anosmia / Ageusia | 2 | 25.0% | 6 | 75.0% | 8 | 100.0% | |
| Anosmia | 3 | 100.0% | 0 | 0.0% | 3 | 100.0% | |
| Total | 9 | 47.4% | 10 | 52.6% | 19 | 100.0% | |
| Musculoskeletal | Joint Pain | 2 | 67.0% | 1 | 33.0% | 3 | 100.0% |
| Muscle Pain | 0 | 0.0% | 3 | 100.0% | 3 | 100.0% | |
| Back Pain | 25 | 75.8% | 8 | 24.2% | 33 | 100.0% | |
| Muscle Hypotrophy | 1 | 50.0% | 1 | 50.0% | 2 | 100.0% | |
| Total | 28 | 68.3% | 13 | 31.7% | 41 | 100.0% | |
| Psychological | Anxiety, Depression | 0 | 1 | 100.0% | 1 | 100.0% | |
| Total | 0 | 1 | 100.0% | 1 | 100.0% | ||
| Others | Hair Loss | 0 | 0.0% | 2 | 100.0% | 2 | 100.0% |
| Digestive Symptoms | 3 | 60.0% | 2 | 40.0% | 5 | 100.0% | |
| Itching | 0 | 0.0% | 1 | 100.0% | 1 | 100.0% | |
| Total | 3 | 37.5% | 5 | 62.5% | 8 | 100.0% | |
Aditional Information
Conflict of interest statement: The authors declare no conflict of interest. Authorship contribution: LACD and NLRB participated in the conception and design of the article, data collection, writing, and approval of the final version. JPS performed data analysis. LACD and NLRB contributed to the writing of the letter to the editor and were involved until final approval. Funding: Self-funded. Recibido: February 15, 2024 Aprobado: October 1, de 2024
Datos de Correspondencia del Autor
Correspondence: Juan Pablo Salazar Trujillo. Address: Dirección: Jr. General Prado N°278, Huánuco, Perú Phone number: 947780374 E-mail: jpsalazartrujillo@gmail.com
Artículo publicado por la Revista de la Facultad de Medicina Humana de la Universidad Ricardo Palma. Es un artículo de acceso abierto, distribuido bajo los términos de la Licencia Creative Commons: Creative Commons Attribution 4.0 International, CC BY 4.0 , que permite el uso no comercial, distribución y reproducción en cualquier medio, siempre que la obra original sea debidamente citada. Para uso comercial, por favor póngase en contacto con revista.medicina@urp.edu.pe.
REFERENCIAS BIBLIOGRAFICAS
1
Siete ML, Carmona MH, Manzano MS, Montiel BVM, Castro EG, Galicia AG, et al.
Funcionalidad antes y después de fisioterapia en pacientes post COVID-19. Rev Fac Med Hum [Internet]. 6 de diciembre de 2023 [citado 15 de enero de 2024];23(3):73-8.
Disponible en: https://revistas.urp.edu.pe/index.php/RFMH/article/view/5532
2
Goicochea Ríos E del S, Córdova Paz Soldán OM, Gómez Goicochea NI, Vicuña Villacorta J.
Secuelas post infección por COVID 19 en pacientes del Hospital I Florencia de Mora. Trujillo - Perú. Rev Fac Med Hum [Internet]. octubre de 2022 [citado 20 de enero de 2024];22(4):754-64.
Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_abstract&pid=S2308-05312022000400754&lng=es&nrm=iso&tlng=es
3
Febré N, Mondaca Gómez K, Méndez Celis P, Badilla Morales V, Soto-Parada P, Ivanovic P, et al.
Calidad en Enfermería: Su gestión, implementación y medición. Rev Med Cli Cond [Internet]. 1 de mayo de 2018 [citado 16 de enero de 2024];29(3):278-87.
Disponible en: https://www.sciencedirect.com/science/article/pii/S0716864018300567
4
García Moreno JJ.
Eficacia de la fisioterapia respiratoria en la mejora de la capacidad respiratoria y calidad de vida en adultos post-COVID-19 [Internet] [Tesis para optar el título profesional de médico cirujano]. [Trujillo - Perú]: Universidad Cesar Vallejo; 2021 [citado 16 de enero de 2023].
Disponible en: https://repositorio.ucv.edu.pe/bitstream/handle/20.500.12692/87355/Garc%c3%ada_MJJ-SD.pdf?sequence=1&isAllowed=y
5
Miller L, Marín Rodríguez I.
Estrategias experimentales para el análisis y evaluación de políticas públicas. Gestión y Análisis de Políticas Públicas [Internet]. 1 de marzo de 2023 [citado 16 de enero de 2024];(31):56-70.
Disponible en: https://revistasonline.inap.es/index.php/GAPP/article/view/11133
6
Organización Panamericana de la Salud.
Acceso a servicios de rehabilitación despues de un año de pandemia de COVID-19. 2021 [citado 16 de enero de 2024].
Disponible en: https://www.paho.org/es/noticias/23-9-2021-acceso-servicios-rehabilitacion-despues-ano-pandemia-covid-19