The Effects of Early Rehabilitation and Diaphragm Kinesiotaping on Diaphragm Muscle Thickness in Patients with Severe COVID-19 Pneumonia in the Intensive Care Unit

Authors : Sinem AKSELİM, Taner DANDİNOĞLU, Serra TOPAL, Gülbahar ÇALIŞKAN

Pages : 199-208

Doi:10.46310/tjim.1279770

View : 96 | Download : 99

Publication Date : 2023-07-29

Article Type : Research Paper

Abstract :Objective The efficacy of early rehabilitation in patients in the intensive care unit is apparent. However, it is still unclear in COVID-19 patients. Also, the effects of diaphragm kinesiotaping on outcomes and muscle thickness were not shown previously. Thus, we aimed to investigate the efficacy of rehabilitation and diaphragm kinesiotaping in patients with severe COVID-19 pneumonia by evaluating with the ultrasonography of the diaphragm. Methods Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy included in the study. Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy were divided into three groups: Group 1 insert ignore into journalissuearticles values(n = 22); rehabilitation, group 2 insert ignore into journalissuearticles values(n = 26); rehabilitation and diaphragm kinesiotaping, Group 3 insert ignore into journalissuearticles values(n = 24); control group-only standard intensive care unit care. Ultrasonographic measurements of diaphragm thickness and thickening fraction were recorded repeatedly. Results The demographic characteristics, mortality, and length of stay were not different between groups. However, invasive mechanic ventilation requirement and the decrease in diaphragm thickness and thickening fraction values were significantly lower in the diaphragm kinesiotaping group. Baseline diaphragm thickness and thickening fraction values were found to impact invasive mechanic ventilation requirement. Cut-off values for these parameters are 2.85 mm and 37.95%, respectively. Conclusion Baseline diaphragm thickness can be used to predict noninvasive ventilation failure. By the way, the patients who are more likely to develop respiratory failure should receive inspiratory muscle training exercises combined with general rehabilitation principles. Also, diaphragm kinesiotaping should be included in the rehabilitation protocol.
Keywords : COVID 19, intensive care unit, rehabilitation, diaphragm kinesiotape, diaphragm thickness, diaphragmatic thickening fraction