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Dynamics of the severity of astheno-depressive syndrome at the 3rd stage of rehabilitation of patients who have had COVID-19

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About the Authors

Slivkina N. – NpJSC "Astana Medical University", Astana city, Kazakhstan

Head of the Department of Rehabilitation and Sports Medicine, https://orcid.org/0000-0002-8165-0114, This email address is being protected from spambots. You need JavaScript enabled to view it.

Kurban Zh. – NpJSC "Astana Medical University", Astana city, Kazakhstan

Doctoral student, https://orcid.org/0009-0004-2572-6948, This email address is being protected from spambots. You need JavaScript enabled to view it.

Yessengulova A. – NpJSC "Astana Medical University", Astana city, Kazakhstan

Student, https://orcid.org/0009-0008-6757-5446, This email address is being protected from spambots. You need JavaScript enabled to view it.

Myrzaly A. – NpJSC "Astana Medical University", Astana city, Kazakhstan

Student, https://orcid.org/0009-0003-8786-6148, This email address is being protected from spambots. You need JavaScript enabled to view it.


Abstract

Objective: To improve the effectiveness of the 3rd stage rehabilitation for patients who have had COVID-19 pneumonia by developing individualized rehabilitation programs that include correction of astheno-depressive syndrome, based on criteria from the International Classification of Functioning, Disability and Health (ICF).

Methods: The study involved 121 patients (30 men, 91 women) who had COVID-19 pneumonia and were referred for 3rd stage rehabilitation at a private charitable foundation. Patients underwent 10 days of rehabilitation treatment. Assessment methods included general clinical examination, visual analogue scale for pain, Spielberger-Hanin State-Trait Anxiety Inventory, SF-36 quality of life questionnaire, and Pittsburgh Sleep Quality Index. Patients completed questionnaires on admission and discharge. Statistical analysis was performed using the Wilcoxon signed-rank test in SPSS 27.

Results: The average pain score on visual analogue scale was 4 points. All patients had some degree of sleep disturbance, with 43.3% having significant problems and 29.8% having serious problems with sleep quality. 56.8% of patients showed increased situational anxiety, with 26% having moderate levels and 30.8% having high levels of reactive anxiety. After rehabilitation, there was a significant decrease in pain scores (39.3% reduction), normalization of sleep (22.7% improvement), reduction in reactive anxiety (39.9% decrease) and personal anxiety (15.2% decrease), and improvement in quality of life (41% increase). The use of International Classification of Functioning, Disability and Health domains such as b280 (sensation of pain), b134 (sleep functions), and b1102 (quality of consciousness) allowed for optimization of the multidisciplinary team's work and increased its effectiveness.

Conclusion: The developed individualized programs for 3rd stage rehabilitation of patients who had COVID-19 pneumonia, based on analysis of rehabilitation effectiveness using the proposed International Classification of Functioning, Disability and Health domains, can be used by multidisciplinary team specialists in medical institutions providing rehabilitation services. The study demonstrated significant improvements in pain, sleep quality, anxiety levels, and overall quality of life for patients undergoing this rehabilitation program.


Keywords

Rehabilitation, COVID-19, International Classification of Functioning, Disability and Health, Post-Acute COVID-19 Syndrome, Coronavirus Infections


References

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