【論文摘要】The Effects of a Structured Pulmonary Rehabilitation Program for a Severe Acute Respiratory Syndrome Survivor With Long-Term Sequelae: A Case Report

【論文摘要】結構式肺復原計畫於有嚴重急性呼吸道症候群長期後遺症患者之成效：個案報告

謝秉倫(Ping-Lun Hsieh)

《物理治療》 46卷4期 (2021/12) Pp. 286-287

https://doi.org/10.6215/FJPT.202112.O09

摘要

Background and Purpose: Long-term sequelae of severe acute respiratory syndrome (SARS) such as pulmonary function impairment, reduced exercise capacity, and impaired health status have been reported in the SARS survivors. Evidence showed that post-SARS pulmonary damage and functional decline recovered within 2 years after viral infection, but could be long lasting for more than a decade. Despite the positive effects of exercise training on cardiorespiratory fitness and muscle performance for those who were recovering from SARS, it remained unclear that whether a structured pulmonary rehabilitation (PR) program would benefit SARS survivors with long-term sequelae. This case report aimed to describe the effects of structured PR on long-term sequelae in a patient with a history of SARS. Methods: The patient was an 87-year-old woman with a history of SARS in 2003 complicated with acute respiratory distress syndrome and sequelae of pulmonary fibrosis. She was referred for the outpatient PR in August 2020 due to progressive exertional dyspnea. The patient attended the hospital-based structured PR once per week, which consisted of exercise training, patient education about chest physiotherapy, breathing retraining, and energy-conservation techniques. A home-based exercise plan and exercise log were also provided. Results: The patient could tolerate 20 minutes of light-to-moderate intensity aerobic exercise and moderate-intensity resistance exercises with supplemental oxygen during 8 weeks of PR. Maximal leg press strength increased from 41 kg to 51 kg (153.6% of her body weight), but there was no change regarding respiratory muscle strength, handgrip strength, and health-related quality of life. Six-minute walk distance remained unchanged (182 m with the lowest oxygen saturation of 84% at baseline versus 154 m with the lowest oxygen saturation of 89% in week 8 under room air). Conclusion: The structured PR improved maximal leg press strength for the post-SARS survivor with long-term sequelae, but had limited effects on functional exercise capacity, upper-limb and respiratory muscle strength, and health-related quality of life for the reported case. Clinical Relevance: Structured PR should be more individualized and with cautions when applied to coronavirus disease 2019 (COVID-19) survivors with pulmonary fibrosis and long-term COVID-19 sequelae in the outpatient setting.