Open AccessRehabilitation Therapy for a COVID-19 Patient Who Received Mechanical Ventilation in Japan
Author(s) -
Takuya Saeki,
Fumihiro Ogawa,
Ryosuke Chiba,
Manabu ogaki,
Jo Uesugi,
Ichiro Takeuchi,
Takeshi Nakamura
Publication year - 2020
Publication title -
american journal of physical medicine and rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 101
eISSN - 1537-7385
pISSN - 0894-9115
DOI - 10.1097/phm.0000000000001545
Subject(s) - medicine , mechanical ventilation , rehabilitation , postural drainage , physical therapy , sedation , activities of daily living , emergency medicine , anesthesia
A 65-yr-old man visited a primary care hospital with a continued fever of 38°C for 3 days. As his fever did not improve until 8 days after, he was admitted into another acute care hospital, where his respiratory condition rapidly worsened. Therefore, the patient was transferred to our hospital. On the day of transfer (day 1), he was started on mechanical ventilation. COVID-19 was diagnosed using a polymerase chain reaction assay 6 days after admission (day 6). The rehabilitation therapy was begun on day 6. The initial rehabilitation programs focused on positioning and postural drainage. The patient was extubated on day 19, and he began standing and stepping on the same day. Gait exercises began on day 22, and endurance training was initiated on day 28. The patient was discharged from our hospital on day 34 as he met the physical function milestones. One month after discharge, the Medical Research Council sum score and Barthel Index had each improved; therefore, muscle strength and daily activities had returned to normal. It was assumed that mobilization should be performed as soon as possible after the end of sedation during the acute phase of severe COVID-19 infection in patients receiving mechanical ventilation.