Quality of life, exercise capacity, cognition, and mental health of Chilean patients after COVID-19: an experience of a multidisciplinary rehabilitation program at a physical and rehabilitation medicine unit
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2023
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Background: Post-COVID disabilities, encompassing physical, cognitive, and
psychological aspects, constitute the primary health sequelae for survivors.
While the rehabilitation needs post COVID-19 are now well understood, each
country possesses unique characteristics in terms of populations, healthcare
systems, social dynamics, and economic profiles, necessitating context-specific
recommendations. This study aims to address two main objectives: (1) analyze
the impact of an 8-week multidisciplinary rehabilitation program on the quality
of life, functional capacity, cognition, and mental health adaptations in adults
recovering from COVID-19 in northern Chile, and (2) propose a personalized
model for predicting program dropouts and responses.
Methods: A total of 44 subjects were enrolled, forming two groups during the
study: a treatment group (n = 32) and a dropout group (n = 12). The treatment
group participated in the 8-week multidisciplinary rehabilitation program.
Results: The results indicate that (1) After 8 weeks, the quality of life of the patients
in the treatment group exhibited significant improvements reflected in all aspects
of the Short Form-36 Health Survey (SF36, p < 0.005) and the total score (p <
0.001), with a concurrent decrease in dysfunctionality (p < 0.001). (2) Significant
improvements were also observed in various physical performance tests,
including the: 6-minute walk test, 1-min sit-to-stand, dynamometry, Tinetti
balance, and Berg score (p < 0.001). Moreover, physical therapy led to a
reduction in neuropathic symptoms and pain, psychological therapy reduced
anxiety and depression, and language therapy enhanced memory and speech
(all p < 0.05). (3) Demographic and clinical history characteristics did not predict
responses to rehabilitation. (4) A regression model for predicting changes in SF-
36 total score, based on physical function, physical role, general health, and
mental health, was established based on the data from study (p < 0.01, adjusted R2 = 0.893). (5) Classification models for predicting dropouts achieved 68%
accuracy, with key predictors of treatment adherence including diabetes,
hypertension, and dyslipidemia, Tinetti balance, physical role, and vitality of
SF36, and performance on the 6-minute walk test and 1-minute sit-to-stand.
Conclusions: This study demonstrates significant enhancements in quality of life,
improved functional performance, and reductions in mental and cognitive burdens
within an 8-week rehabilitation program. Additionally, it is possible to identify
patients at risk of dropping out using cost-effective, outpatient, and clinically
applicable tests