How to deal with the neuromuscular aftermath left by Covid-19-

limped out of the hospital. The right foot stopped responding. Why stand for weeks in the ICU, pronate in bed for 18 hours a day, it does not help circulation, muscles and nervous system. There are many people who report situations like this: after spending perhaps more than a month in the hospital, they spend others a lfight against tiredness, fatigue, depression, with mobility problems in the limbs. It’s all part of the package, or, as it is defined around the world today, of the sindrome post-Covid: the aftermath of ailments (from mild to disabling) that most of those who have been hospitalized for this respiratory infection carry with them.

The list of symptoms

As Professor Tim Spector of King’s College London better defined it, this is the other side of Covid: fatigue, mental fog, muscle aches, breathing difficulties, coughs, headaches, depression, neurological problems, balance disorders and even dermatitis. And the list goes on and on. Fatigue is the most common symptom. The way out exists, and is based on awareness, discipline and exercise, with the help of physiatrists, physiotherapists and, when needed, technology. But above all, patience is needed. To tackle the problem, we work both on the side of neurological problems and on that of muscular disorders due to this syndrome: In the case of the former we are talking about disorders affecting the central and peripheral nervous system – he explains Arnaldo Andreoli, pulmonologist and head physician of the Specialized Rehabilitation Unit of the Sacco Hospital in Milan – as happens in the Guillain-Barr syndrome (an acute inflammatory polyneuropathy characterized by muscle weakness, ed), in stroke or in the case of compression of peripheral nerves. In the case of the latter we refer to persistent muscle pain and spasms or tendon inflammation that last for a longer time.

Targeted exercises

All these conditions give rise to other imbalances: balance problems, sleep disorders, fatigue in covering shorter or longer distances, difficulty controlling movements, sensitivity problems. For example, one of our patients experienced this – continues Andreoli – who, after two weeks of coma, and one month after waking up, could not stand up. When they discharged him, he was dragging his right foot, completely denervated from the pressure he had been subjected to in the ICU, where he stays in the same position for many hours a day. After months, today he has recovered 70 percent of the functionality of his foot, he manages to do some jogging and is practically back to his usual life. Thanks to targeted exercises, the use of electrostimulators and interactive technologies, the muscles can be strengthened, thus improving the sense of balance, proprioception (the ability to perceive one’s body in space, ed) and ultimately overcome that inexplicable sense of fatigue.

What to do: the physiatric examination

Before starting rehabilitation, it is important understand the origin of these symptoms: Are they caused by illness or immobility due to hospital or home confinement? therefore useful to undergo one specialist physiatric visit than for patients who have had Covid exempt from paying the ticket. At our hospital it was activated a dedicated clinic to the diagnosis and treatment for those suffering from this syndrome where – he points out Fabrizio Gervasoni, physiatrist -. It is used a robotic system which, thanks to the presence of advanced sensors, quantifies movement problems or balance disturbances. Rehabilitation can greatly improve the patient’s clinical picture, so we recommend that patients, who have symptoms even months later, undergo a physiatric examination. Patience, discipline and perseverance are required, but with commitment and determination the results are then seen.

Exercises tailored for recovery

It looks like a treadmill, the kind you saw in the gym when the gyms were open. In fact much more. The interactive system at the Sacco Hospital uses artificial intelligence for the diagnosis and treatment of neuromotor diseases: intercepts problems of weakness and balance of the patient and elaborates the right exercises to make him recover his functionality. To continue their rehabilitation at home, some patients were given briefcases equipped with sensors such as lo spirometro (to measure the breath) and the oximeter (to detect the amount of oxygen in the blood) and a tablet, thanks to which the person can communicate with the doctor and the physiotherapist, in remote connection, who follow him for each exercise. there tele-rehabilitation and, according to doctors and patients who are using it, it gives good results.

March 9, 2021 (change March 9, 2021 | 18:54)

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