Respiratory recovery after discharge from hospital in a patient with novel coronavirus pneumonia

Respiratory rehabilitation for patients discharged with novel coronavirus pneumonia, as follows: 1. Respiratory training: combining evidence from patients discharged with severe acute respiratory syndrome and Middle East respiratory syndrome, generalized weakness as well as shortness of breath were found to be the main cause of patients’ physical functional limitations; some patients discharged with novel coronavirus pneumonia still have respiratory symptoms such as shortness of breath, wheezing, and difficulty in coughing up sputum, especially in critically ill and Critically ill discharged patients, it is recommended to regularly assess lung function and chest imaging in order to develop a long-term, personalized respiratory rehabilitation program; 2.1, inspiratory muscle training: for some ICU patients with acquired weakness, the inspiratory muscles should be trained, using a respiratory trainer, with an initial load of 30% of the maximal inspiratory pressure, 5 inhalations per group, with an interval of not less than 6 seconds between each inhalation, and 6 groups per session with 1 minute of rest, frequency 1 time per day, and frequency 1 time per day. Rest for 1 minute between groups, frequency once a day; 2.2, sputum expectoration training: for patients with sputum retention and difficulty in sputum expectoration, encourage the patient to use postural drainage to expel sputum first, suggesting postural drainage for the affected lobe of the lungs, and let the patient keep the healthy side of the lungs in the downward side lying position. If the effect of postural drainage is not good or the patient has difficulty in coughing up sputum, active cycle breathing technique can be applied; 3. Aerobic exercise: it is a personalized training program. For patients with severe discharges or combined hypertension, heart disease and other underlying diseases, a comprehensive assessment of their mobility needs to be carried out in a specialized rehabilitation institution to formulate targeted exercise prescriptions. For patients with mild and common discharges, aerobic exercise at home is recommended, and patients should follow the principle of gradual progression from low to moderate intensity, with an exercise frequency of 3-5 times/week and an exercise time of 20-40 minutes/times as appropriate; 4.1, basic activities of daily living interventions: focus on improving the ability of basic activities of daily living in the 4 weeks after discharge from the hospital, and for the patients with severe and critical illnesses For severe and critically ill patients, those who are limited in basic activities of daily living due to dyspnea can be instructed to learn the following methods to reduce oxygen consumption: firstly, daily living activities such as transferring, grooming, toileting and bathing can be evaluated, and the focus of the evaluation is to understand whether there is dyspnea, pain, weak force and other factors that cause obstacles in daily living activities when carrying out these activities of daily living, and then give appropriate technical support after clarifying the problematic points. 4.2 Instrumental activities of daily living intervention: 4 weeks after discharge from the hospital, for patients with mild and severe discharges, it is necessary to pay attention to social participation and other high-level activities of daily living ability, so it is recommended to use the instrumental activities of daily living ability assessment scale for evaluation, and to take targeted treatment; 5. Strength training: for long-term bedridden and patients with weakness, weakness, etc., it is possible to provide targeted strength training guidance. For patients who are bedridden and have weakness, they can be instructed in strength training, initially using unarmed training and gradually increasing the load, which can be roughly divided into three parts: upper limb strength training, waist and abdominal core strength training and lower limb strength training; 6. Balance training: patients with balance dysfunction should be intervened in balance training under the guidance of the rehabilitation therapist, such as unarmed balance training or the use of balance training instrument and other methods to carry out. Balance training. If the patient can maintain the sitting position but can’t stand up, the method of weight transfer under the sitting position can be used for training, so that the patient can widen the distance between the two feet, so that he or she can take the things on the table alone, and then put them from one end to the other, and this training must be protected by someone next to him or her, so as to prevent the fall. If there is no relief or aggravation of symptoms during the training, please consult a doctor in time; 7. How to adjust if there is discomfort: If there are discomfort symptoms during the activity, such as the presence of musculoskeletal pain symptoms in patients, the exercise prescription should be adjusted as appropriate; if there is fatigue, for patients with mild disease after discharge, you can gradually increase the intensity of the activity to a moderate intensity under the monitoring of blood oxygen, and for patients with severe disease, the intensity of the recommended adjustment cycle should be longer. adjustments should be made in longer intervals, among other methods. Source: Dr. Yurai