Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25759/spmfr.445 |
Resumo: | Introduction: The disease caused by coronavirus 19 (COVID-19) is an international health emergency and has reached pandemic proportions worldwide. Since March 2020, the Portuguese government implemented measures to prevent the spread of the virus, including almost total temporary suspension of outpatient rehabilitation treatments. Patients with chronic spinal cord injury have an increased risk of developing severe forms of COVID-19 infection. However, they need rehabilitation treatment to control and prevent complications. The aim of this study was to evaluate the impact of the first wave of the COVID-19 pandemic on the clinical evolution of patients with chronic spinal cord injury, regarding pain, spasticity and functionality.Material and Methods: This is a cross-sectional observational study. A telephonic questionnaire was applied to a group of patients with chronic spinal cord injury. The results allowed the comparison of symptoms and functionality before the pandemic and six months after its onset.Results: After exclusion criteria were applied, the sample included a total of 65 participants. All patients who were previously undergoing physiotherapy treatments had to suspend them. Six months after the beginning of the Pandemic in Portugal, 24.6% of the patients reported worsening of pain complaints; 26.2% noted increased spasticity and 21.5% had decreased functionality. In this sample, 12.3% of the patients reported new pressure ulcers or worsening of the previous ones.Patients with cervical spinal cord injury had increased spasticity compared to patients with dorsal or lumbar injury (p=0.003). On the other hand, patients with lumbar spinal cord injury had more frequent worsening of pain complaints (p=0.029). Patients with incomplete motor injury had greater pain worsening when compared to patients with complete injury (p=0.007).Conclusion: The COVID-19 pandemic is having an important impact on the treatment of patients with chronic spinal cord injury, leading to worsening of pain complaints, increased spasticity and decreased functionality. Spasticity worsened more in patients with cervical spinal cord injury while pain worsened more significantly in patients with lumbar injury and incomplete motor injury. |
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Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and FunctionalityConsequências da Primeira Vaga da Pandemia COVID-19 em Doentes com Lesão Medular Crónica: Impacto na Dor, Espasticidade e FuncionalidadeCOVID-19; SARS-CoV-2; Spinal Cord Injuries/ complications; Spinal Cord Injuries/rehabilitation.COVID-19; Lesões Medulares/ complicações; Lesões Medulares/reabilitação; SARS-CoV-2Introduction: The disease caused by coronavirus 19 (COVID-19) is an international health emergency and has reached pandemic proportions worldwide. Since March 2020, the Portuguese government implemented measures to prevent the spread of the virus, including almost total temporary suspension of outpatient rehabilitation treatments. Patients with chronic spinal cord injury have an increased risk of developing severe forms of COVID-19 infection. However, they need rehabilitation treatment to control and prevent complications. The aim of this study was to evaluate the impact of the first wave of the COVID-19 pandemic on the clinical evolution of patients with chronic spinal cord injury, regarding pain, spasticity and functionality.Material and Methods: This is a cross-sectional observational study. A telephonic questionnaire was applied to a group of patients with chronic spinal cord injury. The results allowed the comparison of symptoms and functionality before the pandemic and six months after its onset.Results: After exclusion criteria were applied, the sample included a total of 65 participants. All patients who were previously undergoing physiotherapy treatments had to suspend them. Six months after the beginning of the Pandemic in Portugal, 24.6% of the patients reported worsening of pain complaints; 26.2% noted increased spasticity and 21.5% had decreased functionality. In this sample, 12.3% of the patients reported new pressure ulcers or worsening of the previous ones.Patients with cervical spinal cord injury had increased spasticity compared to patients with dorsal or lumbar injury (p=0.003). On the other hand, patients with lumbar spinal cord injury had more frequent worsening of pain complaints (p=0.029). Patients with incomplete motor injury had greater pain worsening when compared to patients with complete injury (p=0.007).Conclusion: The COVID-19 pandemic is having an important impact on the treatment of patients with chronic spinal cord injury, leading to worsening of pain complaints, increased spasticity and decreased functionality. Spasticity worsened more in patients with cervical spinal cord injury while pain worsened more significantly in patients with lumbar injury and incomplete motor injury.Introdução: A doença causada pelo vírus SARS-CoV-2 (COVID-19) é uma emergência de saúde internacional, que atingiu proporções de pandemia mundial. Desde março de 2020, foram aplicadas em Portugal medidas para evitar a propagação do vírus, incluindo a suspensão temporária, quase total, dos tratamentos de reabilitação em ambulatório. Os doentes com lesão medular crónica apresentam um risco aumentado de desenvolverem formas graves de COVID-19. Por outro lado, são doentes que necessitam de tratamento de reabilitação para controlar e prevenir complicações decorrentes da lesão medular. O objetivo deste estudo foi avaliar o impacto da primeira vaga da pandemia por COVID-19 na evolução clínica dos doentes com lesão medular crónica, nomeadamente quanto à dor, espasticidade e funcionalidade.Material e Métodos: Trata-se de um estudo observacional transversal. Foi aplicado um questionário telefónico a um conjunto de doentes com lesão medular crónica, seguidos em consulta de Medicina Física e de Reabilitação. O questionário aplicado permitiu comparar dor, espasticidade e funcionalidade antes da pandemia e seis meses após o seu início.Resultados: Após terem sido aplicados critérios de exclusão, a amostra incluiu um total de 65 participantes. Todos os doentes que estavam previamente a fazer tratamentos de fisioterapia, suspenderam-nos. Seis meses após o início da pandemia em Portugal, 24,6% dos doentes referiam agravamento das queixas álgicas; 26,2% notaram aumento da espasticidade e 21,5% apresentavam diminuição da funcionalidade.Nesta amostra, 12,3% dos doentes referiam aparecimento de novas úlceras de pressão ou agravamento das prévias. Pacientes com lesão medular cervical tiveram maior agravamento da espasticidade do que aqueles com lesão dorsal ou lombar (p=0,003). Por outro lado, doentes com lesão lombar apresentaram maior intensificação das queixas álgicas (p=0,029). Doentes com lesão incompleta motora tiveram maior agravamento da dor, quando comparados com doentes com lesão completa ou incompleta sensitiva (p=0,007).Conclusão: A pandemia por COVID-19 e a sua interferência no tratamento está a ter um impacto importante nos doentes com lesão medular crónica, levando ao agravamento de dor, espasticidade e diminuição da autonomia. A espasticidade agravou mais em doentes com lesão cervical enquanto que a dor piorou mais significativamente em doentes com lesão lombar e lesão incompleta motora.Sociedade Portuguesa de Medicina Física e de Reabilitação2022-05-08T00:00:00Zjournal articlejournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.25759/spmfr.445oai:ojs.spmfrjournal.org:article/445Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 34, n. 1 (2022): Ano 30; 17-260872-9204reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://spmfrjournal.org/index.php/spmfr/article/view/445https://doi.org/10.25759/spmfr.445https://spmfrjournal.org/index.php/spmfr/article/view/445/239Copyright (c) 2022 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitaçãohttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessFreitas, Margarida Mota; Serviço de MFR do Hospital Garcia de Orta, Almada, PortugalSousa, Luís; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, PortugalRibeiro, Ana Margarida; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, PortugalAraújo, Raquel; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, PortugalAmaral, Sara; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, PortugalAndrade, Maria João; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal2022-09-20T15:28:49Zoai:ojs.spmfrjournal.org:article/445Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:51:23.374770Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality Consequências da Primeira Vaga da Pandemia COVID-19 em Doentes com Lesão Medular Crónica: Impacto na Dor, Espasticidade e Funcionalidade |
title |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
spellingShingle |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality Freitas, Margarida Mota; Serviço de MFR do Hospital Garcia de Orta, Almada, Portugal COVID-19; SARS-CoV-2; Spinal Cord Injuries/ complications; Spinal Cord Injuries/rehabilitation. COVID-19; Lesões Medulares/ complicações; Lesões Medulares/reabilitação; SARS-CoV-2 |
title_short |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
title_full |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
title_fullStr |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
title_full_unstemmed |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
title_sort |
Consequences of the First Wave of the COVID-19 Pandemic in Patients with Chronic Spinal Cord Injury: Impact on Pain, Spasticity and Functionality |
author |
Freitas, Margarida Mota; Serviço de MFR do Hospital Garcia de Orta, Almada, Portugal |
author_facet |
Freitas, Margarida Mota; Serviço de MFR do Hospital Garcia de Orta, Almada, Portugal Sousa, Luís; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Ribeiro, Ana Margarida; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Araújo, Raquel; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Amaral, Sara; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Andrade, Maria João; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal |
author_role |
author |
author2 |
Sousa, Luís; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Ribeiro, Ana Margarida; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Araújo, Raquel; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Amaral, Sara; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Andrade, Maria João; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Freitas, Margarida Mota; Serviço de MFR do Hospital Garcia de Orta, Almada, Portugal Sousa, Luís; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Ribeiro, Ana Margarida; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Araújo, Raquel; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Amaral, Sara; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal Andrade, Maria João; Serviço de MFR do Centro Hospitalar Universitário do Porto, Porto, Portugal |
dc.subject.por.fl_str_mv |
COVID-19; SARS-CoV-2; Spinal Cord Injuries/ complications; Spinal Cord Injuries/rehabilitation. COVID-19; Lesões Medulares/ complicações; Lesões Medulares/reabilitação; SARS-CoV-2 |
topic |
COVID-19; SARS-CoV-2; Spinal Cord Injuries/ complications; Spinal Cord Injuries/rehabilitation. COVID-19; Lesões Medulares/ complicações; Lesões Medulares/reabilitação; SARS-CoV-2 |
description |
Introduction: The disease caused by coronavirus 19 (COVID-19) is an international health emergency and has reached pandemic proportions worldwide. Since March 2020, the Portuguese government implemented measures to prevent the spread of the virus, including almost total temporary suspension of outpatient rehabilitation treatments. Patients with chronic spinal cord injury have an increased risk of developing severe forms of COVID-19 infection. However, they need rehabilitation treatment to control and prevent complications. The aim of this study was to evaluate the impact of the first wave of the COVID-19 pandemic on the clinical evolution of patients with chronic spinal cord injury, regarding pain, spasticity and functionality.Material and Methods: This is a cross-sectional observational study. A telephonic questionnaire was applied to a group of patients with chronic spinal cord injury. The results allowed the comparison of symptoms and functionality before the pandemic and six months after its onset.Results: After exclusion criteria were applied, the sample included a total of 65 participants. All patients who were previously undergoing physiotherapy treatments had to suspend them. Six months after the beginning of the Pandemic in Portugal, 24.6% of the patients reported worsening of pain complaints; 26.2% noted increased spasticity and 21.5% had decreased functionality. In this sample, 12.3% of the patients reported new pressure ulcers or worsening of the previous ones.Patients with cervical spinal cord injury had increased spasticity compared to patients with dorsal or lumbar injury (p=0.003). On the other hand, patients with lumbar spinal cord injury had more frequent worsening of pain complaints (p=0.029). Patients with incomplete motor injury had greater pain worsening when compared to patients with complete injury (p=0.007).Conclusion: The COVID-19 pandemic is having an important impact on the treatment of patients with chronic spinal cord injury, leading to worsening of pain complaints, increased spasticity and decreased functionality. Spasticity worsened more in patients with cervical spinal cord injury while pain worsened more significantly in patients with lumbar injury and incomplete motor injury. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-05-08T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25759/spmfr.445 oai:ojs.spmfrjournal.org:article/445 |
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https://doi.org/10.25759/spmfr.445 |
identifier_str_mv |
oai:ojs.spmfrjournal.org:article/445 |
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por |
language |
por |
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https://spmfrjournal.org/index.php/spmfr/article/view/445 https://doi.org/10.25759/spmfr.445 https://spmfrjournal.org/index.php/spmfr/article/view/445/239 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 info:eu-repo/semantics/openAccess |
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Copyright (c) 2022 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 |
eu_rights_str_mv |
openAccess |
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Sociedade Portuguesa de Medicina Física e de Reabilitação |
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Sociedade Portuguesa de Medicina Física e de Reabilitação |
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Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 34, n. 1 (2022): Ano 30; 17-26 0872-9204 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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