Unfortunately, the coronavirus epidemic continues intensely both in the world and in our country during this period. A very large number of people are affected by this disease. I hope that we will overcome this epidemic with minimal damage, thanks to our strong health system.
Some of the patients affected by the coronavirus, especially young people (under the age of 30) and children, can easily overcome the disease, and sometimes they do not even have any complaints. Therefore, these patients do not experience any general health problems after recovery. However, in those who have a severe disease, especially in elderly patients who are admitted to intensive care, serious problems may arise after the disease. The most important of these is the deterioration in the musculoskeletal system caused by lying down for a long time. The human body is programmed for movement. The most important effect of long-term inactivity is on muscles and bones. One month of complete bed rest for a person corresponds to the loss of 30 percent of muscle mass. This means; An elderly patient who walked normally unaided before coronavirus may be able to walk with assistance or a cane when he leaves the hospital. On the other hand, a patient who walked with difficulty or with a cane before corona may become unable to walk afterwards, even if he or she recovers from the disease. Although muscle strength due to lying down is effective in this, the aggravation of the slight loss of balance that may already occur at this age is also effective. In other words, lying down not only reduces muscle strength but also causes loss of balance in the elderly patient. When you add the damage to the lungs to these, exertion dyspnea, that is, respiratory distress caused by movement, is also added to the situation. For example, when the patient climbs a flight of stairs, he becomes breathless and weak. Again, as there will be mineral loss from the bones due to long-term hospitalization, this may lead to osteoporosis, that is, osteoporosis. The effects of osteoporosis are bone fractures that may occur due to falls, especially hip fractures, which are an extremely serious problem in older ages. Since these patients lose their muscle strength and will be prone to falling, rehabilitation is very important in this regard.
There is also a group of patients over the age of 65 who cannot leave the house after the long-term curfew, even though there is no corona, and are forced to reduce their movements. These people are affected by inactivity, although not as much as those who have corona. It will fall. There will be a greater or lesser decrease in muscle strength and balance, although not as much as inpatients. Therefore, the walking and balance of elderly people among this group of people who had difficulty walking before the epidemic will be affected when they go out due to staying at home for a long time during the epidemic.
Fortunately, the treatment of the damage caused to the musculoskeletal system by lying down for a long time is more than treating the corona. It is easy. The treatment is a multifaceted rehabilitation. Generally, such patients are included in a rehabilitation program of 20 sessions, 3 days a week. Before starting treatment, these patients are given a cardiopulmonary exercise test, their exercise capacity is determined and a program is drawn accordingly. It is also checked whether there is any loss of balance. If there are joint problems, they are treated before starting the program, as they will prevent exercise. Based on their initial evaluation, patients are placed on an exercise program that provides strengthening, balance and endurance, which we call endurance. The intensity of the exercises is also increased with the patient's advancing exercise capacity. Patients with balance problems are especially trained with computerized balance devices. Patients with respiratory problems are taken to respiratory rehabilitation (this subject is explained in another article in the respiratory rehabilitation section of the articles section). With these treatments, patients generally achieve a rapid recovery. Patients may even become better than before the disease. All of these treatments can also be applied to middle and young age group patients who are severely affected by the disease.
It should not be forgotten that any disease that causes immobility (including corona) requires rehabilitation. Otherwise, the damage caused to the body's musculoskeletal and even nervous system may cause permanent damage that may seriously affect the patient's walking and quality of life.
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