Postural balance, mobility, and handgrip strength one year after hospitalization due to COVID-19

Caroline Gil de Godoy; Ana Carolina Basso Schmitt; Gabriela Sayuri Ochiai; Erika Christina Gouveia E Silva; Danielle Brancolini de Oliveira; Elizabeth Mendes da Silva; Celso Ricardo Fernandes de Carvalho; Carlos Toufen Junior; Julia Maria D'Andre A Greve; Keith Hill; José Eduardo Pompeu

doi:10.1016/j.gaitpost.2024.08.012

Postural balance, mobility, and handgrip strength one year after hospitalization due to COVID-19

Gait Posture. 2024 Oct:114:14-20. doi: 10.1016/j.gaitpost.2024.08.012. Epub 2024 Aug 22.

Affiliations

¹ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
² Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
³ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
⁴ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
⁵ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
⁶ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
⁷ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].
⁸ Pulmonology Division of Hearth Hospital - InCor. Hospital to School of Medicine, University of São Paulo, 44, Av. Dr. Enéas de Carvalho Aguiar, São Paulo 05403-900, Brazil. Electronic address: [email protected].
⁹ Laboratório de Estudos do Movimento, Institute of Orthopedics and Traumatology, Hospital to School of Medicine University of São Paulo, 333, R. Dr. Ovídio Pires de Campos, São Paulo 05403-010, Brazil. Electronic address: [email protected].
¹⁰ Monash University - Peninsula Campus, Frankston, VIC, Australia. Electronic address: [email protected].
¹¹ Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil. Electronic address: [email protected].

PMID: 39208539
DOI: 10.1016/j.gaitpost.2024.08.012

Abstract

Background: Symptoms such as impairment of postural balance, mobility and muscle strength can last up to 12 months post COVID-19 hospitalization, need to be better understood, as they can have repercussions in activities of daily living.

Research question: What happens to postural balance, mobility, and handgrip strength of COVID-19 patients after hospitalization?

Methods: A prospective cohort study was conducted with patients of both sexes, aged ≥18, admitted to hospital diagnosed with COVID-19. Outcomes were assessed at 1, 4, 6, and 12 months post-discharge, including: postural balance - Brief-Balance Evaluation Systems Test, mobility - Timed "Up & Go" Test, and handgrip strength - dynamometry. Prevalence values of impaired postural balance and mobility and lower-than-expected handgrip strength were calculated by point estimate and 95 % confidence interval. Shapiro-Wilk test showed that our data did not have a normal distribution, so the Friedman Test and the test of proportions were used for the statistical analysis.

Results: Performance on postural balance was improved after four months of hospital discharge, but the improvement in mobility and handgrip strength only occurred after six months. After six months of discharge, the proportion of individuals with impairments began to decrease. A higher prevalence of impairments in postural balance and mobility occurred at one month post-discharge, which reduced over time. However, the values of impairments for postural balance and mobility were still high after 12 months of follow-up.

Significance: There was a high prevalence of postural balance and mobility impairment 1 month after discharge, which was still high 12 months after discharge. The prevalence of lower-than-expected handgrip strength demonstrated limited change over time. Results highlight the need for assessment of postural balance, mobility and hand grip strength in post COVID-19 related hospitalization protocols, and long-term physical therapy interventions to address these impairments when identified to improve long term outcomes.

Keywords: Hospital discharge; Post-acute COVID-19 syndrome; Postural balance; Walking.

MeSH terms

Activities of Daily Living
Adult
Aged
COVID-19* / physiopathology
Female
Hand Strength* / physiology
Hospitalization* / statistics & numerical data
Humans
Male
Middle Aged
Mobility Limitation
Postural Balance* / physiology
Prospective Studies
SARS-CoV-2