Ann Rehabil Med.  2024 Dec;48(6):389-395. 10.5535/arm.240033.

The Assessment of Muscle Strength and Cardiorespiratory Parameters Using Simple Tests in Older Adults With Recovery From Mild COVID-19

Affiliations
  • 1Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
  • 2Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao, Thailand
  • 3Department of Traditional Chinese Medicine, School of Public Health, University of Phayao, Phayao, Thailand

Abstract


Objective
To evaluate muscle strength and cardiorespiratory parameters, this study uses simple tests in older adults, including those who have and have not recovered from mild coronavirus disease 2019 (COVID-19).
Methods
Eighty older adults (age≥60 years old) were divided into two groups: those without previous COVID-19 (control group, n=40) and those with recovery from mild COVID-19 (recovered group, n=40). Muscle strength was assessed using a handgrip strength test and the sit-to-stand test (STS10). Cardiorespiratory parameters were evaluated with a 1-minute sitto- stand (1-min STS) test and a 6-minute walk test (6MWT).
Results
Both groups had normal values for body mass index, blood pressure, heart rate, and pulse oxygen saturation. The recovered group showed significant differences in handgrip strength test (24.73±6.99 vs. 22.03±4.36, p=0.041) and duration for the STS10 (25.15±6.11 vs. 33.40±7.56, p<0.001) when compared to the control group. Furthermore, the recovered group had significantly decreased repetitions of a 1-min STS (31.38±4.89 vs. 21.25±3.64, p<0.001) and increased the rate of perceived exertion (RPE) (7.43±1.20 vs. 8.95±1.01, p=0.01) and leg fatigue (1.49±1.13 vs. 3.00±1.04, p=0.03) after performing a 1-min STS when compared with the control group. Moreover, the recovered group had also significantly decreased distances for the 6MWT (421.68±8.28 vs. 384.35±6.17, p<0.001) and increased the post-test RPE (7.63±1.37 vs. 12.05±1.63, p<0.001) and the post-test leg fatigue (1.71±0.88 vs. 5.28±0.91, p<0.001) compared with the control group.
Conclusion
Older adults with recovery from mild COVID-19 reported reduced muscle strength and exercise tolerance when compared with older adults without COVID-19.

Keyword

COVID-19 Recovery; COVID-19; Older adults; Cardiovascular physiology; Muscle strength

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Reference

1. Ozma MA, Maroufi P, Khodadadi E, Köse Ş, Esposito I, Ganbarov K, et al. Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period. Infez Med. 2020; 28:153–65.
2. Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020; 92:577–83.
Article
3. Jacobs LG, Gourna Paleoudis E, Lesky-Di Bari D, Nyirenda T, Friedman T, Gupta A, et al. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS One. 2020; 15:e0243882.
Article
4. Sagarra-Romero L, Viñas-Barros A. COVID-19: short and long-term effects of hospitalization on muscular weakness in the elderly. Int J Environ Res Public Health. 2020; 17:8715.
Article
5. Van Aerde N, Van den Berghe G, Wilmer A, Gosselink R, Hermans G; COVID-19 Consortium. Intensive care unit acquired muscle weakness in COVID-19 patients. Intensive Care Med. 2020; 46:2083–5.
6. Ferrandi PJ, Alway SE, Mohamed JS. The interaction between SARS-CoV-2 and ACE2 may have consequences for skeletal muscle viral susceptibility and myopathies. J Appl Physiol (1985). 2020; 129:864–7.
Article
7. Dos Santos PK, Sigoli E, Bragança LJG, Cornachione AS. The musculoskeletal involvement after mild to moderate COVID-19 infection. Front Physiol. 2022; 13:813924.
Article
8. Leung TW, Wong KS, Hui AC, To KF, Lai ST, Ng WF, et al. Myopathic changes associated with severe acute respiratory syndrome: a postmortem case series. Arch Neurol. 2005; 62:1113–7.
Article
9. Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, TLC Study Group, et al. Symptoms, complications and management of long COVID: a review. J R Soc Med. 2021; 114:428–42.
Article
10. Stavem K, Ghanima W, Olsen MK, Gilboe HM, Einvik G. Persistent symptoms 1.5-6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study. Thorax. 2021; 76:405–7.
Article
11. Vanichkachorn G, Newcomb R, Cowl CT, Murad MH, Breeher L, Miller S, et al. Post-COVID-19 Syndrome (Long Haul Syndrome): description of a multidisciplinary clinic at mayo clinic and characteristics of the initial patient cohort. Mayo Clin Proc. 2021; 96:1782–91.
Article
12. Stavem K, Ghanima W, Olsen MK, Gilboe HM, Einvik G. Prevalence and determinants of fatigue after COVID-19 in non-hospitalized subjects: a population-based study. Int J Environ Res Public Health. 2021; 18:2030.
Article
13. Amenta EM, Spallone A, Rodriguez-Barradas MC, El Sahly HM, Atmar RL, Kulkarni PA. Postacute COVID-19: an overview and approach to classification. Open Forum Infect Dis. 2020; 7:ofaa509.
Article
14. Rudroff T, Fietsam AC, Deters JR, Bryant AD, Kamholz J. Post-COVID-19 fatigue: potential contributing factors. Brain Sci. 2020; 10:1012.
Article
15. Miyazato Y, Morioka S, Tsuzuki S, Akashi M, Osanai Y, Tanaka K, et al. Prolonged and late-onset symptoms of Coronavirus Disease 2019. Open Forum Infect Dis. 2020; 7:ofaa507.
Article
16. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med. 2021; 27:626–31.
Article
17. Yelin D, Margalit I, Yahav D, Runold M, Bruchfeld J. Long COVID-19-it’s not over until? Clin Microbiol Infect. 2021; 27:506–8.
Article
18. Romero Starke K, Reissig D, Petereit-Haack G, Schmauder S, Nienhaus A, Seidler A. The isolated effect of age on the risk of COVID-19 severe outcomes: a systematic review with meta-analysis. BMJ Glob Health. 2021; 6:e006434.
Article
19. Zhang H, Wu Y, He Y, Liu X, Liu M, Tang Y, et al. Age-related risk factors and complications of patients with COVID-19: a population-based retrospective study. Front Med (Lausanne). 2022; 8:757459.
Article
20. Paneroni M, Simonelli C, Saleri M, Bertacchini L, Venturelli M, Troosters T, et al. Muscle strength and physical performance in patients without previous disabilities recovering from COVID-19 pneumonia. Am J Phys Med Rehabil. 2021; 100:105–9.
Article
21. Welch C, Greig C, Masud T, Wilson D, Jackson TA. COVID-19 and acute sarcopenia. Aging Dis. 2020; 11:1345–51.
Article
22. Tanriverdi A, Savci S, Kahraman BO, Ozpelit E. Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality. Ir J Med Sci. 2022; 191:969–75.
Article
23. Barbosa MH, Bolina AF, Luiz RB, de Oliveira KF, Virtuoso JS Jr, Rodrigues RA, et al. Body mass index as discriminator of the lean mass deficit and excess body fat in institutionalized elderly people. Geriatr Nurs. 2015; 36:202–6.
Article
24. Segura-Ortí E, Martínez-Olmos FJ. Test-retest reliability and minimal detectable change scores for sit-to-stand-to-sit tests, the six-minute walk test, the one-leg heel-rise test, and handgrip strength in people undergoing hemodialysis. Phys Ther. 2011; 91:1244–52.
Article
25. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166:111–7.
26. Balachandran AT, Vigotsky AD, Quiles N, Mokkink LB, Belio MA, Glenn JM. Validity, reliability, and measurement error of a sit-to-stand power test in older adults: a pre-registered study. Exp Gerontol. 2021; 145:111202.
Article
27. Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal consequences of COVID-19. J Bone Joint Surg Am. 2020; 102:1197–1204.
Article
28. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020; 181:271–80.e8.
Article
29. Benton DJ, Wrobel AG, Xu P, Roustan C, Martin SR, Rosenthal PB, et al. Receptor binding and priming of the spike protein of SARS-CoV-2 for membrane fusion. Nature. 2020; 588:327–30.
Article
30. Montes-Ibarra M, Oliveira CLP, Orsso CE, Landi F, Marzetti E, Prado CM. The impact of long COVID-19 on muscle health. Clin Geriatr Med. 2022; 38:545–57.
Article
31. Mittal J, Ghosh A, Bhatt SP, Anoop S, Ansari IA, Misra A. High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: a case-control study. Diabetes Metab Syndr. 2021; 15:102302.
Article
32. Akbarialiabad H, Taghrir MH, Abdollahi A, Ghahramani N, Kumar M, Paydar S, et al. Long COVID, a comprehensive systematic scoping review. Infection. 2021; 49:1163–86.
Article
33. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, ISARIC4C investigators, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020; 369:m1985.
Article
34. Ong KC, Ng AW, Lee LS, Kaw G, Kwek SK, Leow MK, et al. Pulmonary function and exercise capacity in survivors of severe acute respiratory syndrome. Eur Respir J. 2004; 24:436–42.
Article
35. Reeves WC, Lloyd A, Vernon SD, Klimas N, Jason LA, Bleijenberg G, International Chronic Fatigue Syndrome Study Group, et al. Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Serv Res. 2003; 3:25.
Article
36. Jennings G, Monaghan A, Xue F, Mockler D, Romero-Ortuño R. A systematic review of persistent symptoms and residual abnormal functioning following acute COVID-19: ongoing symptomatic phase vs. post-COVID-19 syndrome. J Clin Med. 2021; 10:5913.
Article
37. Jahn K, Sava M, Sommer G, Schumann DM, Bassetti S, Siegemund M, et al. Exercise capacity impairment after COVID-19 pneumonia is mainly caused by deconditioning. Eur Respir J. 2021; 59:2101136.
Article
38. Ferreira EVM, Oliveira RKF. Mechanisms of exercise intolerance after COVID-19: new perspectives beyond physical deconditioning. J Bras Pneumol. 2021; 47:e20210406.
39. Fagard RH, Cornelissen VA. Effect of exercise on blood pressure control in hypertensive patients. Eur J Cardiovasc Prev Rehabil. 2007; 14:12–7.
Article
40. Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee DC, et al. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circ Res. 2015; 117:207–19.
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