PROPOSTA DI CONDOTTA TERAPEUTICA FISIOTERAPICA IN PAZIENTI CON POST COVID SYNDROME (PCS), UNA REVISIONE SISTEMATICA DELLA LETTERATURA

AIM: The goal of this dissertation, considering the data obtained from the scientific literature currently available, is to outline a proposal for a physiotherapeutic treatment for the management of Long Covid patients. In doing so, we will try to highlight the possible role of the physiotherapist in taking care of patients affected by this pluri-symptomatic condition. DEFINING THE PROBLEM: Since January 2020, the world of scientific research, medical clinics and health professionals has found itself having to face an invisible enemy that has unexpectedly upset world health. Initially, the management of acute infection required the expenditure of a lot of energy, economic resources and scientific investigations. Subsequently, medical science also had to deal with a large number of cases of Post Covid Syndrome which has led to a reduction in the wellness and quality of life of affected individuals. The fact that this topic is not well known makes it difficult both to understand the phenomena involved and the way to manage them. It is also the task of Rehabilitation to understand what and how many needs the patients affected by this condition have and how to intervene to solve them, reduce them or manage them. METHODS AND MATERIALS: The literature search was conducted by analyzing the databases of PubMEd, Cochrane Library, PEDro and Google Scholar. To structure a clinical question based on the foundations of Evidence Based Medicine, we were based on the PICO model, this acronym contains the 4 fundamental and useful elements to be analyzed for a safe research and is that they are: population, intervention, comparison, out come. Thanks to the creation of different research strings it was possible to analyze 43 articles and 38 sites, of these only 27 articles and 16 sites reported interesting and useful data for understanding the condition of PCS from a management and rehabilitation point of view. Based on the information obtained and simplified, it was possible to propose a physiotherapy rehabilitation treatment model for the management of these patients. RESULTS: All the studies analyzed that had PCS as their main theme reported a quantitative and qualitative reduction in the physical abilities of the affected patient, the onset of early fatigue and a reported disability in the performance of ADL. DISCUSSION: Although the literature is still devoid of concrete and objectified results regarding the need to subject a patient with LC to physiotherapy rehabilitation treatment, the indications and studies that have been carried out to date support the importance of this. Exercise has been proven for years to be the best contributor to good health. CONCLUSION: Patients with PCS, in particular all those patients who have sensory-motor damage due to direct infection of the microorganism, from the state of bed rest and sedentary lifestyle, must be directed to a physical, motor and sensitive reconditioning process. The Physiotherapist fits into this context, aiming to achieve the physical well-being of the patient suffering from Long Covid through a re-conditioning program for sensory and proprioceptive recovery.

L’obiettivo di questa tesi è quello di delineare una proposta di condotta terapeutica fisioterapica per la gestione dei pazienti long covid. Così facendo, si riuscirà a profilare il ruolo del fisioterapista nella presa in carico di pazienti affetti da questa condizione pluri sintomatologica. Da gennaio del 2020 ci si è ritrovati a dover fronteggiare un nemico invisibile che ha inaspettatamente sconvolto la sanità mondiale. Inizialmente la gestione dell’infezione acuta ha richiesto il dispendio di molte energie, risorse economiche e indagini scientifiche. Successivamente si sono verificati anche i primi casi di Sindrome Post Covid che ha portato ad una riduzione del benessere e della qualità della vita degli individui affetti. Il fatto che questo argomento sia ancora così poco conosciuto ne rende difficile la gestione. Ma per quanto possa essere nuovo e complicato, il fisioterapista, così come tutte le figure sanitarie, opera per il benessere del singolo e della collettività. E’ nostro compito capire quali e quanti bisogni hanno i pazienti affetti e come intervenire per risolverli, ridurli o gestirli