Do Patients With COVID-19 Benefit from Rehabilitation? Functional Outcomes of the First 100 Patients in a COVID-19 Rehabilitation Unit - Archive ouverte HAL
Article Dans Une Revue Archives of Physical Medicine and Rehabilitation Année : 2021

Do Patients With COVID-19 Benefit from Rehabilitation? Functional Outcomes of the First 100 Patients in a COVID-19 Rehabilitation Unit

Violaine Piquet
  • Fonction : Auteur
Cédric Luczak
  • Fonction : Auteur
Fabien Seiler
  • Fonction : Auteur
Jordan Monaury
  • Fonction : Auteur
Alexandre Martini
  • Fonction : Auteur
Anthony Ward
  • Fonction : Auteur
Jean-Michel Gracies
  • Fonction : Auteur
Damien Motavasseli
  • Fonction : Auteur
Violaine Piquet
  • Fonction : Auteur
Cédric Luczak
  • Fonction : Auteur
Fabien Seiler
  • Fonction : Auteur
Jordan Monaury
  • Fonction : Auteur
Estelle Lépine
  • Fonction : Auteur
Lucile Chambard
  • Fonction : Auteur
Alexandre Martini
  • Fonction : Auteur
Andrés Samaniego
  • Fonction : Auteur
Nicolas Bayle
  • Fonction : Auteur
Anthony Ward
  • Fonction : Auteur
Jean-Michel Gracies
  • Fonction : Auteur
Damien Motavasseli
  • Fonction : Auteur

Résumé

Background and Purpose: Guided self-rehabilitation contracts (GSCs) are a diary-based rehabilitation strategy, wherein specific muscles are identified for prescription of high-load, home self-stretching techniques. We assessed the effect of GSCs combined with simultaneous upper limb (UL) and lower limb (LL) abobotulinumtoxinA injections on composite active range of motion (CX A ) in adults with chronic spastic paresis. Methods: This was an international, prospective, single-arm, open-label study (ENGAGE, NCT02969356). Personalized GSCs were monitored by phone every other week, alongside 2 consecutive abobotulinumtoxinA injections (1500 U) across UL and LL, over 6 to 9 months. Primary outcomes were responder rates (CX A improvement ≥35° [UL] or ≥5° [LL]) at week 6 cycle 2. Secondary outcomes were active function (UL: Modified Frenchay Scale [MFS]; LL: 10-m barefoot maximal walking speed [WS]) and quality of life (12-item Short Form Health Survey, SF-12). Results: Of the 153 treated participants, 136 had primary endpoint data; 72.1% (95% confidence interval [CI], 64.0-78.9) were responders. Mean (SD) CX A changes from baseline to last study visit were +49.3° (63.4) for UL and +20.1° (27.6) for LL. Mean (95% CI) changes from baseline to week 12 cycle 2 were +0.55 (0.43-0.66) in MFS, +0.12 m/s (0.09-0.15) for WS, and +4.0 (2.8-5.2) for SF-12 physical scores. In the safety population (n = 157), 49.7% of participants reported treatment-emergent adverse events (AEs); 12.1% reported 25 serious AEs. Discussion and Conclusions: GSC combined with simultaneous UL and LL abobotulinumtoxinA injections led to improvements in CX A and function in both limbs, and quality-of-life physical scores. These results suggest the beneficial effect of combined GSC and abobotulinumtoxinA therapy in the management of spastic paresis. Video Abstract available for more insight from the authors (see the Supplementary Video, available at: http://links.lww.com/JNPT/A346).
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hal-04293527 , version 1 (22-07-2024)

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Violaine Piquet, Cédric Luczak, Fabien Seiler, Jordan Monaury, Alexandre Martini, et al.. Do Patients With COVID-19 Benefit from Rehabilitation? Functional Outcomes of the First 100 Patients in a COVID-19 Rehabilitation Unit. Archives of Physical Medicine and Rehabilitation, 2021, 102 (6), pp.1067-1074. ⟨10.1016/j.apmr.2021.01.069⟩. ⟨hal-04293527⟩

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