Experts consensus on rehabilitation of coronavirus disease 2019_West China Medical Journal

Authors：

 Chinese Medical Association Physical Medicine and Rehabilitation Branch

Corresponding author：

Chinese Medical Association Physical Medicine and Rehabilitation Branch, Email: hxkfhcq@126.com

Keywords：

Coronavirus disease 2019; Rehabilitation; Experts consensus

DOI：

10.7507/1002-0179.202004191

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Previous studies have shown that rehabilitation can relieve clinical symptoms, prevent complications, and improve physical function and quality of life in patients with pneumonia. This consensus summarizes the rehabilitation assessment, self-protection, rehabilitation goals, rehabilitation programs, indications for termination of treatment, nutrition support and psychological rehabilitation for patients with mild, moderate, severe and critical types of coronavirus disease 2019 based on the relevant literature and previous practice of coronavirus disease 2019. We hope this consensus can provide a reference for rehabilitation of coronavirus disease 2019.

Citation： Chinese Medical Association Physical Medicine and Rehabilitation Branch. Experts consensus on rehabilitation of coronavirus disease 2019. West China Medical Journal, 2020, 35(5): 505-512. doi: 10.7507/1002-0179.202004191 Copy

1.	国家卫生健康委办公厅, 国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. (2020-03-03)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2.	国家卫生健康委, 民政部, 国家医疗保障局, 国家中医药管理局. 关于印发新冠肺炎出院患者主要功能障碍康复治疗方案的通知. (2020-05-13)[2020-05-18]. http://www.nhc.gov.cn/yzygj/s7653pd/202005/b15d59b5228341129cc8c5126f663b10.shtml.
3.	中国康复医学会. 基于新型冠状病毒肺炎的呼吸道感染性疾病疫情期间康复诊疗专家共识. 中华物理医学与康复杂志.(2020-03-02)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183309.htm.
4.	赖克方. 慢性咳嗽. 北京: 人民卫生出版社, 2008: 51-52.
5.	Johnson MJ, Close L, Gillon SC, et al. Use of the modified Borg scale and numerical rating scale to measure chronic breathlessness: a pooled data analysis. Eur Respir J, 2016, 47(6): 1861-1864.
6.	中国医师协会呼吸医师分会肺功能与临床呼吸生理工作委员会, 中华医学会呼吸病学分会呼吸治疗学组肺功能专业组. 新型冠状病毒肺炎疫情防控期间开展肺功能检查的专家共识. 中华结核和呼吸杂志. (2020-03-04)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183736.htm.
7.	Hough CL, Lieu BK, Caldwell ES. Manual muscle strength testing of critically ill patients: feasibility and interobserver agreement. Crit Care, 2011, 15(1): R43.
8.	刘茜, 王荣帅, 屈国强, 等. 新型冠状病毒肺炎死亡尸体系统解剖大体观察报告. 法医学杂志, 2020, 36(1): 19-21.
9.	Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
10.	Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, 2020, 382(18): 1708-1720.
11.	管汉雄, 熊颖, 申楠茜, 等. 新型冠状病毒肺炎(COVID-19)临床影像学特征. 放射学实践, 2020(2): 125-130.
12.	Corner EJ, Wood H, Englebretsen C, et al. The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy, 2013, 99(1): 33-41.
13.	李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试. 中华预防医学杂志, 2002, 36(2): 109-113.
14.	Garrod R, Bestall JC, Paul EA, et al. Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living Scale (LCADL). Respir Med, 2000, 94(6): 589-596.
15.	Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 2020, 323(13): 1239-1242.
16.	国家卫生健康委办公厅. 关于印发医疗机构内新型冠状病毒感染预防与控制技术指南(第一版)的通知. (2020-01-23)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml.
17.	疾病预防控制局. 关于印发新型冠状病毒感染的肺炎疫情紧急心理危机干预指导原则的通知. (2020-01-27)[2020-04-13]. http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b2b791be5c3b9467.shtml.
18.	中国康复医学会, 中国康复医学会呼吸康复专委会, 中华医学会物理医学与康复学分会心肺康复学组. 2019新型冠状病毒肺炎呼吸康复指导意见(第二版). 中华结核和呼吸杂志. (2020-03-03)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183323.htm.
19.	Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.
20.	Fuest K, Schaller SJ. Recent evidence on early mobilization in critical-Ⅲ patients. Curr Opin Anaesthesiol, 2018, 31(2): 144-150.
21.	Fossat G, Baudin F, Courtes L, et al. Effect of in-bed leg cycling and electrical stimulation of the quadriceps on global muscle strength in critically Ⅲ adults: a randomized clinical trial. JAMA, 2018, 320(4): 368-378.
22.	喻鹏铭, 何成奇, 高强, 等. 新型冠状病毒肺炎患者全周期物理治疗操作规范和建议. 中华物理医学与康复杂志, 2020, 42(2): 102-104.
23.	Bissett B, Leditschke IA, Green M, et al. Inspiratory muscle training for intensive care patients: a multidisciplinary practical guide for clinicians. Aust Crit Care, 2019, 32(3): 249-255.
24.	Vorona S, Sabatini U, Al-Maqbali S, et al. Inspiratory muscle rehabilitation in critically Ⅲ adults. A systematic review and meta-analysis. Ann Am Thorac Soc, 2018, 15(6): 735-744.
25.	Tonella RM, Ratti LDSR, Delazari LEB, et al. Inspiratory muscle training in the intensive care unit: a new perspective. J Clin Med Res, 2017, 9(11): 929-934.
26.	Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil, 2015, 29(11): 1051-1063.
27.	于恺英, 石汉平. 《关于新型冠状病毒肺炎患者的医学营养治疗专家建议》解读. 中华医学杂志, 2020, 100: E005-E005.
28.	中华医学会肠外肠内营养学分会. 中华医学会肠外肠内营养学分会（CSPEN）《关于新型冠状病毒肺炎患者的医学营养治疗专家建议》. (2020-01-30)[2020-04-13]. https://www.cma.org.cn/art/2020/1/30/art_15_32196.html.
29.	中华医学会肠外肠内营养学分会. 新型冠状病毒肺炎重症患者的肠内肠外营养治疗专家建议. 中华医学杂志, 2020, 100: E009-E009.
30.	Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: a randomized controlled study. Complement Ther Clin Pract, 2020, 5(39): 101166.
31.	Carda S, Invernizzi M, Bavikatte G, et al. The role of physical and rehabilitation medicine in the COVID-19 pandemic: the clinician’s view. Ann Phys Rehabil Med, 2020, 4(18): S1877-0657(20)30076-2.

1. 国家卫生健康委办公厅, 国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. (2020-03-03)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2. 国家卫生健康委, 民政部, 国家医疗保障局, 国家中医药管理局. 关于印发新冠肺炎出院患者主要功能障碍康复治疗方案的通知. (2020-05-13)[2020-05-18]. http://www.nhc.gov.cn/yzygj/s7653pd/202005/b15d59b5228341129cc8c5126f663b10.shtml.
3. 中国康复医学会. 基于新型冠状病毒肺炎的呼吸道感染性疾病疫情期间康复诊疗专家共识. 中华物理医学与康复杂志.(2020-03-02)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183309.htm.
4. 赖克方. 慢性咳嗽. 北京: 人民卫生出版社, 2008: 51-52.
5. Johnson MJ, Close L, Gillon SC, et al. Use of the modified Borg scale and numerical rating scale to measure chronic breathlessness: a pooled data analysis. Eur Respir J, 2016, 47(6): 1861-1864.
6. 中国医师协会呼吸医师分会肺功能与临床呼吸生理工作委员会, 中华医学会呼吸病学分会呼吸治疗学组肺功能专业组. 新型冠状病毒肺炎疫情防控期间开展肺功能检查的专家共识. 中华结核和呼吸杂志. (2020-03-04)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183736.htm.
7. Hough CL, Lieu BK, Caldwell ES. Manual muscle strength testing of critically ill patients: feasibility and interobserver agreement. Crit Care, 2011, 15(1): R43.
8. 刘茜, 王荣帅, 屈国强, 等. 新型冠状病毒肺炎死亡尸体系统解剖大体观察报告. 法医学杂志, 2020, 36(1): 19-21.
9. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
10. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, 2020, 382(18): 1708-1720.
11. 管汉雄, 熊颖, 申楠茜, 等. 新型冠状病毒肺炎(COVID-19)临床影像学特征. 放射学实践, 2020(2): 125-130.
12. Corner EJ, Wood H, Englebretsen C, et al. The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy, 2013, 99(1): 33-41.
13. 李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试. 中华预防医学杂志, 2002, 36(2): 109-113.
14. Garrod R, Bestall JC, Paul EA, et al. Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living Scale (LCADL). Respir Med, 2000, 94(6): 589-596.
15. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 2020, 323(13): 1239-1242.
16. 国家卫生健康委办公厅. 关于印发医疗机构内新型冠状病毒感染预防与控制技术指南(第一版)的通知. (2020-01-23)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml.
17. 疾病预防控制局. 关于印发新型冠状病毒感染的肺炎疫情紧急心理危机干预指导原则的通知. (2020-01-27)[2020-04-13]. http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b2b791be5c3b9467.shtml.
18. 中国康复医学会, 中国康复医学会呼吸康复专委会, 中华医学会物理医学与康复学分会心肺康复学组. 2019新型冠状病毒肺炎呼吸康复指导意见(第二版). 中华结核和呼吸杂志. (2020-03-03)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183323.htm.
19. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.
20. Fuest K, Schaller SJ. Recent evidence on early mobilization in critical-Ⅲ patients. Curr Opin Anaesthesiol, 2018, 31(2): 144-150.
21. Fossat G, Baudin F, Courtes L, et al. Effect of in-bed leg cycling and electrical stimulation of the quadriceps on global muscle strength in critically Ⅲ adults: a randomized clinical trial. JAMA, 2018, 320(4): 368-378.
22. 喻鹏铭, 何成奇, 高强, 等. 新型冠状病毒肺炎患者全周期物理治疗操作规范和建议. 中华物理医学与康复杂志, 2020, 42(2): 102-104.
23. Bissett B, Leditschke IA, Green M, et al. Inspiratory muscle training for intensive care patients: a multidisciplinary practical guide for clinicians. Aust Crit Care, 2019, 32(3): 249-255.
24. Vorona S, Sabatini U, Al-Maqbali S, et al. Inspiratory muscle rehabilitation in critically Ⅲ adults. A systematic review and meta-analysis. Ann Am Thorac Soc, 2018, 15(6): 735-744.
25. Tonella RM, Ratti LDSR, Delazari LEB, et al. Inspiratory muscle training in the intensive care unit: a new perspective. J Clin Med Res, 2017, 9(11): 929-934.
26. Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil, 2015, 29(11): 1051-1063.
27. 于恺英, 石汉平. 《关于新型冠状病毒肺炎患者的医学营养治疗专家建议》解读. 中华医学杂志, 2020, 100: E005-E005.
28. 中华医学会肠外肠内营养学分会. 中华医学会肠外肠内营养学分会（CSPEN）《关于新型冠状病毒肺炎患者的医学营养治疗专家建议》. (2020-01-30)[2020-04-13]. https://www.cma.org.cn/art/2020/1/30/art_15_32196.html.
29. 中华医学会肠外肠内营养学分会. 新型冠状病毒肺炎重症患者的肠内肠外营养治疗专家建议. 中华医学杂志, 2020, 100: E009-E009.
30. Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: a randomized controlled study. Complement Ther Clin Pract, 2020, 5(39): 101166.
31. Carda S, Invernizzi M, Bavikatte G, et al. The role of physical and rehabilitation medicine in the COVID-19 pandemic: the clinician’s view. Ann Phys Rehabil Med, 2020, 4(18): S1877-0657(20)30076-2.

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