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.	國家衛生健康委辦公廳, 國家中醫藥管理局辦公室. 關于印發新型冠狀病毒肺炎診療方案(試行第七版)的通知. (2020-03-03)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2.	國家衛生健康委, 民政部, 國家醫療保障局, 國家中醫藥管理局. 關于印發新冠肺炎出院患者主要功能障礙康復治療方案的通知. (2020-05-13)[2020-05-18]. http://www.nhc.gov.cn/yzygj/s7653pd/202005/b15d59b5228341129cc8c5126f663b10.shtml.
3.	中國康復醫學會. 基于新型冠狀病毒肺炎的呼吸道感染性疾病疫情期間康復診療專家共識. 中華物理醫學與康復雜志.(2020-03-02)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183309.htm.
4.	賴克方. 慢性咳嗽. 北京: 人民衛生出版社, 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.	中國醫師協會呼吸醫師分會肺功能與臨床呼吸生理工作委員會, 中華醫學會呼吸病學分會呼吸治療學組肺功能專業組. 新型冠狀病毒肺炎疫情防控期間開展肺功能檢查的專家共識. 中華結核和呼吸雜志. (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.	劉茜, 王榮帥, 屈國強, 等. 新型冠狀病毒肺炎死亡尸體系統解剖大體觀察報告. 法醫學雜志, 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.	管漢雄, 熊穎, 申楠茜, 等. 新型冠狀病毒肺炎(COVID-19)臨床影像學特征. 放射學實踐, 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.	李魯, 王紅妹, 沈毅. SF-36健康調查量表中文版的研制及其性能測試. 中華預防醫學雜志, 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.	國家衛生健康委辦公廳. 關于印發醫療機構內新型冠狀病毒感染預防與控制技術指南(第一版)的通知. (2020-01-23)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml.
17.	疾病預防控制局. 關于印發新型冠狀病毒感染的肺炎疫情緊急心理危機干預指導原則的通知. (2020-01-27)[2020-04-13]. http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b2b791be5c3b9467.shtml.
18.	中國康復醫學會, 中國康復醫學會呼吸康復專委會, 中華醫學會物理醫學與康復學分會心肺康復學組. 2019新型冠狀病毒肺炎呼吸康復指導意見(第二版). 中華結核和呼吸雜志. (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.	喻鵬銘, 何成奇, 高強, 等. 新型冠狀病毒肺炎患者全周期物理治療操作規范和建議. 中華物理醫學與康復雜志, 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.	于愷英, 石漢平. 《關于新型冠狀病毒肺炎患者的醫學營養治療專家建議》解讀. 中華醫學雜志, 2020, 100: E005-E005.
28.	中華醫學會腸外腸內營養學分會. 中華醫學會腸外腸內營養學分會（CSPEN）《關于新型冠狀病毒肺炎患者的醫學營養治療專家建議》. (2020-01-30)[2020-04-13]. https://www.cma.org.cn/art/2020/1/30/art_15_32196.html.
29.	中華醫學會腸外腸內營養學分會. 新型冠狀病毒肺炎重癥患者的腸內腸外營養治療專家建議. 中華醫學雜志, 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. 國家衛生健康委辦公廳, 國家中醫藥管理局辦公室. 關于印發新型冠狀病毒肺炎診療方案(試行第七版)的通知. (2020-03-03)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2. 國家衛生健康委, 民政部, 國家醫療保障局, 國家中醫藥管理局. 關于印發新冠肺炎出院患者主要功能障礙康復治療方案的通知. (2020-05-13)[2020-05-18]. http://www.nhc.gov.cn/yzygj/s7653pd/202005/b15d59b5228341129cc8c5126f663b10.shtml.
3. 中國康復醫學會. 基于新型冠狀病毒肺炎的呼吸道感染性疾病疫情期間康復診療專家共識. 中華物理醫學與康復雜志.(2020-03-02)[2020-04-13]. http://rs.yiigle.com/yufabiao/1183309.htm.
4. 賴克方. 慢性咳嗽. 北京: 人民衛生出版社, 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. 中國醫師協會呼吸醫師分會肺功能與臨床呼吸生理工作委員會, 中華醫學會呼吸病學分會呼吸治療學組肺功能專業組. 新型冠狀病毒肺炎疫情防控期間開展肺功能檢查的專家共識. 中華結核和呼吸雜志. (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. 劉茜, 王榮帥, 屈國強, 等. 新型冠狀病毒肺炎死亡尸體系統解剖大體觀察報告. 法醫學雜志, 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. 管漢雄, 熊穎, 申楠茜, 等. 新型冠狀病毒肺炎(COVID-19)臨床影像學特征. 放射學實踐, 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. 李魯, 王紅妹, 沈毅. SF-36健康調查量表中文版的研制及其性能測試. 中華預防醫學雜志, 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. 國家衛生健康委辦公廳. 關于印發醫療機構內新型冠狀病毒感染預防與控制技術指南(第一版)的通知. (2020-01-23)[2020-04-13]. http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml.
17. 疾病預防控制局. 關于印發新型冠狀病毒感染的肺炎疫情緊急心理危機干預指導原則的通知. (2020-01-27)[2020-04-13]. http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b2b791be5c3b9467.shtml.
18. 中國康復醫學會, 中國康復醫學會呼吸康復專委會, 中華醫學會物理醫學與康復學分會心肺康復學組. 2019新型冠狀病毒肺炎呼吸康復指導意見(第二版). 中華結核和呼吸雜志. (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. 喻鵬銘, 何成奇, 高強, 等. 新型冠狀病毒肺炎患者全周期物理治療操作規范和建議. 中華物理醫學與康復雜志, 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. 于愷英, 石漢平. 《關于新型冠狀病毒肺炎患者的醫學營養治療專家建議》解讀. 中華醫學雜志, 2020, 100: E005-E005.
28. 中華醫學會腸外腸內營養學分會. 中華醫學會腸外腸內營養學分會（CSPEN）《關于新型冠狀病毒肺炎患者的醫學營養治療專家建議》. (2020-01-30)[2020-04-13]. https://www.cma.org.cn/art/2020/1/30/art_15_32196.html.
29. 中華醫學會腸外腸內營養學分會. 新型冠狀病毒肺炎重癥患者的腸內腸外營養治療專家建議. 中華醫學雜志, 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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Experts consensus on rehabilitation of coronavirus disease 2019

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