Monitored Home-based Exercise Rehabilitation for Patient with Chronic Respiratory and Cardiovascular Diseases During Covid-19 Pandemic: A Case Report

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Arnengsih Nazir
Marina Annette Moeliono

Abstract

ABSTRACTIntroduction: In patients with Chronic Obstructive Pulmonary Disease (COPD), due to shared-risk factors, concomitant chronic cardiovascular diseases include Congestive Heart Failure (CHF) are common and resulting in increase overall morbidity and mortality.Case Report: A female patient, 52 years, came for pulmonary rehabilitation 2 weeks after hospitalization due to acute exacerbation of COPD. One week before the exacerbation, she showed symptoms of CHF. Physical examination showed signs of right and left heart failure, oxygen desaturation, and limited chest expansion. Functional assessment showed disability in self-care, instrumental activities of daily living (ADL), deconditioning, depression, and anxiety. Supporting examination confirmed very severe restriction and obstruction, bronchopneumonia, cardiomegaly, and pulmonary hypertension. Rehabilitation problems include cardiorespiratory, ADL, and psychological problems. The Covid-19 pandemic causing prohibition of supervised cardiorespiratory rehabilitation. Home-based exercise program was given for 5 months. Monitoring was done via video call before and after each exercise and through analysis of exercise diary. Psychological counseling also given at the beginning of the program. Patient did all of prescribed exercises. At the end, symptoms decreased, patient can do ADL and hobbies, no exacerbation or exercise intolerance, patient does not look anxious and consents to leisure activities.Conclusion: Monitored-home based exercise programs can be used as safely alternative to hospitalbased, if done according to the prescription. However , monitoring by physician is mandatory.Keywords: chronic obstructive pulmonary disease, congestive heart failure, covid-19 pandemic, homebased exercise, rehabilitation

Article Details

Section
Case Report
Author Biographies

Arnengsih Nazir, Staff Medical

Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine Universitas Padjadjaran, Jl. Pasteur No. 38 Bandung, Indonesia

Marina Annette Moeliono, Staff Medical

Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine Universitas Padjadjaran, Jl. Pasteur No. 38 Bandung, Indonesia, 40161