Neurological changes and physiotherapeutic performance in patients after COVID-19

Abstract

COVID-19 is a pathology associated with the new coronavirus that has large-scale dissemination, resulting in a pandemic on 11/03/2020. Thus, it is worth emphasizing the importance of adopting measures such as social distancing, hand antisepsis and the use of masks, special attention with the elderly and people with comorbidities (risk groups), in addition to the relevance of testing, especially of symptomatic patients, as prophylactic measures, contributing to the attenuation of the progress of the pandemic. The general objective of the research is to discuss the physical therapy intervention, highlighting the method of proprioceptive neuromuscular facilitation, in view of the neurological manifestations of the central nervous system, with emphasis on stroke, in patients after COVID-19, and as specific objectives to describe the methods of prevention against this disease, to understand the anatomophysiology of the central nervous system, such as discussing about performing neurological physiotherapeutic evaluation in patients after COVID-19, in addition to the methods of diagnosis of this disease, its etiology and biomechanics and to understand how the physical therapist's action occurs in these cases, either in person or by telemonitoring, teleconsultation and teleconsulting due to the current scenario, and can then outline a physiotherapeutic prognosis. Therefore, the present work is an integrative review and for the accomplishment of this study were used the following descriptors: "neurological alterations", "therapeutic performance", "COVID-19", "stroke" and "proprioceptive neuromuscular facilitation" in languages such as Portuguese and English. The work was carried out between the months of August and November 2020, since in that period a systematic research was carried out on the topic of work. Studies published between the years 2010 to 2020 were used, but with a predominance of studies from the year 2020, in databases such as: LILACS, MEDLINE/PubMed and SciELO. Therefore, the new coronavirus can cause systemic changes, taking into account especially the neurological manifestations in the central nervous system of patients after COVID-19, requiring neurofunctional evaluation and physical therapy intervention. That said, it is possible to observe that although the main clinical characteristic of COVID-19 is respiratory, there are also neurological complications and in other systems that are related to the presence of receptors for angiotensin-2-converter enzyme, and neurological deficits due to cerebrovascular disease in patients after COVID-19 may occur more pronouncedly in the acute phase and in the most severe form of the disease. Thus, in order to mitigate the severity of neurological complications and sequelae resulting from COVID-19, the physiotherapist participates in both prevention and health promotion, with physical therapy intervention being performed in person or through telemonitoring, teleconsultation and teleconsulting, in search of a promising prognosis for patient’s victims of COVID-19. However, in view of the neurological alterations manifested in patients after COVID-19, the physiotherapist will have an indispensable role to play in order to bring functionality and improve the quality of life of these patients, reinserting them into society after significant rehabilitation.