Efek Latihan Lengan Atas dan Latihan Napas terhadap Marker Inflamasi pada Pasien Covid-19 Derajat Berat di RSUP H. Adam Malik Medan

Abstract

Background: Lungs are the organ that is most affected by COVID-19, and it may cause impaired lung function. Pulmonary rehabilitation in COVID-19 patients aims to improve dyspnea symptoms, relieve anxiety, reduce complications, minimize disability, and improve quality of life. This study aims to determine the effect of upper-arm and breathing exercise on the inflammatory markers in severe COVID-19 patients. Methods : This study is a clinical trial with a quasi-experimental pre-test/post-test control group design with inclusion criteria. This study was conducted in Adam Malik General Hospital, Medan, Sumatera Utara, Indonesia. The criteria were patients with severe COVID-19 aged 18-70 years old, can be with or without comorbidities, and. The patients using High Flow Nasal Canule (HFNC), experiencing loss of consciousness and mental disorders, were excluded from this study. All subjects underwent laboratory tests for inflammatory markers, such as ferritin, LDH, CRP, and procalcitonin baseline before exercise. The upper-arm and breathing exercise were performed for ten days, twice a day (morning and evening) with the guidance of watching videos from a cell phone. Then repeated inflammatory markers examinations were performed. We used paired T-test to analyzed the data using SPSS version 22. Result: From the 20 severe COVID-19 patients who performed upper-arm and breathing exercise, the average ferritin levels before exercise was 1358.81 ± 663.31 and after exercise was 1207 ± 872 (p = 0.299). The LDH levels before exercise and after exercise were accounted for 481.35 ± 206.42 and 331.80 ± 103.95 (p=0.01) respectively. The CRP levels before exercise were 2.83 ± 6.11 and after exercise were 0.96 ± 0.53 (p=0.183). Meanwhile, the procalcitonin level before exercise was 0.78 ± 1.83 and after exercise was 1.89 ± 6.94 (p=0.354). Conclusion: A significant improvement in LDH levels was found, however; there was no improvement in ferritin, CRP and procalcitonin levels in this study.