Effectiveness of upper arm and breathing exercises to improve inflammatory markers in severe COVID-19 patients

Amira P. Tarigan; Ruby  Firdaus; Pandiaman  Pandia; Andika  Pradana; Muntasir  Abdullah; Sudirman P. Sinaga; Wahyu  Wijanarko; Bibit  Triwahyudi; Yeni  Vera; Maryaningsih Maryaningsih; Putri C. Eyanoer; Aditya S.  Listyoko

doi:10.52225/narra.v4i1.417

Authors

Amira P. Tarigan Divison of Asthma COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0003-1744-1833
Ruby Firdaus Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-7361-3284
Pandiaman Pandia Divison of Asthma COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Andika Pradana Divison of Asthma COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-7761-2086
Muntasir Abdullah Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Sudirman P. Sinaga Department of Medical Rehabilitation, H. Adam Malik Central General Hospital, Medan, Indonesia
Wahyu Wijanarko Faculty of Physiotherapy, SekolahTinggi Ilmu Kesehatan Siti Hajar, Medan, Indonesia
Bibit Triwahyudi Faculty of Physiotherapy, SekolahTinggi Ilmu Kesehatan Siti Hajar, Medan, Indonesia
Yeni Vera Faculty of Physiotherapy, Sekolah Tinggi Ilmu Kesehatan Siti Hajar, Medan, Indonesia https://orcid.org/0000-0002-2249-1934
Maryaningsih Maryaningsih Faculty of Physiotherapy, Sekolah Tinggi Ilmu Kesehatan Siti Hajar, Medan, Indonesia
Putri C. Eyanoer Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Aditya S. Listyoko Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan https://orcid.org/0000-0002-6811-7163

DOI:

https://doi.org/10.52225/narra.v4i1.417

Keywords:

COVID-19, pulmonary rehabilitation, upper arm exercise, breathing exercise, C-reactive protein

Abstract

Studies have suggested associations between inflammatory markers with the severity of coronavirus disease 2019 (COVID-19). Therefore, exercises that could reduce the level of inflammatory markers might be beneficial. The aim of this study was to determine the effect of upper arms and breathing exercises on inflammatory markers such as ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in severe COVID-19 patients. A quasi-experimental with pre-test and post-test control group design was conducted among severe COVID-19 aged 18–70 years old, with or without comorbidities. Baseline data of inflammatory markers (ferritin, LDH, and CRP) were measured before the exercises and repeated post-exercise. The upper arm and breathing exercises were performed for ten days, twice a day (morning and evening) for ten minutes. A paired Student t-test was used to assess the changes in the inflammatory markers’ levels. Our data indicated that levels of ferritin and CRP were not significantly different between pre- and post-exercise. However, the level of LDH decreased significantly from 481.35 U/L to 331.80 U/L (p=0.001). This study highlights that pulmonary rehabilitation exercises might be beneficial to enhance the recovery process in severe COVID-19 patients.