Mechanotherapy and virtual reality technologies in the rehabilitation of patients with post-covid syndrome: impact on endurance, muscle strength, gait and balance

Objective. To investigate the effectiveness of the use of mechanotherapy and virtual reality technologies in increasing muscle strength, motor activity and balance in patients with post-COVID syndrome.

Material and methods. The study included 120 patients who underwent a novel coronavirus infection COVID-19, aged 40 to 70 years, with manifestations of post-COVID syndrome. The rehabilitation program for patients of the main group (n=60) included 10 sessions on a robotic simulator with biofeedback for training the muscles of the lower extremities, 10 sessions of interactive balance therapy and 10 sessions on an interactive rehabilitation system with virtual reality technology against the background of basic treatment. In the control group (n=60), patients received only basic treatment. The effectiveness of the treatment was assessed using functional tests, stabilometry, assessment of walking speed on the C-mill ergometer, and tensodynamometry.

Results. Stabilometry indicators in the main group after the end of the rehabilitation course were significantly better than in the control group in terms of parameters: frontal deviation with open (χ²=13.8; p=0.000) and closed eyes (χ²=11.4; p=0.000) ; sagittal displacement with closed eyes (χ²=4.4; p=0.041); the speed of movement of the center of pressure with open (χ²=5.2; p=0.026); the rate of change in the area of the statokinesiogram with open (χ²=7.5; p=0.007) and closed eyes (χ²=7.1; p=0.009). Also, in the main group after treatment, the maximum extension force of the right leg was higher than in the control group (1245.5 N versus 1241 N; p=0.008) and the maximum extension force of the left leg (1471.5 N versus 1257 N; p=0.013). In patients in both groups, walking speed increased: from 1 m/s to 1.6 m/s on average in the main group (p<0.000); from 1.1 to 1.4 in the control (p<0.001), and the step length increased: from 0.37 m to 0.7 m (p<0.001) and from 0.45 to 0.6 m (p=0.019), respectively. In the dynamics in the main group, both indicators of both parameters were better than in the control group (p=0.013 and p=0.023, respectively).

Conclusion. The use of mechanotherapy and virtual reality technologies in the framework of medical rehabilitation programs for patients with post-COVID syndrome improves motor function, increases muscle strength, improves balance and gait quality.