Postural balance assessment and its association with quality of life and functionality in individuals after COVID-19 infection

Abstract

Introduction: As some countries relaxed restrictive measures and allowed the return of activities, while still maintaining social distancing policies, questions arose about the impacts of the post-COVID-19 period on patients with sequelae of the disease. As the pandemic spread throughout the world, different forms of neurological involvement of SARS-CoV-2 infection were described, including reports of myoclonus and opsoclonus, as well as cases of acute demyelinating polyradiculopathy possibly associated with immune-mediated phenomena. Furthermore, there are reported cases of ataxia, stroke related to antiphospholipid antibodies and Guillain-Barré syndrome. With this in mind, there was a need to investigate whether there are changes in postural balance after the acute phase of COVID-19, since the virus causes numerous changes in the body, which, once infected, may have several functional sequelae. Objective: The objective of the present study was to evaluate the body balance in individuals after the period of contamination by COVID-19 and, secondarily, to evaluate the association of body balance with quality of life (QoL) and functionality. Methods: This is a cross-sectional study, in which 40 patients with post-COVID-19 syndrome (PCS) and 40 matched controls who did not have SARS-CoV-2 infection were evaluated. To assess QOL, the Brazilian version of the SF-36 QL questionnaire was used, to assess body balance, the Tinetti scale and the Berg scale were used, to assess fatigue, the Functional Assessment of Chronic Illness Therapy (FACIT- F) and to measure the maximum voluntary handgrip strength (handgrip) a manual dynamometer was used. Results: When compared to controls, patients with CPS had lower scores on both the Tinetti scale and the Berg scale (P = 0.001 for both). The FACIT-F scale score was lower in patients than in controls (P = 0.0001). Handgrip was lower in patients compared to controls, although there was no significant difference (P = 0.71). Regarding QoL, patients showed worse evaluations in several dimensions of the SF-36. Both the Berg scale and the Tinetti scale correlated significantly with the FACIT-F scale, handgrip and SF-36 dimensions. Conclusion: The results indicate that patients with PCS show worse body balance, which points to a greater risk of falls. In these patients, there is greater general fatigue and worse QOL. Furthermore, balance control is associated with general fatigue, handgrip and QOL. Thus, routine assessment of balance control should be considered in the follow-up of these patients.