NMC Provita- UAE best post-acute care and rehabilitation services

                 In this Covid Pandemic Situation, the survivors were really meant to be lucky. Following the safety guidelines like the vaccination Programs, washing the hands, using the mask, avoiding the crowds really saved peoples from getting covid infection. Even though we had a lot of successful outcomes, a few people affected with covid faced really a different kind of disabilities than usual. One of its kind is post covid peripheral neuropathy or polyneuropathy, which is also termed as critical illness myopathy.

Recent studies showed that few patients after post covid infection who had an ICU stay for more than a month resulted in some kind of Muscle weakness, unexplained fatigue/exertional intolerance and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy affecting the small-fiber (sensory/autonomic) axons.

                Our Patient Mr. Ali Saleh Abdelrahman is belong to such kind, He was a 58 year old Jordanian male, working as a supervisor at Emirates steel industry in Abu Dhabi. He was initially developed severe breathing difficulty and he was immediately admitted to a private hospital (Phoenix hospital) where he was found to be having acute respiratory failure followed by covid infection, he was intubated immediately on 5th july,2022 and transferred to SSMC for further treatment, there he was extubated successfully on 14th Aug. He was then transferred to our NMC Provita facility on Sept 1st 2022 for inpatient rehabilitation program. This patient was also having a history of Diabetes/ HTN/ CHF with dilative cardiomyopathy with EF 20%.

              During admission, our patient was supported with O2 cannula with 2-3 Litres continuously, NG tube fed, showed a left sided generalized muscle weakness with poor sitting balance, BP fluctuations and desaturation risks. He was awake, alert and oriented, can follow commands and can express himself verbally in Arabic and English. He wasn’t able to sit up from the bed independently. He needed a moderate assistance for standing and balance self. Complained numbness over the left limbs and Pain on the left shoulder and knee joints. Initially he was able to roll both sides of the bed with moderate assistance to sitting on edge of bed.  Initially he was able to help out in slide board transfer with maximal assistance. His cardiovascular endurance was poor. He was getting tired easily. His active range of motion was affected in the bilateral hips and left side shoulder. His Muscle strength was grossly graded as 3/5 on the Right side extremities except the Hip Flexion and abduction scored 2/5. In his left side extremity shoulder 2/5, elbows and wrist 3/5, hip flexion 1/5, abduction 2/5, knee and ankles scored 3/5. He was completely dependent in his ADLs and mobility.

             Ali Saleh received intensive Physiotherapy, Occupational Therapy and Speech and language therapy over his course of stay. Regular goal planning meetings were conducted with the team and patient’s family. He was progressive on all aspects of his physical performance such as endurance, breathing capacity, overall muscle strength, sit to stand, balance and ambulation

               Upon discharge on October 21, 2022, he has improved all his gross motor functions, he was able to sit, stand and walk independently without any device for longer periods of time with 800m at a stretch.  His left upper limb ROM and power has improved as well as he can reach now objects with more ease and comfort .He was also weaned off from Oxygen support on all his activities. He is tolerating oral feeding well with no signs of aspiration and NG tube was successfully removed. He is able to do stairs independently as well.  He is independent in all aspects of his activities of daily living (ADLs) without any assistive aids.  Now, he can safely go back to his home and hopefully engage back to his work and to the community as an active member of the society.

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