Postural balance and functional muscle strength in the hands and legs one year after hospitalisation due to COVID-19.
Lena Rafsten, Alexandra Larsson, Annie Palstam and 1 others
PMID 40521990WHAT IT FOUND
One year after hospitalisation for COVID-19, most patients had improved balance and strength, but nearly half still had impaired muscle strength.
Older age and lower pre-illness activity predicted worse hand strength. Discharge strength was the strongest predictor of recovery, suggesting early assessment identifies those needing continued rehabilitation.
Key findings
01Impaired postural balance dropped from 51.8% at discharge to 13.5% at one year, while impaired hand strength dropped from 65% to 41% and leg strength from 94.5% to 53%.
02Strength in the dominant hand at discharge was the strongest predictor of impaired hand strength one year later, along with older age and lower prior physical activity levels.
03Leg strength at discharge was the strongest predictor of impaired leg strength one year later, but age did not significantly affect leg strength recovery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
There was no control group, so it is unclear how much of the impairment was due to COVID-19 versus hospitalisation or pre-existing conditions. Pre-illness muscle strength was unknown, so the true extent of decline cannot be determined. Selection bias is possible, as some patients may have been missed during inclusion due to workload or fatigue. Outcomes were dichotomised into 'impaired' and 'not impaired', which may misclassify patients near the cut-off values. Normative values for leg strength were only available for people aged 60 and older, so these were used for younger participants, potentially affecting accuracy.
Declared interests
The authors declared no conflicts of interest. The work was supported by Swedish research councils and regional research funding.
The easy way to misread this
Do not assume that improvement from discharge to one year means full recovery. Nearly half of the participants still had impaired muscle strength at one year, and this persistence was predicted by low strength at discharge, not by the severity of their hospitalisation or ICU admission.