https://doi.org/10.4081/ejtm.2023.11063
Long-term outcomes of different rehabilitation programs in patients with long COVID syndrome: a cohort prospective study
Submitted: 5 December 2022
Accepted: 20 January 2023
Published: 13 April 2023
Accepted: 20 January 2023
Abstract Views: 1353
PDF: 492
HTML: 8
HTML: 8
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
After the resolution of the acute SARS-COV-2 infection, an important percentage of patients do not fully recover and continue to present several symptoms. Nevertheless, there is a lack of data in the literature on the effects of rehabilitation programs on medium- and long-term long COVID symptoms. Therefore, the aim of this study was to evaluate the long-term outcomes after rehabilitation programs in long COVID syndrome patients. A prospective cohort study was conducted from August 2021 to March 2022, involving 113 patients with long COVID syndrome. The patients in the experimental group (EG, n=25) received a tailored and multidisciplinary rehabilitative program, involving aquatic exercises, respiratory and motor exercises, social integration training and neuropsychologic sessions, LASER therapy and magnetotherapy. Patients in the other three comparison groups received eastern medicine techniques (CG1), balneotherapy and physiotherapy (group CG2), self-training and home-based physical exercise (CG3). Once the several rehabilitation protocols had been performed, a structured telephone contact was made with the patients after 6 months ± 7 days from the end of the rehabilitation treatment, in order to record the frequency of hospital ad-missions due to exacerbation of post-exacerbation syndrome, death or disability, and the need for other types of care or drugs. The patients in the comparison groups were more likely to request therapeutic care for emerging long COVID symptoms (χ2=6.635, p=0.001; χ2=13.463, p=0.001; χ2=10.949, p=0.001, respectively), as well as more likely to be hospitalized (χ2=5.357, p=0.021; χ2=0.125, p=0.724; χ2=0.856, p=0.355, respectively) when compared to the patients of the EG. The relative risk (RR) of hospital admissions in the observed cohort was 0.143 ±1,031 (СI: 0.019; 1.078); 0.580±1,194 (CI: 0.056; 6.022); 0,340±1,087 (CI: 0.040; 2.860). The RR of hospital admissions for patients with long COVID syndrome was reduced by 85.7%; 42.0% and 66.0%, respectively, when the experimental rehabilitation technique was employed. In conclusion, a tailored and multidisciplinary rehabilitative program seems to have a better preventive effect not only in the short term, but also over the next 6 months, avoiding the new onset of disabilities and the use of medicines and specialist advice, than other rehabilitative programs. Future studies will need to further investigate these aspects to identify the best rehabilitation therapy, also in terms of cost-effectiveness, for these patients.
WHO: Clinical case definition post-COVID-19 by Delphi consensus. 06.10.2021. Available online: URL https://apps.who.int/iris/bitstream/handle/ 10665/ 345824/WHO-2019-nCoV-Post-COVID-19-condition-Clinical-case-definition-2021.1-rus.pdf (accessed on 29 May 2022).
Asly M, Hazim A. Rehabilitation of post-COVID-19 patients. Pan Afr Med J. 2020 Jul 9;36:168. PMID: 32952812; PMCID: PMC7467884.
DOI: https://doi.org/10.11604/pamj.2020.36.168.23823
Barker-Davies RM, O'Sullivan O, Senaratne KPP, Baker P, Cranley M, Dharm-Datta S, Ellis H, Goodall D, Gough M, Lewis S, Norman J, Papadopoulou T, Roscoe D, Sherwood D, Turner P, Walker T, Mistlin A, Phillip R, Nicol AM, Bennett AN, Bahadur S. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med. 2020 Aug;54(16):949-959. Epub 2020 May 31. PMID: 32475821; PMCID: PMC7418628.
DOI: https://doi.org/10.1136/bjsports-2020-102596
Yong SJ. lCOVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021 Oct;53(10):737-754. Epub 2021 May 22. PMID: 34024217; PMCID: PMC8146298.
DOI: https://doi.org/10.1080/23744235.2021.1924397
Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, Walshaw C, Kemp S, Corrado J, Singh R, Collins T, O'Connor RJ, Sivan M. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021 Feb;93(2):1013-1022. Epub 2020 Aug 17. PMID: 32729939.
DOI: https://doi.org/10.1002/jmv.26368
Kemp HI, Corner E, Colvin LA. Chronic pain after COVID-19: implications for rehabilitation. Br J Anaesth. 2020 Oct;125(4):436-440. Epub 2020 May 31. PMID: 32560913; PMCID: PMC7261464.
DOI: https://doi.org/10.1016/j.bja.2020.05.021
Weerahandi H, Hochman KA, Simon E, Blaum C, Chodosh J, Duan E, Garry K, Kahan T, Karmen-Tuohy SL, Karpel HC, Mendoza F, Prete AM, Quintana L, Rutishauser J, Santos Martinez L, Shah K, Sharma S, Simon E, Stirniman AZ, Horwitz LI. Post-Discharge Health Status and Symptoms in Patients with Severe COVID-19. J Gen Intern Med. 2021 Mar;36(3):738-745. Epub 2021 Jan 14. PMID: 33443703; PMCID: PMC7808113.
DOI: https://doi.org/10.1007/s11606-020-06338-4
Hodgson CL, Higgins AM, Bailey MJ, Mather AM, Beach L, Bellomo R, Bissett B, Boden IJ, Bradley S, Burrell A, Cooper DJ, Fulcher BJ, Haines KJ, Hopkins J, Jones AYM, Lane S, Lawrence D, van der Lee L, Liacos J, Linke NJ, Gomes LM, Nickels M, Ntoumenopoulos G, Myles PS, Patman S, Paton M, Pound G, Rai S, Rix A, Rollinson TC, Sivasuthan J, Tipping CJ, Thomas P, Trapani T, Udy AA, Whitehead C, Hodgson IT, Anderson S, Neto AS; COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group. The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study. Crit Care. 2021 Nov 8;25(1):382. PMID: 34749756; PMCID: PMC8575157.
DOI: https://doi.org/10.1186/s13054-021-03794-0
Sidorov VV, Lobanov AA, Grishechkina IA, Fesyun AD, Yakovlev MYU, Andronov SV, Barashkov GN, Popov AI. Narushenie mikrocirkulyacii i kletochnogo metabolizma u patientov s post-COVID-sindromom [Violation of microcirculation and cellular metabolism in patients with post-COVID syndrome]. Vestnik novyh medicinskih tekhnologij 2022, Volume 29(2), P. 64-68 [in Russian].
Das S. Microcirculatory changes and thrombotic complications in COVID-19. Br J Community Nurs. 2021 Oct 2;26(10):474-480. PMID: 34632792.
DOI: https://doi.org/10.12968/bjcn.2021.26.10.474
Pandolfi S, Chirumbolo S. Home therapy of COVID-19 at the earliest may greatly prevent hospitalization. Basic Clin Pharmacol Toxicol. 2021 Dec;129(6):395-396. Epub 2021 Sep 26. PMID: 34494369; PMCID: PMC8652880.
DOI: https://doi.org/10.1111/bcpt.13650
Hohberger B, Mardin CY. OCT Angiography as an Interdisciplinary Diagnostic Tool for Systemic Diseases. Klin Monbl Augenheilkd. 2021 Dec;238(12):1294-1298. English, German. Epub 2021 Dec 8. PMID: 34879428.
DOI: https://doi.org/10.1055/a-1654-0504
Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, Walshaw C, Kemp S, Corrado J, Singh R, Collins T, O'Connor RJ, Sivan M. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021 Feb;93(2):1013-1022. Epub 2020 Aug 17. PMID: 32729939.
DOI: https://doi.org/10.1002/jmv.26368
Lobanov AA, Irina A Grishechkina, Andronov SV, Gleb N Barashkov, Andrey I Popov, Anatoliy D Fesyun, Elena P Ivanova, Maccarone MC, Stefano Masiero. Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes? Eur J Transl Myol. 2022 Jul 14;32(3):10698. PMID: 35833897; PMCID: PMC9580543.
DOI: https://doi.org/10.4081/ejtm.2022.10698
Meshcheryakova NN, Belevskij AS, Kuleshov AV Metodicheskie rekomendacii provedenie legochnoj reabilitacii u pacientov s novoj koronavirusnoj infekciej (COVID-19) vnebol'nichnoj dvuhstoronnej pnevmoniej [Guidelines for pulmonary rehabilitation in patients with novel coronavirus infection (COVID-19) community-acquired bilateral pneumonia]. Moscow, 2020. 22 p. Available online: URL https://www.spulmo.ru/upload/metodichka_po_reabilitacii_covid.pdf (accessed on: 3 March 2022) [in Russian].
Belevskij AS, Meshcheryakova NN. Legochnaya reabilitaciya [Pulmonary rehabilitation], Atmosphere: Moscow, Russian Federation, 2018; 76 p. [in Russian] ISBN: 978-5-902123-71-2.
Lobanov AA, Grishechkina IA, Fesyun AD, Rachin AP, Yakovlev MYu, Andronov SV, Barashkov GN, Lebedeva OD, Popov AI, Styazhkina EM, Ansokova MA, Vasil’eva VA. Investigation of the Effectiveness and Safety of a Rehabilitation Program for Patients with Long Covid Using Aquatic Training. Bulletin of Rehabilitation Medi-cine2022, Volume 21(3), P. 45-57. [in Russian].
DOI: https://doi.org/10.38025/2078-1962-2022-21-3-45-57
Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020 Aug 11;324(6):603-605. PMID: 32644129; PMCID: PMC7349096.
DOI: https://doi.org/10.1001/jama.2020.12603
King’s College London. ZOE Global Limited. How long does COVID-19 last? 2020. Available online: URL https://www.kcl.ac.uk/news/spotlight/zoe-covid-study-app-kings-researchers-slowed-the-spread-COVID-19 (accessed on: 12 May 2022).
Rutsch M, Frommhold J, Buhr-Schinner H, Djeiranachvili L, Gross T, Schüller PO, Katalinic A, Deck R. Study protocol medical rehabilitation after COVID-19 disease: an observational study with a comparison group with obstructive airway disease / Re_Co. BMC Health Serv Res. 2021 Apr 22;21(1):373. PMID: 33888104; PMCID: PMC8061875.
DOI: https://doi.org/10.1186/s12913-021-06378-4
Glöckl R., Buhr-Schinner H, Koczulla AR, Schipmann R, Schultz K, Spielmanns M, Stenzel N, Dewey S. DGP-Empfehlungen zur pneumologischen Rehabilitation bei COVID-19 [Recommendations from the German Res-piratory Society for Pulmonary Rehabilitation in Patients with COVID-19]. Pneumologie 2020, Volume 74 (8), P. 496-504. [German.]
DOI: https://doi.org/10.1055/a-1193-9315
Nesina IA, Golovko EA, Shakula AV, Figurenko NN, Zhilina IG, Khomchenko TN, Smirnova EL, Chursina VS, Koroleva AV. Experience of Outpatient Rehabilitation of Patients after Pneumonia Associated with the New Coronavirus Infection COVID-19. Bulletin of Rehabilitation Medicine 2021, Volume 20 (5), P. 4-11.
DOI: https://doi.org/10.38025/2078-1962-2021-20-5-4-11
Bek LM, Berentschot JC, Hellemons ME, Huijts SM, Aerts JGJV, van Bommel J, van Genderen ME, Gommers DAMPJ, Ribbers GM, Heijenbrok-Kal MH, van den Berg-Emons RJG; CO-FLOW Collaboration Group. CO-FLOW: COvid-19 Follow-up care paths and Long-term Outcomes Within the Dutch health care system: study protocol of a multicenter prospective cohort study following patients 2 years after hospital discharge. BMC Health Serv Res. 2021 Aug 21;21(1):847. PMID: 34419032; PMCID: PMC837959624.
DOI: https://doi.org/10.1186/s12913-021-06813-6
Petrie A, Sabin C. Medical Statistics at a Glance, 4th ed.; Wiley-Blackwell: USA, 2019; 208p. ISBN: 978-1-119-16781-5.
Vremennye metodicheskie rekomendacii. Medicinskaya reabilitaciya pri novoj koronovirusnoj infekcii (COVID-19). [Temporary guidelines. Medical rehabilitation for new coronovirus infection (COVID-19)]. Available online: URL xn–80aesfpebagmfblc0a.xn–p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf (accessed on 12 Feb 2022) [in Russian].
Bogolyubov VM. Physiotherapy and balneology. BINOM: Russian Federation, Мoscow, 2021; 999 p. [in Russian].
Understanding of guidance for acupuncture and moxibustion interventions on COVID-19 (Second edition) issued by CAAM. World Journal of Acupuncture - Moxibustion 2020, Volume 30 (1), P. 1–4.
DOI: https://doi.org/10.1016/j.wjam.2020.03.005
Orlova IV. Mnogomernyjstatisticheskijanaliz v ekonomicheskihzadachah: komp'yuternoemodeliro vanie v SPSS: Uchebnoeposobie [Multivariate Statistical Analysis in Economics: Computer Simulation in SPSS: A Tutorial]; Vuzovskijuchebnik: Moscow, Russian Federation, 2014; 310 p. Available online: URL https://r-analytics.blogspot.com/2013/01/2-2-k.html [in Russian].
WHO European Regional Technical Briefing. Rehabilitation after COVID-19: what we know and what resources we have. Virtual meeting hosted by the WHO Regional Office for Europe. Copenhagen: WHO Regional Office for Europe, 2022. Available online: URL: https://apps.who.int/iris/bitstream/ handle/10665/351043/WHO-EURO-2022-3995-43754-62897-rus.pdf?sequence=1&isAllowed=y (accessed on 04 April 2022).
Gilmutdinova IR, Kolyshenkov VA, Lapickaya KA, Trepova AS, Vasileva VA, Prosvirnin AN, Marchenkova LA, Terentev KV, Yakovlev MY, Rachin AP, Fesyun AD, Reverchuk IV. Telemedicine platform COVIDREHAB for remote rehabilitation of patients after COVID-19. Eur J Transl Myol. 2021 May 13;31(2):9783. PMID: 33985320; PMCID: PMC8274224.
DOI: https://doi.org/10.4081/ejtm.2021.9783
Bryant MS, Fedson SE, Sharafkhaneh A. Using Telehealth Cardiopulmonary Rehabilitation during the COVID-19 Pandemic. J Med Syst. 2020 May 28;44(7):125. PMID: 32462352; PMCID: PMC7253228.
DOI: https://doi.org/10.1007/s10916-020-01593-8
Ansokova MA, Vasil’eva VA. Rehabilitation of a patient with acute cerebral circulation disturbance due to COVID-19. Materials of the Russian scientific-practical conference with international participation, Kursk Russian Federation, 2022. pp. 44-45.
Marchenkova LA, Makarova EV, Yurova OV. [The role of micronutrients in the comprehensive rehabilitation of patients with the novel coronavirus infection COVID-19]. Vopr Pitan. 2021;90(2):40-49. [in Russian]. Epub 2021 Mar 11. PMID: 34019347.
DOI: https://doi.org/10.33029/0042-8833-2021-90-2-40-49
van Haastregt JCM, Everink IHJ, Schols JMGA, Grund S, Gordon AL, Poot EP, Martin FC, O'Neill D, Petrovic M, Bachmann S, van Balen R, van Dam van Isselt L, Dockery F, Holstege MS, Landi F, Pérez LM, Roquer E, Smalbrugge M, Achterberg WP. Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance. Eur Geriatr Med. 2022 Feb;13(1):291-304. Epub 2021 Nov 20. PMID: 34800286; PMCID: PMC8605452.
DOI: https://doi.org/10.1007/s41999-021-00575-4
Rezaei N. Coronavirus Disease-COVID-19: E-book; Springer, Switzerland, 2019; 964 pp.
Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, Kang L, Guo L, Liu M, Zhou X, Luo J, Huang Z, Tu S, Zhao Y, Chen L, Xu D, Li Y, Li C, Peng L, Li Y, Xie W, Cui D, Shang L, Fan G, Xu J, Wang G, Wang Y, Zhong J, Wang C, Wang J, Zhang D, Cao B. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021 Jan 16;397(10270):220-232. Epub 2021 Jan 8. PMID: 33428867; PMCID: PMC7833295.
DOI: https://doi.org/10.1016/S0140-6736(20)32656-8
Han X, Fan Y, Alwalid O, Li N, Jia X, Yuan M, Li Y, Cao Y, Gu J, Wu H, Shi H. Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia. Radiology 2021; Volume 299(1), p. E177-E186.
DOI: https://doi.org/10.1148/radiol.2021203153
Taboada M, Cariñena A, Moreno E, Rodríguez N, Domínguez MJ, Casal A, Riveiro V, Diaz-Vieito M, Valdés L, Álvarez J, Seoane-Pillado T. Post-COVID-19 functional status six-months after hospitalization. J Infect. 2021 Apr;82(4):e31-e33. Epub 2020 Dec 26. PMID: 33373650; PMCID: PMC7834022.
DOI: https://doi.org/10.1016/j.jinf.2020.12.022
Yan X, Huang H, Wang C, Jin Z, Zhang Z, He J, Yin S, Fan M, Huang J, Chen F, Zeng Y, Han X, Zhu Y. Follow-up study of pulmonary function among COVID-19 survivors 1 year after recovery. J Infect. 2021 Sep;83(3):381-412. Epub 2021 May 29. PMID: 34062186; PMCID: PMC8164517.
DOI: https://doi.org/10.1016/j.jinf.2021.05.034
Nasserie T, Hittle M, Goodman SN. Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19: A Systematic Review. JAMA Netw Open. 2021 May 3;4(5):e2111417. PMID: 34037731; PMCID: PMC8155823.
DOI: https://doi.org/10.1001/jamanetworkopen.2021.11417
Carvalho AC, Moreira J, Cubelo P, Cantista P, Branco CA, Guimarães B. Therapeutic respiratory and functional rehabilitation protocol for intensive care unit patients affected by COVID-19: a structured summary of a study protocol for a randomised controlled trial. Trials. 2021 Apr 12;22(1):268. PMID: 33845878; PMCID: PMC8039799.
DOI: https://doi.org/10.1186/s13063-021-05210-y
Carvalho AC, Moreira J, Cubelo P, Cantista P, Branco CA, Guimarães B. Therapeutic respiratory and functional rehabilitation protocol for intensive care unit patients affected by COVID-19: a structured summary of a study protocol for a randomised controlled trial. Trials. 2021 Apr 12;22(1):268. PMID: 33845878; PMCID: PMC8039799.
DOI: https://doi.org/10.1186/s13063-021-05210-y
Stam HJ, Stucki G, Bickenbach J; European Academy of Rehabilitation Medicine. COVID-19 and Post Intensive Care Syndrome: A Call for Action. J Rehabil Med. 2020 Apr 15;52(4):jrm00044. PMID: 32286675.
DOI: https://doi.org/10.2340/16501977-2677
Maniscalco M, Fuschillo S, Ambrosino P, Martucci M, Papa A, Matera MG, Cazzola M. Preexisting cardiorespiratory comorbidity does not preclude the success of multidisciplinary rehabilitation in post-COVID-19 patients. Respir Med. 2021 Aug;184:106470. 106470. Epub 2021 May 15. PMID: 34022502; PMCID: PMC8123366.
DOI: https://doi.org/10.1016/j.rmed.2021.106470
Yagudina RI, Kulikov AYu, Serpik VG. Farmakoekonomika: uchebnoeposobie [Pharmaco-economics: textbook]; Phoenix: Rostov-on-Don, Russian Federation, 2018; 237p. [in Russian].
Maccarone MC, Kamioka H, Cheleschi S, Tenti S, Masiero S, Kardeş S. Italian and Japanese public attention toward balneotherapy in the COVID-19 era. Environ Sci Pollut Res Int. 2021 Nov;28(43):61781-61789. Epub 2021 Jun 29. PMID: 34185269; PMCID: PMC8239328.
DOI: https://doi.org/10.1007/s11356-021-15058-z
Masiero S, Maccarone MC, Agostini F. Health resort medicine can be a suitable setting to recover disabilities in patients tested negative for COVID-19 discharged from hospital? A challenge for the future. Int J Biometeorol. 2020 Oct;64(10):1807-1809. Epub 2020 Jun 5. PMID: 32504142; PMCID: PMC7272594.
DOI: https://doi.org/10.1007/s00484-020-01947-4
Masiero S, Maccarone MC. Health resort therapy interventions in the COVID-19 pandemic era: what next? Int J Biometeorol. 2021 Nov;65(11):1995-1997. Epub 2021 Apr 21. PMID: 33880643; PMCID: PMC8057917.
DOI: https://doi.org/10.1007/s00484-021-02134-9
Agostini F, Mangone M, Ruiu P, Paolucci T, Santilli V, Bernetti A. Rehabilitation setting during and after COVID-19: An overview on recommendations. J Rehabil Med. 2021 Jan 5;53(1):jrm00141. PMID: 33284353; PMCID: PMC8772378.
DOI: https://doi.org/10.2340/16501977-2776
Maccarone MC, Masiero S. Spa therapy interventions for post respiratory rehabilitation in COVID-19 subjects: does the review of recent evidence suggest a role? Environ Sci Pollut Res Int. 2021 Sep;28(33):46063-46066. Epub 2021 Jul 17. PMID: 34273080; PMCID: PMC8286038.
DOI: https://doi.org/10.1007/s11356-021-15443-8
Maccarone MC, Magro G, Tognolo L, Masiero S. Post COVID-19 persistent fatigue: a proposal for rehabilitative interventions in the spa setting. Int J Biometeorol. 2021 Dec;65(12):2241-2243. Epub 2021 Jun 4. PMID: 34086142; PMCID: PMC8175920.
DOI: https://doi.org/10.1007/s00484-021-02158-1
Masiero S, Maccarone MC, Magro G. Balneotherapy and human immune function in the era of COVID-19. Int J Biometeorol. 2020 Aug;64(8):1433-1434. Epub 2020 Apr 16. PMID: 32300868; PMCID: PMC7160818.
DOI: https://doi.org/10.1007/s00484-020-01914-z
How to Cite
Grishechkina, I. A., Lobanov , A. A., Andronov, S. V., Rachin, A. P., Fesyun, A. D., Ivanova, E. P., Masiero, S., & Maccarone, M. C. (2023). Long-term outcomes of different rehabilitation programs in patients with long COVID syndrome: a cohort prospective study. European Journal of Translational Myology, 33(2). https://doi.org/10.4081/ejtm.2023.11063
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Nicola Manocchio, Isabella Iovene, Antonio Santoro, Maria Chiara Maccarone, Calogero Foti, Report and Abstracts of the 15th Congress of the Mediterranean Forum of Physical and Rehabilitation Medicine: Rome, July 6-8, 2023 , European Journal of Translational Myology: Vol. 33 No. 4 (2023)
You may also start an advanced similarity search for this article.