Centrokinetic is the most performant medical center in Bucharest that focuses on osteoarticular diseases. Its departments are: Orthopedics, Neurology, Medical imaging, Medical rehabilition, Rheumatology, Nutrition and Psychology and it helps both adults and children.

Designed, created and managed by one of the most renowned orthopedic doctors from Romnania, dr. Andrei Ioan Bogdan, the clinic is founded on a unique concept that focuses on diagnosing a disease as fast as possible, using advanced medical investigations (MRI, musculoskeletal ultrasound, EEG, EMG, osteodensitometry) and on initiating a complete treatment until the patient is healed.

Coronaviruses, such as the newly discovered (SARS-CoV-2), which causes COVID-19 disease, produce respiratory infections with varying degrees of severity, from mild to severe.

Following infection with the new Coronavirus, some people may experience certain sequelae:

• intense fatigue
• decreased respiratory capacity
• muscle atrophies
• damage to the muscles involved in breathing
• joint stiffness (limitation of normal movements)
• tendon retractions

In isolated cases, more serious sequelae may occur, such as nerve damage or paralysis, the effect of which depends very much on the ailments the patient has suffered from in the past.

After healing of COVID-19, these patients must make significant efforts to quickly return to everyday life. To meet these needs, Centrokinetic clinic created a program called "Recovery from COVID-19 infection."

The program is dedicated to patients who have gone through infection with the new virus, and to those suffering from diseases in the field of pneumology with physical consequences: chronic obstructive pulmonary disease (COPD), asthma, emphysema, bronchiectasis, respiratory allergies, occupational diseases, primary or secondary bronchial asthma.

What the recovery program for pulmonary disorders consists of?

# 1 The first step is always going to consultation.

During this time, the patient discusses with the doctor the medical problems encountered during the period in which they were positive with SARS-Cov-2, will be examined clinically by the doctor and will be instructed what this recovery program consists of. Consultation is performed by one of our recovery doctors:

• Dr. Georgiana Tache, primary care physician in recovery, physical medicine, and balneology, with 31 years of experience in the field. She is a university teacher - chief of works at the UMF Carol Davila Medical Recovery Discipline, Bucharest.
  Dr. Fatulescu Simona, primary care physician in recovery, physical medicine, and balneology, with over 15 years of experience, EMG competence.
  
• Dr. Mustafa Edis, recovery specialist, physical medicine, and balneology, being the first doctor in Romania to approach transcranial electrical stimulation.

# 2 The following is the evaluation of the patient's health condition, performed through a series of tests that assess the type of sequelae existing after infection with the new Coronavirus or caused by other pulmonary diseases (muscle, respiratory, nervous), but also their severity.

• Walking test
• Oximetry test (saturation measurement)

Following these tests, the medical team will decide which recovery program should be followed to obtain optimal results in the shortest time possible.

# 3 Start the recovery treatment, customized according to the patient's condition.

If the sequelae involve only muscle fatigue, mild atrophy, and joint stiffness, the patient is included in a group recovery program, with exercises of slightly higher intensity. All patients who enter this program will perform exercises on a bicycle or treadmill, training of the muscles of the upper, and lower limbs, breathing exercises, medical-gymnastics, therapeutic education. To be effective, the program must be followed rigorously for 6-8 weeks, with a minimum of 3 sessions per week of 1 hour.

All patients are constantly watched, also their blood oxygen saturation, pulse, and blood pressure are recorded. In each physical therapy room, we have a monitoring system that measure the vital parameters of each patient, which will be used constantly, and all parameters will be displayed in real-time on digital systems, so that the medical team can monitor the patients' condition any time.

All patients will be monitored by professional devices for measuring vital functions (blood pressure, pulse, saturation), and heart function will also be checked by electrocardiogram (EKG). Physical therapists will guide patients through breathing exercises, postures to facilitate expectoration, coughing exercises, and other techniques, depending on the established treatment plan.

All Centrokinetic physical therapists are accredited and trained to provide first aid to patients in need. The clinic also has devices for patients who need oxygen support. If the saturation decreases during training, the team will equip the patient with a nasal mask linked to the oxygen cylinders, to ensure optimal oxygen intake.

# 4 Outcome evaluations

• Reducing symptoms
• Increasing the capacity of effort
• Increasing the autonomy of patients with respiratory sequelae
• Increasing the quality of life
• Muscle toning
• Increased joint mobility