@article{SchaeferBittmann2023,
  author    = {Schaefer, Laura and Bittmann, Frank},
  title     = {Case report},
  series = {Frontiers in medicine},
  volume    = {9},
  journal   = {Frontiers in medicine},
  publisher = {Frontiers Media},
  address   = {Lausanne},
  issn      = {2296-858X},
  doi       = {10.3389/fmed.2022.879971},
  pages     = {10},
  year      = {2023},
  abstract  = {The increasing prevalence of Long COVID is an imminent public health disaster, and established approaches have not provided adequate diagnostics or treatments. Recently, anesthetic blockade of the stellate ganglion was reported to improve Long COVID symptoms in a small case series, purportedly by "rebooting" the autonomic nervous system. Here, we present a novel diagnostic approach based on the Adaptive Force (AF), and report sustained positive outcome for one severely affected Long COVID patient using individualized pulsed electromagnetic field (PEMF) at the area C7/T1. AF reflects the capacity of the neuromuscular system to adapt adequately to external forces in an isometric holding manner. In case, maximal isometric AF (AFiso(max)) is exceeded, the muscle merges into eccentric muscle action. Thereby, the force usually increases further until maximal AF (AFmax) is reached. In case adaptation is optimal, AFiso(max) is similar to 99-100\% of AFmax. This holding capacity (AFiso(max)) was found to be vulnerable to disruption by unpleasant stimulus and, hence, was regarded as functional parameter. AF was assessed by an objectified manual muscle test using a handheld device. Prior to treatment, AFiso(max) was considerably lower than AFmax for hip flexors (62 N = similar to 28\% AFmax) and elbow flexors (71 N = similar to 44\% AFmax); i.e., maximal holding capacity was significantly reduced, indicating dysfunctional motor control. We tested PEMF at C7/T1, identified a frequency that improved neuromuscular function, and applied it for similar to 15 min. Immediately post-treatment, AFiso(max) increased to similar to 210 N (similar to 100\% AFmax) at hip and 184 N (similar to 100\% AFmax) at elbow. Subjective Long COVID symptoms resolved the following day. At 4 weeks post-treatment, maximal holding capacity was still on a similarly high level as for immediately post-treatment (similar to 100\% AFmax) and patient was symptom-free. At 6 months the patient's Long COVID symptoms have not returned. This case report suggests (1) AF could be a promising diagnostic for post-infectious illness, (2) AF can be used to test effective treatments for post-infectious illness, and (3) individualized PEMF may resolve post-infectious symptoms.},
  language  = {en}
}
@article{FrankFrank2022,
  author    = {Frank, Ulrike and Frank, Katrin},
  title     = {COVID-19},
  series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  volume    = {93},
  journal   = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  number    = {2},
  publisher = {Springer},
  address   = {New York},
  issn      = {0028-2804},
  doi       = {10.1007/s00115-021-01162-5},
  pages     = {167 -- 174},
  year      = {2022},
  abstract  = {Eine COVID-19-Erkrankung kann zu schweren Krankheitsverl{\"a}ufen mit multiplen Organbeteiligungen und respiratorischen und neurologischen Funktionseinschr{\"a}nkungen f{\"u}hren. Schluckst{\"o}rungen (Dysphagien) k{\"o}nnen in dieser Patientengruppe durch prim{\"a}re Sch{\"a}digungen des zentralen und peripheren neuronalen Netzwerkes der Schluckfunktion entstehen, aber auch bedingt durch die h{\"a}ufig l{\"a}ngere intensivmedizinische Behandlung und Beatmung. Erste klinische Befunde zeigen persistierende Dysphagien im Rahmen des Post-COVID-Syndroms („Long-COVID"), sodass die Patienten auch l{\"a}ngerfristige Maßnahmen zur Rehabilitation einer sicheren und suffizienten oralen Nahrungsaufnahme ben{\"o}tigen. Daher sollte in die Behandlung von COVID-19-Patienten ein strukturiertes erkrankungsspezifisches Monitoring in Bezug auf Dysphagiesymptome integriert werden, und atemtherapeutische Maßnahmen zur Regulation von Husteneffektivit{\"a}t und Atem-Schluck-Koordination sollten auch bei diesen Patienten essenzieller Bestandteil des Dysphagiemanagements sein. Herausforderungen ergeben sich dabei einerseits durch die erforderlichen Anpassungen etablierter Behandlungsstandards an den Infektionsschutz. Zudem m{\"u}ssen Auswahl und Durchf{\"u}hrungsintensit{\"a}t therapeutischer Maßnahmen an die Kapazit{\"a}ten und die spezifische Pathophysiologie der COVID-19- und Long-COVID-Patienten angepasst werden, um weitere funktionelle Verschlechterungen zu vermindern.},
  language  = {de}
}