A Randomized Controlled Study of Muscle Training Exercise Based Pulmonary Rehabilitation on Activity of Daily Living in Patients with Coronavirus Disease 2019

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> Hospitalized patients with Coronavirus Disease 2019 (COVID-19) pneumonia showed a severve loss of muscle mass and strength over admission. Therefore, early physical interventions might be conducive to prevent disability and fasten recovery. <jats:bold>Methods: </jats:bold>We designed a prospective, randomized controlled trial to identify the effectiveness and safety of pulmonary rehabilitation based on muscle exercise in COVID-19 patients. The study was conducted between February 7<jats:sup>th</jats:sup> and March 31<jats:sup>st</jats:sup> 2020 in Union Hospital. Patients were randomly assigned to the pulmonary rehabilitation exercise group or the control group. Primary outcome was improvement of activity of daily living (ADL). Secondary outcome was changes of muscle strength assessed by manual muscle test (MMT) and arterial blood gas analysis. Length of hospital staying (LOS) and adverse events related to physical activity were also observed.<jats:bold>Results: </jats:bold>A total of sixty patients were in analysis, and thirty patients were in PR group. Patients had a mean age of 54.43±10.57 years. A statistically and clinically significant increase in ADL was observed in PR group (75.00 [66.25,90.00] to 100.00 [100.00,100.00], p&lt;0.001). We also found that the improvement of ADL was related to younger age and higher PaO<jats:sub>2</jats:sub> (p&lt;0.01). Both groups had MMT improvement and there was no statistical difference between groups. There was a significant increase in PaO<jats:sub>2</jats:sub> (80.23±6.49 vs. 90.47±7.82, respectively, p&lt;0.001) between two groups before discharge. There was no statically significant difference in LOS between study group and control group (p=0.62). None of these patients had severe complications during the study.<jats:bold>Conclusions:</jats:bold> The protocal of pulmonary rehabilitation based on muscle training exercise was feasible in COVID-19 patients and it might accelerate recovery in ADL as compared with the spontaneous recovery in the control group.<jats:bold>Clinical Trial Registration: </jats:bold>ChiCTR, ChiCTR2000032457. Registered 29 April 2020- Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52925.</jats:p>