Efficacy and Safety of Respiratory Telerehabilitation in Patients with Long COVID-19: A Systematic Review and Meta-Analysis

Abstract

The aim of this review was to identify, map, and synthesize the extent and nature of research activity on the use of telerehabilitation to support Long COVID-19 rehabilitation and examine the efficacy and safety of respiratory telerehabilitation in patients with Long COVID-19. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials that tested the effect of respiratory telerehabilitation interventions in patients with Long COVID-19 versus no intervention, usual care, placebo, or face-to-face intervention. The data were pooled, and a meta-analysis was completed for quality of life, dyspnea, lung function, anxiety and depression, respiratory muscle strength, functional capacity, and lower limb strength. Finally, 10 studies were included. The meta-analysis results show significant differences in favor of respiratory telerehabilitation in quality of life (p = 0.02), dyspnea (p < 0.00001), respiratory muscle strength (p < 0.001), functional capacity (p < 0.0001), and lower limb strength (p = 0.01) but not in lung function (p = 0.28) and anxiety and depression (p = 0.55). In addition, there were no statistically significant differences in adverse effects (p = 0.06) between the telerehabilitation and comparator groups. The results suggest that these interventions can improve quality of life, reduce dyspnea, and increase respiratory and lower extremity muscle strength as well as functional capacity in patients with Long COVID-19.

Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis

“…Tele-rehabilitation, typically spanning 6–8 weeks with 3–4 weekly sessions lasting 20 to 60 minutes, offers a flexible and effective way to improve respiratory function and quality of life from patients’ homes via video conferencing. Supported by evidence of its efficacy and safety for COVID-19 patients, 168,169 this method reports high patient adherence due to its adaptability, without severe adverse events. 52,108 However, it faces challenges such as the need for individualized assessments, integration of technology into clinical practices, advanced practitioner training, and updates to legal and regulatory frameworks to ensure broad access and effective implementation, especially in disadvantaged areas.…”

“…Breathing exercises have proven to significantly alleviate respiratory distress and improve lung function parameters (Vital Capacity, Total Lung Capacity, Forced Expiratory Volume in 1 s, Partial Pressure of Oxygen), as confirmed by systematic reviews. 166–168 Moreover, improvements in respiratory function have been linked to increased strength in lower limb muscles and enhanced functional capacity, 169 emphasizing the role of comprehensive rehabilitation programs that incorporate breathing exercises to meet the specific needs of patients.…”

Digital physiotherapy is a satisfactory and effective method to improve the quality of life in Long COVID patients

“…The results of reviews indicated that digital physiotherapy intervention may be an effective strategy to improve quality of life and reduce dyspnoea, 56 functional capacity, 57 and has been found at least non-inferior to usual care. 58 However, caution should be exercised to avoid overestimating the results, 14 due to possible methodological shortcomings.…”

Outcomes among patients with chronic obstructive pulmonary disease after recovery from COVID-19 infection of different severity

“…They will need timely assessment to consider escalation of COPD pharmacotherapy to relieve their dyspnea, which was shown to be worsened after COVID-19. Pulmonary rehabilitation should also be considered in these patients [16][17][18] . While patients with mild to moderate COVID-19 would have symptomatic deterioration, those with severe COVID-19 also had increase in future risks of severe exacerbation and mortality.…”