Evaluating the Efficiency of Breathing Exercises via Telemedicine in Post-Covid-19 Patients: Randomized Controlled Study

Okan, Fatih; Okan, Sevil; Yücesoy, Fadime Duran

doi:10.1177/10547738221097241

Cited by 22 publications

(78 citation statements)

References 35 publications

(39 reference statements)

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“…The pulmonary symptom scores in our study using the CAT demonstrated a statistically significant reduction during the course of the study, which was consistent with prior studies that have demonstrated that pulmonary exercises are effective in improving quality of life and pulmonary symptom scores in patients with COPD, asthma, bronchiectasis, and restrictive lung diseases (Essam et al, 2022; Pehlivan et al, 2019; Renolleau-Courtois et al, 2014; Tarigan et al, 2020). Recently, a 5-week, randomized controlled study of 52 individuals with post-COVID-19-related dyspnea who received a respiratory exercise breathing program via tele-medicine reported significantly improved quality of life scores in those individuals who were in the intervention group (Okan et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19

et al. 2023

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It is estimated that at least 10% of people who have had COVID-19 will experience ongoing symptoms such as shortness of breath, fatigue, and cognitive disturbances. Pulmonary exercise has demonstrated improved dyspnea outcomes in other respiratory conditions. Thus, the purpose of this study was to assess the efficacy of a home-based pulmonary rehabilitation program in post-COVID-19 survivors who continue to experience dyspnea. This was a longitudinal, single group pilot study in which 19 patients received a home-based expiratory muscle strength training program over 12 weeks. Outcomes measured at baseline, 6 weeks, and 12 weeks included pulmonary symptoms, functional performance, thoracic expansion, forced expiratory volume, and expiratory resistance measures. Significant improvements were found in pulmonary symptoms ( p < .001), functional performance ( p = .014), and progressive expiratory resistance capabilities ( p < .001). A home-based pulmonary program may be an inexpensive strategy for post-COVID-19 survivors who continue to experience dyspnea.

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Section: Discussionmentioning

confidence: 99%

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19

et al. 2023

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“…Five trials 21,24,25,27,29 reported treatment outcomes on overall quality of life among 366 participants 2). Figure 3 and eFigure 8 and eFigure 9 in Supplement 1 display the association of rehabilitation interventions with physical and mental health separately.…”

Section: Quality Of Lifementioning

confidence: 99%

Rehabilitation Interventions for Physical Capacity and Quality of Life in Adults With Post–COVID-19 Condition

Pouliopoulou,

Macdermid,

Saunders

et al. 2023

JAMA Netw Open

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ImportanceCurrent rehabilitation guidelines for patients with post–COVID-19 condition (PCC) are primarily based on expert opinions and observational data, and there is an urgent need for evidence-based rehabilitation interventions to support patients with PCC.ObjectiveTo synthesize the findings of existing studies that report on physical capacity (including functional exercise capacity, muscle function, dyspnea, and respiratory function) and quality of life outcomes following rehabilitation interventions in patients with PCC.Data SourcesA systematic electronic search was performed from January 2020 until February 2023, in MEDLINE, Scopus, CINAHL, and the Clinical Trials Registry. Key terms that were used to identify potentially relevant studies included long-covid, post-covid, sequelae, exercise therapy, rehabilitation, physical activity, physical therapy, and randomized controlled trial.Study SelectionThis study included randomized clinical trials that compared respiratory training and exercise-based rehabilitation interventions with either placebo, usual care, waiting list, or control in patients with PCC.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A pairwise bayesian random-effects meta-analysis was performed using vague prior distributions. Risk of bias was assessed using the Cochrane risk of bias tool version 2, and the certainty of evidence was evaluated using the GRADE system by 2 independent researchers.Main Outcomes and MeasuresThe primary outcome was functional exercise capacity, measured at the closest postintervention time point by the 6-minute walking test. Secondary outcomes were fatigue, lower limb muscle function, dyspnea, respiratory function, and quality of life. All outcomes were defined a priori. Continuous outcomes were reported as standardized mean differences (SMDs) with 95% credible intervals (CrIs) and binary outcomes were summarized as odds ratios with 95% CrIs. The between-trial heterogeneity was quantified using the between-study variance, τ2, and 95% CrIs.ResultsOf 1834 identified records, 1193 were screened, and 14 trials (1244 patients; 45% female participants; median [IQR] age, 50 [47 to 56] years) were included in the analyses. Rehabilitation interventions were associated with improvements in functional exercise capacity (SMD, −0.56; 95% CrI, −0.87 to −0.22) with moderate certainty in 7 trials (389 participants). These improvements had a 99% posterior probability of superiority when compared with current standard care. The value of τ2 (0.04; 95% CrI, 0.00 to 0.60) indicated low statistical heterogeneity. However, there was significant uncertainty and imprecision regarding the probability of experiencing exercise-induced adverse events (odds ratio, 1.68; 95% CrI, 0.32 to 9.94).Conclusions and RelevanceThe findings of this systematic review and meta-analysis suggest that rehabilitation interventions are associated with improvements in functional exercise capacity, dyspnea, and quality of life, with a high probability of improvement compared with the current standard care; the certainty of evidence was moderate for functional exercise capacity and quality of life and low for other outcomes. Given the uncertainty surrounding the safety outcomes, additional trials with enhanced monitoring of adverse events are necessary.

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“…Effects of treatment for persisting respiratory symptoms have been investigated in several studies. A combination of different breathing exercises for 5 weeks has been found to improve pulmonary function, quality of life and exercise capacity of patients with respiratory symptoms following COVID‐19 [93]. A breathing and wellbeing program including singing techniques had minor effects on breathlessness [94].…”

Section: Managementmentioning

confidence: 99%

Cardiorespiratory dysautonomia in post‐COVID‐19 condition: Manifestations, mechanisms and management

et al. 2023

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A significant proportion of COVID‐19 patients experience debilitating symptoms for months after the acute infection. According to recent estimates, approximately 1 out of 10 COVID‐19 convalescents reports persistent health issues more than 3 months after initial recovery. This ‘post‐COVID‐19 condition’ may include a large variety of symptoms from almost all domains and organs, and for some patients it may mean prolonged sick‐leave, homestay and strongly limited activities of daily life. In this narrative review, we focus on the symptoms and signs of post‐COVID‐19 condition in adults – particularly those associated with cardiovascular and respiratory systems, such as postural orthostatic tachycardia syndrome or airway disorders – and explore the evidence for chronic autonomic dysfunction as a potential underlying mechanism. The most plausible hypotheses regarding cellular and molecular mechanisms behind the wide spectrum of observed symptoms – such as lingering viruses, persistent inflammation, impairment in oxygen sensing systems and circulating antibodies directed to blood pressure regulatory components – are discussed. In addition, an overview of currently available pharmacological and non‐pharmacological treatment options is presented.

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Evaluating the Efficiency of Breathing Exercises via Telemedicine in Post-Covid-19 Patients: Randomized Controlled Study

Cited by 22 publications

References 35 publications

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19

Rehabilitation Interventions for Physical Capacity and Quality of Life in Adults With Post–COVID-19 Condition

Cardiorespiratory dysautonomia in post‐COVID‐19 condition: Manifestations, mechanisms and management

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