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

Abstract

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.

Respiratory Muscle Strength Training in Patients Post-COVID-19: A Systematic Review

“…Some studies did not mention or have blinding processes related to study design, leading to n/a ratings in this category (Table 1). Using the OCEBM instrument to evaluate the level of evidence for each study, six of the studies had a 1b level of evidence (Del Corral et al, 2023a;Jimeno-Almazan et al, 2023;Liu et al, 2020;McNarry et al, 2022;Nagy et al, 2022;Palau et al, 2022), three had a 2b level of evidence (Abodonya et al, 2021;Hayden et al, 2021;Nopp et al, 2022), and two had a 2c level of evidence (Hockele et al, 2022;Morgan et al, 2023) (Table 2). These relatively high levels of methodological quality led to the inclusion of these studies in the review.…”

“…Among the 11 included studies, five were randomized controlled trial studies (Del Corral et al, 2023a;Jimeno-Almazan et al, 2023;McNarry et al, 2022;Nagy et al, 2022;Palau et al, 2022), one was quasi-experimental (Liu et al, 2020), and five were prospective (Abodonya et al, 2021;Hayden et al, 2021;Hockele et al, 2022;Morgan et al, 2023;Nopp et al, 2022). All of the studies focused on respiratory muscle strength training in individuals experiencing post-COVID-19 symptoms, with four including an aerobic or peripheral strengthening exercise component in the intervention (Hayden et al, 2021;Hockele et al, 2022;Liu et al, 2020;Nopp et al, 2022), and one including a diaphragmatic release intervention (Nagy et al, 2022).…”

“…All but two studies used a pulmonary function measure as an indicator, comparing pre-and post-intervention means (Jimeno-Almazan et al, 2023;Palau et al, 2022). The included studies reported at least one significant pulmonary outcome measure post-intervention, except one (Morgan et al, 2023). Forced Vital Capacity.…”

“…Dyspnea. Dyspnea was measured in all but three of the included studies (Liu et al, 2020;Morgan et al, 2023;Palau et al, 2022). The MCID for patient-reported dyspnea has not yet been established for the post-COVID-19 population, but for the five studies that used the modified Medical Research Council Dyspnea Scale (Hayden et al, 2021;Hockele et al, 2022;Jimeno-Almazan et al, 2023;Nagy et al, 2022;Nopp et al, 2022), outcomes exceeded the MCID of −1 that is reported in the chronic obstructive pulmonary disease (COPD) population (Ammous et al, 2023).…”

“…Three different physiologic measurement strategies were used to determine physical capacity. Seven of the studies used the 6-minute walk test (6MWT) (Abodonya et al, 2021;Hayden et al, 2021;Hockele et al, 2022;Liu et al, 2020;Morgan et al, 2023;Nagy et al, 2022;Nopp et al, 2022), three measured cardiorespiratory fitness (Del Corral et al, 2023a;Jimeno-Almazan et al, 2023;Palau et al, 2022), and one used V02 max (McNarry et al, 2022). The MCID for the 6MWT has not yet been established for the post-COVID-19 population.…”