Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study

Abstract

Background In addition to the cardiorespiratory, muscular, and neurological manifestations, coronavirus disease 2019 (COVID-19) alters patients’ health-related quality of life (HRQoL), induces a large variety of psychiatric manifestations, and reduces mobility and motor activity. Several studies have raised the impact of a pulmonary rehabilitation program (PRP) on social disadvantage (e.g., HRQoL, anxiety, depression) and physical activity of COVID-19 patients, but very few have been performed in low-income countries. This study aimed to investigate the impact of a PRP on post-COVID-19 HRQoL, hospital anxiety and depression (HAD), and physical activity in Tunisian post-COVID19-patients. Methods This was a cross-sectional study in an outpatient care setting. Patients with post-COVID-19 were included. They completed an interview (including three questionnaires) before and after a PRP (three sessions/week for four weeks, each session was 70 minutes in duration, PRP items: aerobic cycle endurance, strength training, and education). The VQ11 questionnaire assessed functional dimension, psychological dimension, relational dimension, and total score; HAD appraised depression and anxiety; and Voorrips physical activity assessed daily activity, physical activity, leisure activity, and total scores. Data were expressed as mean±standard deviation in PRP change (PRP change=after-PRP values − before-PRP values). Results In total, 14 moderate to severe post-COVID-19 patients (61±4 years) were included. The PRP significantly improved the i) functional, psychological, and relational dimensions, and the VQ11 total score by 1.79±1.58 (p=0.0033), 2.00±2.15 (p=0.0108), 1.57±1.50 (p=0.0077), and 5.36±3.97 (p=0.0015), respectively; ii) HAD anxiety and depression scores by 2.07±2.40 (p=0.0076), and 2.57±3.08 (p=0.0058); and iii) physical activity and total scores by 1.75±2.44 (p=0.0251), and 1.78±2.65 (p=0.0341), respectively. Conclusion The PRP improved HRQoL, HAD, and physical activity of Tunisian post-COVID-19 patients.

Effect of Implementing Telerehabilitation versus Traditional Pulmonary Rehabilitation Program on Clinical Outcomes of Patients Post Covid-19

“…This finding may be attributed to the effect of Covid-19 on the respiratory system that affect lung tissue and decrease o2 saturation so, patients complain from extreme fatigue.Additionally, this improvement may be due to the effect of the rehabilitation program via using the information technology such as (whatsapp text messaging, video, and audio calls ) , most of telerehablitation group were health care provider and highly educated in addition to, using the traditional colored educational booklet with clear, attractive and simple written information and sending the colored educational photo and recorded video to the studied group. Moreover, this finding was in consistence with Graham (2021) (42) and de Sire (2022) (42) who reported that the most of post covid-19 patients experienced fatigue. Meanwhile, in telehealth group one month after implementing the pulmonary rehabilitation program the finding was in agreement with Bickton (2021) (41) who reported that the fatigue score was decrease to normal fatigue level in post-acute COVID-19 who utilized the qualified physiotherapist's supervision via whatsapp text messaging, video and audio calls for (telerehablitation ) for 3 weeks.…”

“…Moreover, Gilmutdinova (2021) (41) who stated that the well-being improved in the majority of patients who participated in an intervention involving telerehabilitation and telemonitoring after COVID-19. Also, Betschart (2021) (33) and Benzarti (2022) (42) who reported that there was a statistically significant improvement in HRQoL from more than half before the program to the majority after implementing the program in Vol. 28.…”

Pulmonary rehabilitation in patients with prior COVID-19 infections

“…Benzarti et al studied the outcome of a pulmonary rehabilitation program in 14 patients with moderate to severe post-COVID symptoms. 13 They used questionnaires for health-related quality of life, depression, anxiety, and physical activity. The rehabilitation program involved three sessions per week for four weeks.…”