2022

DOI: 10.4187/respcare.09808

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In-Patient Trajectories and Effects of Training in Survivors of COVID-19-Associated Acute Respiratory Failure

Michele Vitacca

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(7 citation statements)

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“…Additionally, debate persists regarding the impact of physical therapy on forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Four studies 44,88,111,118 reported positive effects when combining breathing exercises with aerobic exercise/strength training on FEV1/FVC, whereas four studies 49,54,85,101 did not. Among these, Qi et al 85 concentrated on severely and critically ill ICU patients, potentially influenced by ventilator use.…”

Section: Resultsmentioning

confidence: 97%

“…These consisted of 99 in English and two in Chinese. The final analysis included 39 RCTs, 15 Non-RCTs, [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84] 18 cohort studies (one ambispective, 85 eight prospective, [86][87][88][89][90][91][92][93] and nine retrospective [94][95][96][97][98][99][100][101][102] ), and 29 before-and-after studies (19 prospective [103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119]…”

Section: Resultsmentioning

confidence: 99%

“…Yet, their study highlighted that early rehabilitation in these patients increased the duration ventilator-free days. The other three studies 49,54,101 focused on mild symptom patients without substantial airflow obstruction. Exercise capacity outcomes, including the Six-Minute Walk Test (6MWD) and the Sit-To-Stand Test (STS), were synthesized from data obtained in 16 RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, patients were recommended exercise intensity ranging from 40% to 70% of predicted maximal HR 71,90,98 or maximum HR max <80% with BS ≤ 3-6 as their intensity. 54,73,101 As for patients in the acute phase, it was acknowledged that this intensity should be appropriately reduced. 64,92 Two out of these 26 studies reported negative results.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies 38,51,[59][60][61]85,87,91,94,[99][100][101] reported length of ICU or hospital stay (LOS) for patients. Among them, eight studies 38,[59][60][61]85,87,94,100 did not demonstrate a shorter average LOS following rehabilitation interventions.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

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

Huang,

Qiao,

Song

et al. 2024

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Objective Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases. Data sources Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023. Review methods Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies. Results The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, −1.85; 95% CI, −3.00 to −0.70, low certainty), the mMRC Dyspnea Scale (MD, −0.45; 95% CI, −0.72 to −0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, −4.64; 95% CI, −6.54 to −2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33–51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07–5.01, low certainty). Conclusion Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.

“…Additionally, debate persists regarding the impact of physical therapy on forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Four studies 44,88,111,118 reported positive effects when combining breathing exercises with aerobic exercise/strength training on FEV1/FVC, whereas four studies 49,54,85,101 did not. Among these, Qi et al 85 concentrated on severely and critically ill ICU patients, potentially influenced by ventilator use.…”

Section: Resultsmentioning

confidence: 97%

“…These consisted of 99 in English and two in Chinese. The final analysis included 39 RCTs, 15 Non-RCTs, [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84] 18 cohort studies (one ambispective, 85 eight prospective, [86][87][88][89][90][91][92][93] and nine retrospective [94][95][96][97][98][99][100][101][102] ), and 29 before-and-after studies (19 prospective [103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119]…”

Section: Resultsmentioning

confidence: 99%

“…Yet, their study highlighted that early rehabilitation in these patients increased the duration ventilator-free days. The other three studies 49,54,101 focused on mild symptom patients without substantial airflow obstruction. Exercise capacity outcomes, including the Six-Minute Walk Test (6MWD) and the Sit-To-Stand Test (STS), were synthesized from data obtained in 16 RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, patients were recommended exercise intensity ranging from 40% to 70% of predicted maximal HR 71,90,98 or maximum HR max <80% with BS ≤ 3-6 as their intensity. 54,73,101 As for patients in the acute phase, it was acknowledged that this intensity should be appropriately reduced. 64,92 Two out of these 26 studies reported negative results.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies 38,51,[59][60][61]85,87,91,94,[99][100][101] reported length of ICU or hospital stay (LOS) for patients. Among them, eight studies 38,[59][60][61]85,87,94,100 did not demonstrate a shorter average LOS following rehabilitation interventions.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Huang,

Qiao,

Song

et al. 2024

View full text Add to dashboard Cite

Objective Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases. Data sources Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023. Review methods Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies. Results The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, −1.85; 95% CI, −3.00 to −0.70, low certainty), the mMRC Dyspnea Scale (MD, −0.45; 95% CI, −0.72 to −0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, −4.64; 95% CI, −6.54 to −2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33–51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07–5.01, low certainty). Conclusion Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.

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