Short-Term Effects of a Respiratory Telerehabilitation Program in Confined COVID-19 Patients in the Acute Phase: A Pilot Study

Abstract

The COVID-19 pandemic has caused distress for healthcare providers due to the respiratory problems it causes, among others. In this situation, rehabilitation of the respiratory system has been suggested and implemented in different COVID-19 patients. This study evaluated the feasibility and effectiveness of a novel program based on breathing exercises through telerehabilitation tools in COVID-19 patients with mild to moderate symptomatology in the acute stage. Forty subjects were randomized in an experimental group, based on pulmonary rehabilitation, and in a control group, of which the subjects did not perform physical activity. Thirty-eight subjects, with nineteen in each group, completed the one-week intervention. We performed measurements using the Six-Minute Walk Test, Multidimensional Dyspnoea-12, Thirty-Second Sit-To-Stand Test, and Borg Scale. Both groups were comparable at baseline. Significant differences were found for all of the outcome measures in favour of the experimental group. Ninety percent adherence was found in our program. A one-week telerehabilitation program based on respiratory exercises is effective, safe, and feasible in COVID-19 patients with mild to moderate symptomatology in the acute stage.

Will Remotely Based Pulmonary Rehabilitation Water Down Its Effectiveness?

“…Out of the total 26 studies conducted between 2011 and 2021; 15 (58%) were cohort studies, 10 (38%) were RCTs and one (4%) was a case series (Table 1). Twenty-one (81%) of the studies included participants with COPD [16][17][18][19][20][21][22][23][24][25][26][29][30][31][32][33][34][35][36]39,40], four (15%) with COVID-19 [27,28,37,38] and one (4%) with cystic fibrosis [15].…”

“…Four studies (Table 4) compared tele-rehabilitation to no rehabilitation [37][38][39][40], three of which were RCTs [37,38,40], and one was a cohort study [39]. The RCTs included a total of n = 234 participants, of which n = 115 received a tele-rehabilitation-based intervention.…”

“…Modes of Tele-Rehabilitation: When comparing tele-rehabilitation to no rehabilitation, the various modes of delivery included real-time broadcast by an HCP to the participant's home [39,40], pre-recorded sessions on a smartphone-based application [38], and twice weekly phone calls to otherwise unsupervised study participants [37]. Among studies utilizing real time broadcast, one study [39] used individualized sessions three times a week for 12 weeks, whereas group sessions three times a week for 8 weeks was used in the other [40].…”

“…Another study used a smartphone-based application which provided weekly teleconsultations in addition to 3-4 unsupervised sessions per week [38]. Unsupervised breathing exercises for 7 days with biweekly check-ins using telephone calls was used in one study [37]. Outcomes: Tele-rehabilitation compared with no rehabilitation was found to be feasible [37,39] and efficacious [38,40].…”

“…Unsupervised breathing exercises for 7 days with biweekly check-ins using telephone calls was used in one study [37]. Outcomes: Tele-rehabilitation compared with no rehabilitation was found to be feasible [37,39] and efficacious [38,40]. These studies showed that compared to no rehabilitation intervention, the tele-rehabilitation group showed improvements in the following areas: perceived dyspnea using the Borg scale [37], lower limb muscle strength using a static squat test [38], HRQoL using Short Form Health Survey-12 (SF-12), Physical Component Score (PCS) and CRQ scores, [38,40], and both the 6MWT and ESWT [37,38,40].…”