The Comparison of the Effectiveness of Respiratory Physiotherapy Plus Myofascial Release Therapy Versus Respiratory Physiotherapy Alone on Cardiorespiratory Parameters in Patients With COVID-19

Abstract

Background: Respiratory involvement is a common consequence of COVID-19; changes in cardiorespiratory parameters of these patients during respiratory rehabilitation program are very important. Previous studies showed that myofascial release therapy (MFRT) could affect the respiratory muscle and adjunct fascia. Purpose: The aim of this study was to evaluate the effects of MFRT techniques and respiratory physiotherapy, in comparison with respiratory physiotherapy alone, on improving cardiorespiratory parameter in patients with COVID-19. Setting: A hospital affiliated to Tehran University of Medical Sciences in Tehran, Iran, from February to July 2021. Participants: Fifty patients with COVID-19 participated in this study. Research Design: A single-blind, ran-domized control design. Intervention: The patients with COVID-19 randomly assigned to an intervention group who received respiratory physiotherapy combined with MFRT or a control group receiving respiratory physiotherapy alone. Main Outcome Measure(s): Heart rate, systolic and diastolic blood pressure, respiration rate, oxygen saturation, chest expansion, and ease of breathing were assessed at baseline and after the first and third session of treatment. Dyspnea and fatigue perception and 6-minute walking were assessed at baseline and at the end of treatment. Patient’s thoughts about the treatment were examined through the 4-point Likert scale. Results: The ANOVAs found significant time effect for ease of breathing, dyspnea perception (F = 32.33, p < .01 and F = 11.72, p < .01, respectively). Also significant time by group interaction was found for chest expansion at xiphoid level (F = 4.02, p = .02). Conclusions: The present study provided evidence that both programs could result in improving ease of breathing and dyspnea perception, although the inclusion of MFR techniques into a respiratory physiotherapy program did not result in better outcomes in cardiorespiratory function of patients with COVID-19.

Pulmonary Rehabilitation in SARS-CoV-2: A Systematic Review and Meta-Analysis of Post-Acute Patients

“…The range of article types included in this review is broad. Six randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], three cohort studies [ 55 , 56 , 57 ], one observational study [ 58 ], and one case-control trial [ 59 ]. The 11 included studies were conducted in Spain [ 49 ], China [ 50 ], Brazil [ 51 ], Iran [ 52 , 53 ], Turkey [ 54 ], France [ 55 ], Germany [ 56 ], Belgium [ 57 ], Switzerland [ 58 ], and Saudi Arabia [ 59 ].…”

“…In total, six studies were evaluated. Only one of the included studies was evaluated as having a “low risk of bias” [ 49 ], three as “some concerns” [ 50 , 51 , 54 ], and two as a “high risk of bias” [ 52 , 53 ], suggesting that only 16% of the included randomized controlled trials have a low risk of bias. According to the domain analysis, the random sequencing and reporting of incomplete data had a low risk of bias in all the included studies, while the blinding participants and allocation concealment were the main risks of bias in the included studies.…”

“…Eight studies analyzed the effects of pulmonary rehabilitation on dyspnea [ 49 , 50 , 51 , 52 , 53 , 54 , 56 , 59 ]. To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ].…”

“…Eight studies analyzed the effects of pulmonary rehabilitation on dyspnea [ 49 , 50 , 51 , 52 , 53 , 54 , 56 , 59 ]. To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ]. Six of the included studies were randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], and the risk of bias ranged from a low (16.6%), to unclear (49.8%) to a high risk of bias (33.6%).…”

“…To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ]. Six of the included studies were randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], and the risk of bias ranged from a low (16.6%), to unclear (49.8%) to a high risk of bias (33.6%). Two of included studies were observational [ 56 , 59 ], one of them of low quality [ 56 ], and the other one of high quality [ 59 ].…”