The Effect of Respiratory and Core Stability Tele-exercises on Pulmonary and Functional Status in COVID-19 Survivors: A Randomized Clinical Trial

Abstract

Purpose: Various complications, including physical, cognitive, and functional disorders, have been identified in patients discharged and recovered from COVID-19. Pulmonary rehabilitation (PR) can be considered a strategy for these disorders. This study aimed to investigate the effect of respiratory and core stability tele-exercises on pulmonary function and functional capacity in survivors discharged and recovered from COVID-19. Methods: This randomized clinical trial study was performed in Qom Province, Iran, in 2021. Thirty discharged patients voluntarily participated in this study and were randomly divided into two groups of 15 patients. Eventually, 27 patients in two groups of exercise (13 patients) and control (14 patients) completed this study. The exercise group performed respiratory and core stability tele-exercise for 8 weeks. Before and after the exercise program, pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, and six-minute walk test (6MWT) were assessed in both groups. Mixed repeated measures test in SPSS software v. 27, was used to compare the mean of pre-test-post-test information of the groups. The significance level for this study was considered 0.05. Results: In the exercise group, a significant improvement was observed in FVC, FEV1, and 6MWT after the intervention (P≤0.05), but no significant difference was observed in the FEV1/FVC ratio (P>0.05). Furthermore, a significant interaction was observed in 6MWD, FVC, FVC (predicted), FEV1, and FEV1 (predicted). However, in FEV1/FVC ratio, no significant interaction was observed between the two groups (P>0.05). Conclusion: The results of the study showed that in the new crisis resulting from persistent complications of COVID-19, respiratory and core stability exercises by the tele-exercise method could be used as a helpful method in the rehabilitation of patients discharged and recovered from COVID-19 disease.

Rehabilitation and COVID-19: systematic review by Cochrane Rehabilitation

“…Supplementary Digital Material 3 (Supplementary Table III) 39 - 91 shows the characteristics of the included studies. More than half of the studies (57%, N=30, 2075 participants) included adults with PCC, 42 - 46 , 48 - 51 , 53 , 56 , 57 , 59 - 62 , 64 , 66 , 67 , 70 - 72 , 74 - 76 , 81 , 83 , 85 , 88 , 89 followed by adults with non-severe (34%, N.=18, 1489 participants), severe (6%, N.=3, 230 participants) 39 , 63 , 86 and critical COVID-19 (4%, N.=2, 88 participants). 41 , 90 …”

“…Only 11 RCTs 46 , 55 , 61 , 62 , 64 , 66 , 67 , 74 , 79 , 80 , 85 were similar enough to be grouped within the same comparisons, but the risk of bias across these studies was high and unclear in most of the bias domains. Consequently, we did not pool the data in a meta-analysis but synthesized the evidence narratively.…”

“…Three studies 62 , 66 , 85 assessed respiratory function (FEV1, FVC), showing an effect in favor of multicomponent telerehabilitation compared to no treatment in adults with PCC on FEV 1 ( Figure 12 ), but no evidence of an effect on FVC between multicomponent telerehabilitation and no treatment in adults with PCC ( Figure 13 ) (very low certainty of evidence). Two of these studies 62 , 66 also assessed respiratory function in terms of FEV1/FVC%, showing no evidence of an effect between multicomponent telerehabilitation and no treatment in adults with PCC ( Figure 14 ) (very low certainty of evidence).…”

“…Three studies 62 , 66 , 85 assessed physical exercise capacity, showing an effect in favor of multicomponent telerehabilitation compared to no treatment in adults with PCC ( Figure 15 ) (very low certainty of evidence).…”

“…One study 59 reported adverse effects during the olfactory training, including two (0.8%) reports of headaches and one (0.4%) report of worsening parosmia associated with the intervention. Fourteen studies 42 , 44 , 45 , 48 , 51 , 60 , 62 , 64 , 66 , 67 , 70 , 71 , 75 , 81 did not address adverse events.…”