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Jeyaraman N, Jeyaraman M, Ramasubramanian S, Balaji S, Muthu S. Beyond statistical significance: Embracing minimal clinically important difference for better patient care. World J Methodol 2025; 15:97814. [DOI: 10.5662/wjm.v15.i1.97814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 09/09/2024] [Accepted: 09/13/2024] [Indexed: 09/29/2024] Open
Abstract
The minimal clinically important difference (MCID) represents a pivotal metric in bridging the gap between statistical significance and clinical relevance, addressing the direct impact of medical interventions from the patient's perspective. This comprehensive review analyzes the evolution, applications, and challenges of MCID across medical specialties, emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs. We discuss the evolution of MCID since its inception in the 1980s, its current applications across various medical specialties, and the methodologies used in its calculation, highlighting both anchor-based and distribution-based approaches. Furthermore, the paper delves into the challenges associated with the application of MCID, such as methodological variability and the interpretation difficulties that arise in clinical settings. Recommendations for the future include standardizing MCID calculation methods, enhancing patient involvement in setting MCID thresholds, and extending research to incorporate diverse global perspectives. These steps are critical to refining the role of MCID in patient-centered healthcare, addressing existing gaps in methodology and interpretation, and ensuring that medical interventions lead to significant, patient-perceived improvements.
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Affiliation(s)
- Naveen Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
- Department of Research Methods, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
| | - Madhan Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
- Department of Research Methods, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
| | - Swaminathan Ramasubramanian
- Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India
| | - Sangeetha Balaji
- Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India
| | - Sathish Muthu
- Department of Research Methods, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
- Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore 641021, Tamil Nadu, India
- Department of Orthopaedics, Government Medical College, Karur 639004, Tamil Nadu, India
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Lee JS, Baek CY, Kim HD, Kim DY. Effect of robot-assisted stair climbing training as part of a rehabilitation program to improve pulmonary function, gait performance, balance, and exercise capacity in a patient after severe coronavirus disease 2019: a case report. Physiother Theory Pract 2024; 40:1628-1634. [PMID: 36752656 DOI: 10.1080/09593985.2023.2175188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Severe coronavirus disease 2019 (COVID-19) infection may decrease respiratory and physical functions. OBJECTIVE To evaluate whether robot-assisted stair climbing training (RASCT) would improve pulmonary and physical functions in a patient post-severe COVID-19 infection. CASE DESCRIPTION A 48-year-old woman who had experienced severe COVID-19 underwent a 6-week inpatient rehabilitation. She persistently exhibited impaired pulmonary and physical functions, including walking and balance impairment. We provided a 30-min outpatient RASCT biweekly for 6 weeks. OUTCOMES After training, maximal inspiratory and maximal expiratory pressures improved from 81 and 74 cmH2O to 104 and 81 cmH2O, respectively. The walking speed improved from 1.15 to 1.21 m/s. In balance ability, physical performance battery score and timed up-and-go test improved from 8 to 11 s and 10.89 to 9.95 s, respectively. Regarding exercise capacity, the 6-min walk test distance improved from 453 to 482 m, and the number of 1-min sit-to-stand test improved from 20 to 23, with improved pulse rate and saturation level. The physical and psychological domain scores of the World Health Organization Quality-of-Life Scale-BREF improved from 44 to 63 and 69 to 81, respectively; Falls Efficacy Scale-International scores improved from 38 to 21. CONCLUSION RASCT, as part of a rehabilitation plan, was feasible and effective for this patient after severe COVID-19 infection.
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Affiliation(s)
- June Sung Lee
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
| | - Chang Yoon Baek
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Hyeong Dong Kim
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Dong Yeong Kim
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
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Tay SS, Visperas CA, Zaw EM, Tan MMJ, Samsudin F, Koh XH. Functional outcomes of COVID-19 patients who underwent acute inpatient rehabilitation and the exploration of the benefits of adjunct robotic therapy and the effects of frailty. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058221150078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective To describe the functional outcomes of post COVID-19 patients after inpatient rehabilitation and determine if patients who underwent adjunct daily robotic therapy with Andago had better functional outcomes than those who did not and if patients who were frail had worse functional outcomes than those who were pre-frail or not frail. Design Retrospective study of COVID-19 patients transferred for acute inpatient rehabilitation from 1 November 2021 to 31 December 2021. Results Post COVID-19 patients who underwent inpatient rehabilitation had an improvement in the Functional Independence Measure (FIM) (median 109 vs 82), Functional Ambulation Category(FAC) (median 3 vs 2), distance walked with physiotherapist (mean 143.5 vs 18.7 m), and the Hospital Anxiety and Depression Scale(HADS) (mean 4.5 vs 7.8) from baseline. Robotic therapy may be associated with a shorter rehabilitation medicine length of stay (median 13 vs 19.5 days) and a higher FIM efficiency (mean 2.3 vs 1.2). Patients with a higher frailty score may have a slower 10 Meter Walk Test (10MWT) speed at discharge (Spearman’s rho −0.542). Conclusion Post COVID-19 patients benefit from inpatient rehabilitation with a comprehensive rehabilitation program, and adjunct robotic therapy may be offered to further improve functional outcomes. Frailty may also be considered when establishing rehabilitation goals, as meaningful functional gains can still be achieved.
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Affiliation(s)
- San San Tay
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | | | - Ei Mon Zaw
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | - Mark MJ Tan
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | - Fathiah Samsudin
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | - Xuan Han Koh
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
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Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
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Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
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Mińko A, Turoń-Skrzypińska A, Rył A, Rotter I. The Impact of Comprehensive Rehabilitation on the Exercise Capacity of Patients after COVID-19. Adv Respir Med 2023; 91:504-515. [PMID: 37987299 PMCID: PMC10660722 DOI: 10.3390/arm91060037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is a complex disease that affects multiple body systems, including the respiratory, cardiovascular, neurological, and muscular systems. It is estimated that approximately half of the patients after the treatment for COVID-19 experience persistent symptoms that lead to a decreased physical capacity. Scientific recommendations suggest that cardiovascular and respiratory rehabilitation programs should be implemented in patients who have completed treatment for COVID-19. Therefore, the objective of this study was to evaluate the impact of comprehensive rehabilitation on the exercise capacity of patients after COVID-19 treatment. The study included 146 patients after the treatment for COVID-19 who were eligible for therapeutic rehabilitation. The exercise capacity was assessed using the 6-minute walk test (6MWT). The results showed that patients who underwent rehabilitation had an average increase of 23.83% in their 6MWT score compared to the baseline. A comprehensive rehabilitation program including breathing exercises, aerobic training, and strength and endurance exercises is an effective intervention that can improve the physical capacity of patients after COVID-19 treatment.
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Affiliation(s)
- Alicja Mińko
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (I.R.)
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Yamamoto H, Tanaka S, Kasugai D, Shimizu M, Tsuchikawa Y, Hori Y, Fugane Y, Inoue T, Nagaya M, Omote N, Higashi M, Yamamoto T, Jingushi N, Numaguchi A, Goto Y, Nishida Y. Physical function and mental health trajectories in COVID-19 patients following invasive mechanical ventilation: a prospective observational study. Sci Rep 2023; 13:14529. [PMID: 37666912 PMCID: PMC10477337 DOI: 10.1038/s41598-023-41684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
This prospective observational cohort study was performed to investigate the physical function and mental health trajectories of novel coronavirus disease 2019 (COVID-19) patients requiring invasive mechanical ventilation (IMV) after discharge from the intensive care unit (ICU). The study population consisted of 64 patients (median age, 60 years; 85.9% male; median IMV duration, 9 days). At ICU discharge, 28.1% of the patients had Medical Research Council (MRC) sum score < 48 points, and prolonged IMV was significantly associated with lower MRC sum score and handgrip strength. Symptoms were similar between groups at ICU discharge, and the symptoms most commonly reported as moderate-to-severe were impaired well-being (52%), anxiety (43%), tiredness (41%), and depression (35%). Although muscle strength and mobility status were significantly improved after ICU discharge, Edmonton Symptom Assessment System score did not improve significantly in the prolonged IMV group. EuroQol five-dimension five-level summary index was significantly lower in the prolonged than short IMV group at 6 months after ICU discharge. We found substantial negative physical function and mental health consequences in the majority of surviving COVID-19 patients requiring IMV, with prolonged period of IMV showing greater negative effects not only immediately but also at 6 months after discharge from the ICU.
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Affiliation(s)
- Hiromasa Yamamoto
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Daisuke Kasugai
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan.
| | - Miho Shimizu
- Department of Rehabilitation, Mie University Hospital, Tsu, Japan
| | - Yohei Tsuchikawa
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yuto Hori
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yuki Fugane
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Takayuki Inoue
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Motoki Nagaya
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Norihito Omote
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiko Higashi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Takanori Yamamoto
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Naruhiro Jingushi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Atsushi Numaguchi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Yukari Goto
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Noureddine S, Roux-Claudé P, Eberst G, Westeel V, Barnig C, Claudé F. [The role of the cardiopulmonary exercise test and pulmonary rehabilitation in long COVID-19]. Rev Mal Respir 2023; 40:604-622. [PMID: 37357041 PMCID: PMC10289121 DOI: 10.1016/j.rmr.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/12/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms. STATE OF THE ART Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life. PERSPECTIVES Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19. CONCLUSIONS CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time.
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Affiliation(s)
- S Noureddine
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
| | - P Roux-Claudé
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - G Eberst
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - V Westeel
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Barnig
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; UMR1098 Inserm, établissement français du sang de Bourgogne-Franche-Comté, 8, rue du Docteur-Jean-François-Xavier-Girod, 25000 Besançon, France
| | - F Claudé
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
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Pescaru CC, Crisan AF, Marc M, Trusculescu AA, Maritescu A, Pescaru A, Sumenkova A, Bratosin F, Oancea C, Vastag E. A Systematic Review of Telemedicine-Driven Pulmonary Rehabilitation after the Acute Phase of COVID-19. J Clin Med 2023; 12:4854. [PMID: 37510969 PMCID: PMC10381369 DOI: 10.3390/jcm12144854] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The acute phase of COVID-19 often leaves patients with persistent pulmonary deficits. Pulmonary Rehabilitation (PR) has been recommended as an essential part of post-acute COVID-19 management. In light of the global pandemic, telerehabilitation has been increasingly employed to deliver PR. This systematic review aimed to evaluate the effectiveness of telemedicine-driven PR in patients recovering from the acute phase of COVID-19, assessing variations in telerehabilitation practices and identifying the degree of change in mental health, physical health, quality of life, and lung function. A systematic search was conducted across PubMed, Web of Science, Cochrane, and Scopus up until April 2023. Studies focusing on telerehabilitation in PR for post-acute COVID-19 patients with outcomes including pulmonary function, exercise capacity, and quality of life were included after careful assessment of this study's protocol. The selection process involved careful scrutiny of abstracts and full texts, and the quality assessment was performed using the National Heart, Lung, and Blood Institute (NHLBI) tool. Seven studies, published between 2021 and 2022, involving a total of 412 patients, were included. The evaluated telerehabilitation programs stretched between 4 and 10 weeks, involving a mobile app or video connection with the patient, integrating a mix of aerobic and resistance training, breathing exercises, functional activities, and muscle strengthening. Findings revealed that telemedicine-driven PR significantly improved physical health, measured by the step test score (73 vs. 71), 6MWD (30.2 vs. 17.1) and BPAQ, mental health evaluated by SF-12 (6.15 vs. 4.17) and PHQ-4, quality of life measured by the SF-12 (7.81 vs. 3.84), SGRQ (31.5 vs. 16.9), and CAT scores, and some parameters of pulmonary function in post-acute COVID-19 patients (mMRC, STST, and MVV). This review substantiates the potential of telemedicine-driven PR to improve various health outcomes in post-acute COVID-19 patients. The findings underscore the importance of integrating telerehabilitation into the management of post-acute COVID-19 and call for further exploration of its long-term effects, cost-effectiveness, and best practices.
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Affiliation(s)
- Camelia Corina Pescaru
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Alexandru Florian Crisan
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
- Research Center for the Assessment of Human Motion, Functionality and Disability (CEMFD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Marc
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Ana Adriana Trusculescu
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Adelina Maritescu
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andrei Pescaru
- Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Anastasiia Sumenkova
- Penza State University, Faculty of Medicine, Ulitsa Krasnaya 40, 440026 Penza, Russia
| | - Felix Bratosin
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Emanuela Vastag
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
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Spielmanns M, Schaer CE, Pekacka-Egli AM, Spielmanns S, Ibish O, Gafina G, Stiube A, Hermann M. Pulmonary Rehabilitation Outcomes of Post-Acute COVID-19 Patients during Different Waves of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105907. [PMID: 37239633 DOI: 10.3390/ijerph20105907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Between the beginning of the coronavirus pandemic and summer 2022, we distinguished four pandemic waves, with different characteristics of the affected patients. This study investigated the impact of patient characteristics on the outcome of inpatient pulmonary rehabilitation (PR). (2) Methods: Using a prospective approach, the characteristics of post-acute COVID-19 patients of the different waves who participated in inpatient PR were compared based on their assessments and results collected as part of PR (Cumulative Illness Rating Scale (CIRS), six-minute walk test (6-MWT), Pulmonary Function Testing (PFT), and Functional Independent Measurement (FIM). (3) Results: A total of 483 patients were included in the analysis (Wave 1 n = 51, Wave 2 n = 202, Wave 3 n = 84, Wave 4 n = 146). Compared to Wave 3 + 4, patients of Wave 1 + 2 were older (69 vs. 63 years; p < 0.001), had a significantly lower CIRS (13.0 vs. 14.7 points; p = 0.004), had significant better PFT (FVC: 73 vs. 68%pred; p = 0.009; DLCOSB: 58 ± 18 vs. 50 ± 17%pred; p = 0.001), and showed significantly more comorbidities (2.0 vs. 1.6 n/pers.; p = 0.009). Wave 3 + 4 showed significantly greater improvements according to the 6-MWT (147 vs. 188 m; p < 0.001) and the FIM (5.6 vs. 21.1 points; p < 0.001). (4) Conclusions: Patients of the COVID-19 infection waves differed significantly according to their anthropometric data, incidence of comorbidities, and impact of the infection. All cohorts achieved clinically relevant and significant functional improvements during PR, with significant higher improvements in Wave 3 + 4.
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Affiliation(s)
- Marc Spielmanns
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
- Department for Pulmonary Medicine, Faculty of Health, University Witten Herdecke, 58455 Witten, Germany
| | - Corina E Schaer
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
| | | | - Sabine Spielmanns
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
| | - Olberk Ibish
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
| | - Guzel Gafina
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
| | - Antonela Stiube
- Pulmonary Medicine, Zuercher RehaZentren, Klinik Wald, 8636 Wald, Switzerland
| | - Matthias Hermann
- Department of Cardiology, University Heart Center, University Hospital Zurich, 8006 Zurich, Switzerland
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Tamburlani M, Cuscito R, Servadio A, Galeoto G. Effectiveness of Respiratory Rehabilitation in COVID-19's Post-Acute Phase: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11081071. [PMID: 37107905 PMCID: PMC10137696 DOI: 10.3390/healthcare11081071] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by the new grave and acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), generated an unprecedented danger to public health. This condition may impact survivors' quality of life and includes extensive pulmonary and respiratory outcomes. Respiratory rehabilitation is known for its effects in improving dyspnea, alleviating anxiety and depression, reducing complications, preventing and ameliorating dysfunctions, reducing morbidity, preserving functions and improving subjects' quality of life. For this reason, respiratory rehabilitation may be recommended for this category of patients. OBJECTIVE Our objective was to evaluate the effectiveness and benefits produced by the adoption of pulmonary rehabilitation (PR) programs in COVID-19's post-acute phase. MATERIAL AND METHODS A search of relevant publications was conducted using the following electronic databases: PubMed, Scopus, PEDro, and Cochrane Library. A single reviser selected pertinent articles that studied the effects of pulmonary rehabilitation during COVID-19's post-acute phase in improving the respiratory function, physical performance, autonomy and quality of life (QoL). RESULTS After an initial selection, 18 studies were included in this systematic review, of which 14 concern respiratory rehabilitation delivered in conventional form and 4 concern respiratory rehabilitation provided in telehealth. CONCLUSIONS Pulmonary rehabilitation combining different types of training-breathing, aerobic, fitness and strength-and not bypassing the neuropsychological aspects revealed itself to be capable of improving pulmonary and muscular functions, general health and quality of life in post-acute COVID-19 patients, besides increasing workout capacity and muscle strength, improving fatigue states and reducing anxiety and depression.
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Affiliation(s)
| | - Rossana Cuscito
- Master's Degree Course in Rehabilitation Sciences of the Health Professions, University of Rome Tor Vergata, 00133 Roma, Italy
| | | | - Giovanni Galeoto
- Departement of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed, IRCCS, 86077 Pozzilli, Italy
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11
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Gabunia S, Harmon EY, Sonagere MB, Teale AE. Characteristics and Outcomes of COVID-19 Survivors Requiring Inpatient Rehabilitation: A Comparison of Two Waves. Am J Phys Med Rehabil 2023; 102:206-213. [PMID: 35762847 PMCID: PMC9940787 DOI: 10.1097/phm.0000000000002059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Many survivors of severe or critical COVID-19 have required rehabilitation during the pandemic. The primary objective was to compare characteristics and outcomes of survivors of severe or critical COVID-19 admitted to the inpatient rehabilitation facility during the first two waves of the pandemic. Our secondary objective was to identify the factors contributing to functional dependence on admission, discharge, and length of stay. DESIGN This is a retrospective cohort study of 138 patients admitted to an inpatient rehabilitation facility in two waves after hospitalization for severe or critical COVID-19 illness between April 1, 2020, and May 3, 2021. RESULTS Inpatient rehabilitation facility patients in wave 2 had significantly greater functional independence (GG scores) on admission (52; interquartile range, 44-58 vs 41; interquartile range, 28-52), lower incidence of dysphagia and anemia. The patients in both waves experienced similar functional improvement efficiencies with a median GG score change of 3.6 per day and similar discharge GG scores. Neurological sequela (odds ratio, 0.12; P < 0.001) and anemia (odds ratio, 1.35; P < 0.002) were identified as independent predictors of functional independence on admission. CONCLUSIONS Patients with functional deficits after COVID-19 should be considered for acute inpatient rehabilitation as both patient cohorts benefited from their inpatient rehabilitation facility stays with similar length of stays (11-12 days) and discharge to home rates (88%-90%).
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12
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Simpson AJ, Green A, Nettleton M, Hyde L, Shepherdson J, Killingback C, Marshall P, Crooks MG. Group-based pulmonary telerehabilitation is feasible, safe, beneficial and well-received in patients who have been hospitalised with COVID-19. ERJ Open Res 2023; 9:00373-2022. [PMID: 36915803 PMCID: PMC9703872 DOI: 10.1183/23120541.00373-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has caused worldwide mass hospitalisation. The need for multidisciplinary post-hospitalisation rehabilitation is becoming increasingly apparent, and telerehabilitation has been endorsed. The aim of study was to investigate the feasibility and efficacy of pulmonary telerehabilitation for COVID-19 survivors. Methods This was a single-centre, mixed-methods, fast-track (wait-list), randomised controlled trial of telerehabilitation for patients who had been hospitalised with COVID-19. 40 patients discharged from two university teaching hospitals in the north of England were recruited. Telerehabilitation consisted of 12 exercise classes, six education events and opportunity for peer support. Patients commenced telerehabilitation 14 days after randomisation in the fast-track group and 56 days after randomisation in the wait-list group. Outcome measures and results Descriptive and statistical improvements were noted in several clinical outcome measures. Exercise capacity increased from a median (interquartile range) 20 (14-24) sit-to-stand repetitions in 1 min at baseline to 25 (24-30) post-telerehabilitation. Breathlessness rated using the Medical Research Council dyspnoea scale changed from 3.5 (3-4) at baseline to 2 (1.5-3) post-telerehabilitation, with additional favourable outcomes noted in respiratory symptoms measured using numerical rating scales and visual analogue scales (VAS). Quality of life measured using the EuroQol VAS improved from 55 (60-70) units at baseline to 70 (55-80) units following telerehabilitation. Improvements in fatigue (modified Functional Assessment of Chronic Illness Therapy: Fatigue) and mood (Hospital Anxiety and Depression Scale - Depression) were also observed. Natural recovery was observed in the wait-list group prior to receiving telerehabilitation; however, improvements were accelerated by early telerehabilitation in the fast-track group. Conclusions We have shown that group-based telerehabilitation is feasible, safe, beneficial and well-received in this population.
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Affiliation(s)
- Andrew J Simpson
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Angela Green
- Hull University Teaching Hospitals National Health Service Trust, Hull, UK
| | - Marion Nettleton
- Hull University Teaching Hospitals National Health Service Trust, Hull, UK
| | - Lucy Hyde
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Joanne Shepherdson
- Hull University Teaching Hospitals National Health Service Trust, Hull, UK
| | - Clare Killingback
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Phil Marshall
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Michael G Crooks
- Hull University Teaching Hospitals National Health Service Trust, Hull, UK.,Hull York Medical School, University of Hull, Hull, UK
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13
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Gephine S, Lemyze M, Pauquet P, Rouzic OL, Fry S, Chenivesse C, Grosbois JM. Effectiveness of a home-based pulmonary rehabilitation programme in people recovering from a severe and critically COVID-19 infection. Respir Med Res 2023; 83:100991. [PMID: 37043972 PMCID: PMC9827746 DOI: 10.1016/j.resmer.2023.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/18/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023]
Affiliation(s)
- Sarah Gephine
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, EA 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59000 Lille, France.,FormAction Santé, F-59840 Pérenchies, France
| | - Malcolm Lemyze
- CH Arras, Service de réanimation et Unité de Sevrage Intensif et Réhabilitation Post-Réanimation, F-62000 Arras
| | - Philippe Pauquet
- CH Arras, Service de réanimation et Unité de Sevrage Intensif et Réhabilitation Post-Réanimation, F-62000 Arras
| | - Olivier Le Rouzic
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, F-59000 Lille
| | - Stéphanie Fry
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, F-59000 Lille
| | - Cécile Chenivesse
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, F-59000 Lille
| | - Jean-Marie Grosbois
- FormAction Santé, F-59840 Pérenchies, France.,Corresponding author: Jean-Marie Grosbois, Zone d'Activité du Bois, Rue de Pietralunga, Pérenchies F-59840, France
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14
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Coakley K, Friedman L, McLoughlin K, Wozniak A, Hutchison P. Acute Occupational and Physical Therapy for Patients With COVID-19: A Retrospective Cohort Study. Arch Phys Med Rehabil 2023; 104:27-33. [PMID: 35926570 PMCID: PMC9340124 DOI: 10.1016/j.apmr.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the function of patients with COVID-19 admitted to an acute care hospital early in the pandemic and to characterize change in function among those admitted to intensive care units (ICU) and to non-critical care services. DESIGN This descriptive, retrospective cohort study examined patients infected with SARS-CoV-2 admitted to a tertiary care medical center during the first wave of the pandemic in 2020. Included patients were stratified into 4 cohorts based on whether or not they received therapy during their hospitalization and whether or not their hospitalization included time in the ICU. Data on demographic characteristics, functional impairments, medical interventions, and functional outcomes were collected. SETTING Hospital. PARTICIPANTS 432 adult patients were included in this study (N=432). RESULTS ICU patients receiving therapy were more likely to have impaired cognition, impaired strength, and impaired sensation than non-ICU patients receiving therapy. Patients made improvements from evaluation to discharge on the Functional Status Score for the ICU, Activity Measure for Post-Acute Care Daily Activity, and AM-PAC Basic Mobility Short Forms. CONCLUSION Patients admitted with COVID-19 experienced significant functional impairments but also demonstrated improvement during the course of their hospitalizations. This study can facilitate health care provider awareness of the detrimental functional effects of COVID-19 and the potential role of rehabilitation services for these patients.
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Affiliation(s)
- Katie Coakley
- Corresponding author Katie Coakley, OTR/L, Loyola University Medical Center, Maywood, IL
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15
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Corna S, Giardini M, Godi M, Bellotti L, Arcolin I. Effects of Aerobic Training in Patients with Subacute COVID-19: A Randomized Controlled Feasibility Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16383. [PMID: 36554262 PMCID: PMC9778393 DOI: 10.3390/ijerph192416383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
Many clinical practice recommendations indicate rehabilitation as essential for patients with sequelae of severe or critical COVID-19 and suggest the prompt initiation of a multicomponent rehabilitation program focused on aerobic and endurance training. However, randomized controlled trials (RCTs) regarding aerobic exercise are lacking. Therefore, we aimed to assess the feasibility and effectiveness of the addition of aerobic training to standard rehabilitation in subjects with subacute COVID-19. Participants were 32/214 patients with the sequelae of severe or critical COVID-19 in the acute phase who were eligible and agreed to participate in the study (eligibility = 15%, recruitment = 100%). After randomization and assessment with functional and strength tests, all the participants underwent an inpatient-tailored rehabilitation program (50 min/day, 5 days/week, 10 sessions); in addition, the experimental group performed a low- to moderate-intensity aerobic exercise (30 min/day, 10 sessions). No dropouts or severe adverse events were reported, with an attendance rate of 95.6%. Most of the secondary outcomes significantly improved in both groups, but the improvement in the Functional Independence Measure and Cumulated Ambulation Score-Italian version was significantly greater in the experimental group (at least, p < 0.05). This RCT showed that aerobic exercise is feasible and safe in subacute COVID-19. Moreover, it appears to be beneficial and useful in improving patients' independence and mobility.
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Affiliation(s)
| | - Marica Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Division of Physical Medicine and Rehabilitation of Veruno Institute, 28013 Gattico-Veruno, Italy
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16
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Reinert G, Müller D, Wagner P, Martínez-Pozas O, Cuenca-Záldivar JN, Fernández-Carnero J, Sánchez Romero EA, Corbellini C. Pulmonary Rehabilitation in SARS-CoV-2: A Systematic Review and Meta-Analysis of Post-Acute Patients. Diagnostics (Basel) 2022; 12:3032. [PMID: 36553039 PMCID: PMC9776761 DOI: 10.3390/diagnostics12123032] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Pulmonary Rehabilitation (PR) was initially developed for the management of Chronic Obstructive Pulmonary Disease (COPD) and is now recognized as a core management of COVID-19 patients. This systematic review and meta-analysis examined the efficacy of PR in patients with post-acute COVID-19 infection. METHODS A literature search was conducted in PubMed, the Web of Science (WoS), and the Cochrane Library from their inceptions until October 2022, and randomized controlled trials and observational studies were considered. The outcomes measured included dyspnea, physical function, and quality of life. RESULTS Eleven studies including 677 participants with post-acute COVID-19 were included in this analysis. From a qualitative point of view and analyzing the studies separately, PR improves dyspnea, physical function, and quality of life in patients with post-acute COVID-19. However, in pooling the data of all the studies, no significant changes pre-postintervention, compared to the control, were found among the experimental studies included in the analysis in any outcome measures, due to the high heterogeneity between the studies, as well as no significant improvements being found in the observational studies. A subgroup analysis revealed significant differences in all the included outcomes. Future studies should include the same scale to assess the actual efficacy of PR. CONCLUSION From a qualitative analysis point of view, PR is effective in improving physical function, reducing dyspnea, and improving quality of life in patients with post-acute COVID-19. However, an exploratory meta-analysis was performed to evaluate, by subgroups, the efficacy of PR, and positive results were found in favor of PR.
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Affiliation(s)
- Glenn Reinert
- Hopitaux Robert Schuman-Centre Médical Clinique Sainte Marie, Rue Wurth-Paquet 7, 4350 Esch-sur-Alzette, Luxembourg;
- Physiotherapy Masters of Science Programme, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg; (D.M.); (P.W.)
| | - Daniel Müller
- Physiotherapy Masters of Science Programme, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg; (D.M.); (P.W.)
- Physiotherapy Unit, Centre Hospitalier de Luxembourg, Rue Ernest Barble 4, 1210 Luxembourg, Luxembourg
| | - Pit Wagner
- Physiotherapy Masters of Science Programme, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg; (D.M.); (P.W.)
| | - Oliver Martínez-Pozas
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
| | - Juan Nicolás Cuenca-Záldivar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
- Physical Therapy Unit, Primary Health Care Center “El Abajón”, 28231 Las Rozas de Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - Eleuterio A. Sánchez Romero
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - Camilo Corbellini
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg;
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17
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Bailly M, Pélissier L, Coudeyre E, Evrard B, Bingula R, Rochette C, Mériade L, Blavignac C, Fournier AC, Bignon YJ, Rannou F, Dutheil F, Thivel D, Duclos M. Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159025. [PMID: 35897400 PMCID: PMC9331032 DOI: 10.3390/ijerph19159025] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.
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Affiliation(s)
- Mélina Bailly
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Léna Pélissier
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
- Correspondence:
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Bertrand Evrard
- Service d’Immunologie, Centre Hospitalier Universitaire (CHU) Gabriel-Montpied, 63000 Clermont-Ferrand, France;
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Rea Bingula
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Corinne Rochette
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Laurent Mériade
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Christelle Blavignac
- Centre Imagerie Cellulaire Santé, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Anne-Cécile Fournier
- Cluster Auvergne-Rhône-Alpes Innovation Innovatherm, 63000 Clermont-Ferrand, France;
| | - Yves-Jean Bignon
- U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne, 63000 Clermont Ferrand, France;
- Département d’Oncogénétique, Centre Jean Perrin, 63011 Clermont-Ferrand, France
| | - Fabrice Rannou
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, LaPSCo, Physiological and Psychosocial Stress, Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Witty Fit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - David Thivel
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Martine Duclos
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
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