Center for Rehabilitation Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, People's Republic of China.
School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Thorax. 2022 Jul;77(7):697-706. doi: 10.1136/thoraxjnl-2021-217382. Epub 2021 Jul 26.
To investigate superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to exercise capacity, lower limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL) and dyspnoea.
Parallel-group randomised controlled trial with 1:1 block randomisation.
Three major hospitals from Jiangsu and Hubei provinces, China.
120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO.
Unsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry.
Primary outcome was 6 min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up).
Adjusted between-group difference in change in 6MWD was 65.45 m (95% CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12 s (95% CI 12.34 to 27.9; p<0.001) post-treatment and 22.23 s (95% CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up.
This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL.
ChiCTR2000031834.
比较远程康复（TERECO）与无康复治疗对 COVID-19 患者运动能力、下肢肌肉力量（LMS）、肺功能、健康相关生活质量（HRQOL）和呼吸困难的影响。
平行组随机对照试验，1:1 块随机分组。
中国江苏和湖北三省的三家大医院。
120 名曾住院的 COVID-19 幸存者，仍有呼吸困难症状，随机分为对照组（n=61）和 TERECO 组（n=59）。
非监督家庭 6 周运动方案，包括呼吸控制和胸廓扩张、有氧运动和 LMS 运动，通过智能手机进行，远程监测心率遥测。
主要结局为 6 分钟步行距离（6MWD），以米为单位。次要结局为深蹲时间（秒）；肺功能采用肺活量测定法评估；HRQOL 采用 12 项简明健康调查量表（SF-12）和 mMRC 呼吸困难量表进行评估。在 6 周（治疗后）和 28 周（随访）时进行评估。
治疗后和随访时，6MWD 变化的调整后组间差异分别为 65.45 米（95%置信区间 43.8 至 87.1；p<0.001）和 68.62 米（95%置信区间 46.39 至 90.85；p<0.001）。LMS 的治疗效果分别为 20.12 秒（95%置信区间 12.34 至 27.9；p<0.001）和 22.23 秒（95%置信区间 14.24 至 30.21；p<0.001）。除治疗后最大自主通气量外，肺功能无组间差异。TERECO 组 SF-12 生理成分的增加更大，治疗效果估计为治疗后 3.79（95%置信区间 1.24 至 6.35；p=0.004）和随访时 2.69（95%置信区间 0.06 至 5.32；p=0.045）。
该试验表明，与无康复治疗相比，远程康复对 6MWD、LMS 和生理 HRQOL 具有优越性。
ChiCTR2000031834。
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