Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento n.80, 42123 Reggio Emilia, Italy.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio, Via del Pozzo n.74, 41100 Modena, Italy.
Int J Environ Res Public Health. 2022 Apr 24;19(9):5185. doi: 10.3390/ijerph19095185.
Increasing numbers of individuals suffer from post-acute COVID-19 syndrome (PACS), which manifests with persistent symptoms, the most prevalent being dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. This systematic review investigated the effectiveness of rehabilitation interventions for individuals with PACS. We searched the MEDLINE, Embase, Cochrane Register of Controlled Trials, CINHAL, Scopus, Prospero, and PEDro databases and the International Clinical Trials Registry Platform for randomized controlled trials (RCTs) up to November 2021. We screened 516 citations for eligibility, i.e., trials that included individuals with PACS exposed to exercise-based rehabilitation interventions. Five RCTs were included, accounting for 512 participants (aged 49.2-69.4 years, 65% males). Based on the revised Cochrane risk-of-bias tool (RoB 2.0), two RCTs had "low risk of bias", and three were in the "some concerns" category. Three RCTs compared experimental rehabilitation interventions with no or minimal rehabilitation, while two compared two active rehabilitation interventions. Rehabilitation seemed to improve dyspnea, anxiety, and kinesiophobia. Results on pulmonary function were inconsistent, while improvements were detected in muscle strength, walking capacity, sit-to-stand performance, and quality of life. Pending further studies based on qualitatively sound designs, these first findings seem to advocate for rehabilitation interventions to lessen disability due to PACS.
越来越多的人患有新冠后综合征（PACS），其表现为持续存在的症状，最常见的是呼吸困难、疲劳以及肌肉骨骼、认知和/或心理健康障碍。本系统评价调查了康复干预措施对 PACS 患者的有效性。我们检索了 MEDLINE、Embase、Cochrane 对照试验登记册、CINHAL、Scopus、Prospero 和 PEDro 数据库以及国际临床试验注册平台，以获取截至 2021 年 11 月的随机对照试验（RCT）。我们筛选了 516 条引文以确定其是否符合纳入标准，即纳入了患有 PACS 并接受基于运动的康复干预的个体的试验。纳入了 5 项 RCT，共纳入 512 名参与者（年龄 49.2-69.4 岁，65%为男性）。根据修订后的 Cochrane 偏倚风险工具（RoB 2.0），有 2 项 RCT 为“低偏倚风险”，3 项为“存在一些关注”。有 3 项 RCT 比较了实验性康复干预与无康复或最小康复的效果，而另外 2 项比较了两种积极的康复干预。康复似乎改善了呼吸困难、焦虑和运动恐惧。肺功能的结果不一致，而肌肉力量、步行能力、从坐到站的表现和生活质量都有改善。在基于高质量设计的进一步研究之前，这些初步发现似乎支持康复干预以减轻因 PACS 导致的残疾。
