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远程医疗初级保健康复计划可改善 COVID-19 幸存者的自我感知用力,这些幸存者经历了新冠后疲劳和呼吸困难:一项准实验研究。

A tele-health primary care rehabilitation program improves self-perceived exertion in COVID-19 survivors experiencing Post-COVID fatigue and dyspnea: A quasi-experimental study.

机构信息

Gerencia Asistencial Atención Primaria de Madrid, Centro de Salud Dr. Castroviejo, Madrid, Spain.

Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

PLoS One. 2022 Aug 4;17(8):e0271802. doi: 10.1371/journal.pone.0271802. eCollection 2022.

Abstract

BACKGROUND

Current evidence suggests that up to 70% of COVID-19 survivors develop post-COVID symptoms during the following months after infection. Fatigue and dyspnea seem to be the most prevalent post-COVID symptoms.

OBJECTIVE

To analyze whether a tele-rehabilitation exercise program is able to improve self-perceived physical exertion in patients with post-COVID fatigue and dyspnea.

METHODS

Sixty-eight COVID-19 survivors exhibiting post-COVID fatigue and dyspnea derived to four Primary Health Care centers located in Madrid were enrolled in this quasi-experimental study. A tele-rehabilitation program based on patient education, physical activity, airway clearing, and breathing exercise interventions was structured on eighteen sessions (3 sessions/week). Self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life and distance walked and changes in oxygen saturation and heart rate during the 6-Minute walking test were assessed at baseline, after the program and at 1- and 3-months follow-up periods.

RESULTS

Daily living activities, dyspnea severity and quality of life improved significantly at all follow-ups (p<0.001). Additionally, a significant increase in oxygen saturation before and after the 6-Minute Walking test was found when compared with baseline (P<0.001). Heart rate adaptations at rest were found during the follow-up periods (P = 0.012). Lower perceived exertion before and after the 6-Minute Walking test were also observed, even if larger distance were walked (P<0.001).

CONCLUSION

Tele-rehabilitation programs could be an effective strategy to reduce post-COVID fatigue and dyspnea in COVID-19 survivors. In addition, it could also reduce the economic burden of acute COVID-19, reaching a greater number of patients and releasing Intensive Unit Care beds for prioritized patients with a severe disease.

STUDY REGISTRATION

The international OSF Registry registration link is https://doi.org/10.17605/OSF.IO/T8SYB.

摘要

背景

目前的证据表明,多达 70%的 COVID-19 幸存者在感染后接下来的几个月会出现新冠后症状。疲劳和呼吸困难似乎是最常见的新冠后症状。

目的

分析远程康复锻炼计划是否能够改善新冠后疲劳和呼吸困难患者的自我感知身体用力程度。

方法

68 名患有新冠后疲劳和呼吸困难的 COVID-19 幸存者被纳入这项准实验研究,他们来自马德里的四个初级保健中心。基于患者教育、体育活动、气道清理和呼吸练习干预的远程康复计划分为十八个阶段(每周 3 次)。在基线、计划结束后以及 1 个月和 3 个月随访期间,评估患者在日常生活活动中的自我感知身体用力程度、呼吸困难严重程度、健康相关生活质量以及 6 分钟步行测试中行走的距离,同时评估氧饱和度和心率的变化。

结果

在所有随访中,日常生活活动、呼吸困难严重程度和生活质量均显著改善(p<0.001)。此外,与基线相比,6 分钟步行测试前后的氧饱和度显著增加(P<0.001)。在随访期间发现静息时的心率适应性(P = 0.012)。即使行走距离更大,6 分钟步行测试前后的感知用力程度也较低(P<0.001)。

结论

远程康复计划可能是一种有效策略,可以减轻 COVID-19 幸存者的新冠后疲劳和呼吸困难。此外,它还可以减轻急性 COVID-19 的经济负担,覆盖更多的患者,并为病情严重的优先患者腾出重症监护病房床位。

研究注册

国际 OSF 注册表注册链接为 https://doi.org/10.17605/OSF.IO/T8SYB。

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