Laboratoire Impact de l'Activité Physique sur la Santé IAPS, University of Toulon, Toulon, France -
Service des Maladies Respiratoires, Renée Sabran Hôpital, Hospices Civils de Lyon, Giens, France.
Eur J Phys Rehabil Med. 2023 Feb;59(1):103-110. doi: 10.23736/S1973-9087.22.07702-4. Epub 2023 Jan 26.
Between 30% and 60% of people who have been infected with COVID-19 still had symptoms 3 months after the start of the disease. Prescribing a pulmonary rehabilitation program in rehabilitation facilities for post COVID-19 patients could help alleviate the symptoms. However, rehabilitation facilities known to provide good quality care to COVID-19 patients and all other patients, could become saturated by the rise in cases. Home-based rehabilitation is a potential solution that could be sustainable in the long term to avoid this saturation and/or a very long waiting list for patients.
The aim of this study was to investigate whether home-based rehabilitation would have similar effects compared to inpatient rehabilitation on physical and respiratory variables in post COVID-19 patients.
This is a randomized controlled trial.
Pulmonary rehabilitation facility.
Seventeen post COVID-19 patients were randomized into two groups: inpatient pulmonary rehabilitation (IPR) or home-based pulmonary rehabilitation (HPR).
The comparison of the two rehabilitation methods relied on questionnaires, physical tests and the evaluation of several respiratory parameters. A 2-way Analysis of Variance (ANOVA) with repeated measures was performed to assess the effects of time (pre- vs. post-rehabilitation), group (IPR vs. HPR) and their interaction for all parameters.
The main result of this study is that distance covered in the 6MWT (6MWD) shows significant improvements, between pre- and postrehabilitation program in both groups (+95 m in IPR group vs.+72 m in HPR group, P<0.001) with no significant interaction between time and group (P=0.420).
These results suggest that home-based pulmonary rehabilitation would be as efficient as IPR to decrease physical sequelae in post COVID-19 patients.
It is possible to suggest both methods (home-based rehabilitation or inpatient pulmonary rehabilitation) according to the specificities of each patient and depending on hospital saturation. The choice of one or the other method should not be made to the detriment of the patient.
COVID-19 感染后，仍有 30%至 60%的患者在发病 3 个月后仍有症状。为 COVID-19 后患者在康复机构中制定肺康复计划有助于缓解症状。然而，为 COVID-19 患者和所有其他患者提供高质量护理的康复机构可能会因病例增加而饱和。家庭康复是一种潜在的解决方案，可以长期避免这种饱和和/或患者的长时间等待名单。
本研究旨在调查家庭康复是否会对 COVID-19 后患者的身体和呼吸变量产生与住院康复相似的效果。
这是一项随机对照试验。
肺康复设施。
17 名 COVID-19 后患者被随机分为两组：住院肺康复（IPR）或家庭肺康复（HPR）。
通过问卷、身体测试和对几个呼吸参数的评估比较两种康复方法。使用双向方差分析（ANOVA）进行重复测量，以评估所有参数的时间（康复前与康复后）、组（IPR 与 HPR）及其相互作用的影响。
本研究的主要结果是，在两组中，6 分钟步行测试（6MWD）的距离都有显著改善，从康复前到康复后（IPR 组增加了 95 米，HPR 组增加了 72 米，P<0.001），时间和组之间没有显著的相互作用（P=0.420）。
这些结果表明，家庭肺康复与 IPR 一样有效，可以减少 COVID-19 后患者的身体后遗症。
可以根据患者的具体情况，建议使用这两种方法（家庭康复或住院肺康复），并根据医院的饱和度进行选择。不应为了患者的利益而牺牲选择一种或另一种方法。
