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家庭为基础的肺康复计划联合和不联合远程指导对 COVID-19 幸存者健康相关结局的影响:一项随机对照临床研究。

Effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors: a randomized controlled clinical study.

机构信息

. Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Pulmonary Rehabilitation Unit, Izmir, Turkey.

. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.

出版信息

J Bras Pneumol. 2023 Jan 23;49(1):e20220107. doi: 10.36416/1806-3756/e20220107. eCollection 2023.

Abstract

OBJECTIVE

To compare the effects of a home-based pulmonary rehabilitation (PR) program with and without telecoaching on health-related outcomes in COVID-19 survivors.

METHODS

A total of 42 COVID-19 patients who completed medical treatment were randomly divided into two groups: the study (telecoaching) group (n = 21) and the control (no telecoaching) group (n = 21). Both groups participated in an 8-week home-based PR program including education, breathing exercises, strength training, and regular walking. The study group received phone calls from a physiotherapist once a week. Both groups of patients were assessed before and after the program by means of the following: pulmonary function tests; the modified Medical Research Council dyspnea scale; the six-minute walk test; extremity muscle strength measurement; the Saint George's Respiratory Questionnaire (to assess disease-related quality of life); the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, to assess overall quality of life); and the Hospital Anxiety and Depression Scale.

RESULTS

In both groups, there were significant improvements in the following: FVC; the six-minute walk distance; right and left deltoid muscle strength; Saint George's Respiratory Questionnaire activity domain, impact domain, and total scores; and SF-36 social functioning, role-physical, role-emotional, and bodily pain domain scores (p < 0.05). Decreases in daily-life dyspnea, exertional dyspnea, and exertional fatigue were significant in the study group (p < 0.05), and the improvement in SF-36 social functioning domain scores was greater in the study group (p < 0.05).

CONCLUSIONS

A home-based PR program with telecoaching increases social functioning and decreases daily-life dyspnea, exertional dyspnea, and exertional fatigue in COVID-19 survivors in comparison with a home-based PR program without telecoaching.

摘要

目的

比较基于家庭的肺康复(PR)计划与带或不带远程指导对 COVID-19 幸存者健康相关结局的影响。

方法

共纳入 42 例完成治疗的 COVID-19 患者,随机分为两组:研究(远程指导)组(n=21)和对照组(无远程指导)(n=21)。两组均参加为期 8 周的家庭基于 PR 计划,包括教育、呼吸练习、力量训练和定期行走。研究组每周接受一次物理治疗师的电话随访。两组患者在计划前后均进行以下评估:肺功能检查;改良的医学研究理事会呼吸困难量表;6 分钟步行试验;四肢肌肉力量测量;圣乔治呼吸问卷(评估与疾病相关的生活质量);医疗结果研究 36 项简明健康调查(SF-36,评估整体生活质量);和医院焦虑和抑郁量表。

结果

两组患者 FVC、6 分钟步行距离、右三角肌和左三角肌力量、圣乔治呼吸问卷活动域、影响域和总分以及 SF-36 社会功能、角色身体、角色情感和躯体疼痛域评分均有显著改善(p<0.05)。研究组日常生活呼吸困难、运动呼吸困难和运动疲劳程度降低有显著意义(p<0.05),SF-36 社会功能域评分改善程度更大(p<0.05)。

结论

与不带远程指导的基于家庭的 PR 计划相比,带远程指导的基于家庭的 PR 计划可增加 COVID-19 幸存者的社会功能,减少日常生活呼吸困难、运动呼吸困难和运动疲劳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9970366/93bf3cd43927/1806-3756-jbpneu-49-01-e20220107-gf1.jpg

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