Simpson Andrew J, Green Angela, Nettleton Marion, Hyde Lucy, Shepherdson Joanne, Killingback Clare, Marshall Phil, Crooks Michael G
School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK.
Hull University Teaching Hospitals National Health Service Trust, Hull, UK.
ERJ Open Res. 2023 Mar 13;9(2). doi: 10.1183/23120541.00373-2022. eCollection 2023 Mar.
Coronavirus disease 2019 (COVID-19) has caused worldwide mass hospitalisation. The need for multidisciplinary post-hospitalisation rehabilitation is becoming increasingly apparent, and telerehabilitation has been endorsed. The aim of study was to investigate the feasibility and efficacy of pulmonary telerehabilitation for COVID-19 survivors.
This was a single-centre, mixed-methods, fast-track (wait-list), randomised controlled trial of telerehabilitation for patients who had been hospitalised with COVID-19. 40 patients discharged from two university teaching hospitals in the north of England were recruited. Telerehabilitation consisted of 12 exercise classes, six education events and opportunity for peer support. Patients commenced telerehabilitation 14 days after randomisation in the fast-track group and 56 days after randomisation in the wait-list group.
Descriptive and statistical improvements were noted in several clinical outcome measures. Exercise capacity increased from a median (interquartile range) 20 (14-24) sit-to-stand repetitions in 1 min at baseline to 25 (24-30) post-telerehabilitation. Breathlessness rated using the Medical Research Council dyspnoea scale changed from 3.5 (3-4) at baseline to 2 (1.5-3) post-telerehabilitation, with additional favourable outcomes noted in respiratory symptoms measured using numerical rating scales and visual analogue scales (VAS). Quality of life measured using the EuroQol VAS improved from 55 (60-70) units at baseline to 70 (55-80) units following telerehabilitation. Improvements in fatigue (modified Functional Assessment of Chronic Illness Therapy: Fatigue) and mood (Hospital Anxiety and Depression Scale - Depression) were also observed. Natural recovery was observed in the wait-list group prior to receiving telerehabilitation; however, improvements were accelerated by early telerehabilitation in the fast-track group.
We have shown that group-based telerehabilitation is feasible, safe, beneficial and well-received in this population.
2019年冠状病毒病(COVID-19)已导致全球大规模住院。多学科出院后康复的需求日益明显,远程康复已得到认可。本研究的目的是调查肺部远程康复对COVID-19幸存者的可行性和疗效。
这是一项针对因COVID-19住院患者的远程康复的单中心、混合方法、快速通道(等待名单)随机对照试验。招募了40名从英格兰北部两家大学教学医院出院的患者。远程康复包括12节运动课程、6次教育活动以及同伴支持机会。快速通道组的患者在随机分组后14天开始远程康复,等待名单组的患者在随机分组后56天开始。
在多项临床结果测量中观察到描述性和统计学上的改善。运动能力从基线时1分钟内坐立重复的中位数(四分位间距)20次(14 - 24次)增加到远程康复后的25次(24 - 30次)。使用医学研究委员会呼吸困难量表评定的呼吸困难程度从基线时的3.5(3 - 4)降至远程康复后的2(1.5 - 3),使用数字评分量表和视觉模拟量表(VAS)测量的呼吸症状也有其他有利结果。使用欧洲生活质量视觉模拟量表测量的生活质量从基线时的55(60 - 70)分提高到远程康复后的70(55 - 80)分。还观察到疲劳(改良慢性病治疗功能评估:疲劳)和情绪(医院焦虑抑郁量表 - 抑郁)的改善。在等待名单组接受远程康复之前观察到自然恢复;然而,快速通道组的早期远程康复加速了改善。
我们已经表明,基于小组的远程康复在该人群中是可行的、安全的、有益的且受到欢迎。