Smith Jemma L, Deighton Kevin, Innes Aidan Q, Holl Marc, Mould Laura, Liao Zhining, Doherty Patrick, Whyte Greg, King James A, Deniszczyc Davina, Kelly Benjamin M
Nuffield Health, Epsom, United Kingdom.
Department of Health Sciences, University of York, York, United Kingdom.
Front Med (Lausanne). 2023 May 24;10:1149922. doi: 10.3389/fmed.2023.1149922. eCollection 2023.
Two million people in the UK are experiencing long COVID (LC), which necessitates effective and scalable interventions to manage this condition. This study provides the first results from a scalable rehabilitation programme for participants presenting with LC.
601 adult participants with symptoms of LC completed the Nuffield Health COVID-19 Rehabilitation Programme between February 2021 and March 2022 and provided written informed consent for the inclusion of outcomes data in external publications. The 12-week programme included three exercise sessions per week consisting of aerobic and strength-based exercises, and stability and mobility activities. The first 6 weeks of the programme were conducted remotely, whereas the second 6 weeks incorporated face-to-face rehabilitation sessions in a community setting. A weekly telephone call with a rehabilitation specialist was also provided to support queries and advise on exercise selection, symptom management and emotional wellbeing.
The 12-week rehabilitation programme significantly improved Dyspnea-12 (D-12), Duke Activity Status Index (DASI), World Health Orginaisation-5 (WHO-5) and EQ-5D-5L utility scores (all < 0.001), with the 95% confidence intervals (CI) for the improvement in each of these outcomes exceeding the minimum clinically important difference (MCID) for each measure (mean change [CI]: D-12: -3.4 [-3.9, -2.9]; DASI: 9.2 [8.2, 10.1]; WHO-5: 20.3 [18.6, 22.0]; EQ-5D-5L utility: 0.11 [0.10, 0.13]). Significant improvements exceeding the MCID were also observed for sit-to-stand test results (4.1 [3.5, 4.6]). On completion of the rehabilitation programme, participants also reported significantly fewer GP consultations ( < 0.001), sick days ( = 0.003) and outpatient visits ( = 0.007) during the previous 3 months compared with baseline.
The blended and community design of this rehabilitation model makes it scalable and meets the urgent need for an effective intervention to support patients experiencing LC. This rehabilitation model is well placed to support the NHS (and other healthcare systems worldwide) in its aim of controlling the impacts of COVID-19 and delivering on its long-term plan.
https://www.isrctn.com/ISRCTN14707226, identifier 14707226.
英国有200万人正在经历长期新冠后遗症（LC），这需要有效的、可扩展的干预措施来管理这种情况。本研究提供了首个针对出现长期新冠后遗症的参与者的可扩展康复计划的结果。
601名有长期新冠后遗症症状的成年参与者在2021年2月至2022年3月期间完成了纳菲尔德健康新冠康复计划，并提供了书面知情同意书，同意将结果数据纳入外部出版物。这个为期12周的计划包括每周三次锻炼课程，包括有氧运动和力量训练，以及稳定性和灵活性活动。该计划的前6周是远程进行的，而后6周则在社区环境中进行面对面的康复课程。还提供每周一次与康复专家的电话沟通，以支持解答疑问，并就锻炼选择、症状管理和情绪健康提供建议。
为期12周的康复计划显著改善了呼吸困难-12（D-12）、杜克活动状态指数（DASI）、世界卫生组织-5（WHO-5）和EQ-5D-5L效用评分（均P<0.001），这些结果改善的95%置信区间（CI）超过了每项指标的最小临床重要差异（MCID）（平均变化[CI]：D-12：-3.4[-3.9，-2.9]；DASI：9.2[8.2，10.1]；WHO-5：20.3[18.6，22.0]；EQ-5D-5L效用：0.11[0.10，0.13]）。从坐立试验结果也观察到显著改善，超过了MCID（4.1[3.5，4.6]）。在康复计划完成后，与基线相比，参与者在前3个月报告的全科医生咨询次数（P<0.001）、病假天数（P=0.003）和门诊就诊次数（P=0.007）也显著减少。
这种康复模式的混合式和社区式设计使其具有可扩展性，满足了对有效干预措施的迫切需求，以支持长期新冠后遗症患者。这种康复模式非常适合支持英国国家医疗服务体系（以及全球其他医疗系统）实现控制新冠疫情影响并实施其长期计划的目标。
