Day Hospital Unit, Home Hospitalisation Unit, Hospital Clínico la Florida, Santiago, Chile.
Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
Phys Ther. 2023 Nov 4;103(11). doi: 10.1093/ptj/pzad118.
The aim of this study was to compare the short-term clinical effects of 2 telerehabilitation programs, functional versus aerobic exercises (AEs), both combined with breathing techniques, regarding the improvement of long coronavirus disease 2019 (COVID-19) symptoms.
A randomized controlled trial was conducted. The participants were assigned randomly to either the functional exercise (FE) group or AE group, both including breathing techniques. The interventions lasted for 8 weeks with 3 sessions per week, and they were conducted through the Fisiotrack mobile phone application. Assessments were performed at baseline and after treatment, including testing fatigue (Fatigue Assessment Scale), dyspnea (London Chest Activity of Daily Living Scale), functional performance (30 Seconds Standing Test), perceived stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Questionnaire), and quality of life (European Quality of Life Scale). The perceived change after treatment (Patient Global Impression of Change Scale), the usability of the application (System Usability Scale), and the adherence to treatment were also examined after treatment.
In total, 43 participants (FE group, n = 21; AE group, n = 22; mean age = 42.4 [SD = 6.5] years) completed the study. In the intragroup comparison, the FE group showed improved fatigue (-6.7 points; 95% CI = -11.9 to -1.3), functional capacity (2.6 repetitions; 95% CI = 0.3 to 4.9), and perceived stress (-4.9 points; 95% CI = -9.1 to 0.8), while the AE group showed improved perceived stress (-6.2 points; 95% CI = -10.3 to -2.1). No significant differences in the intergroup effect were identified for the studied variables. Significant differences were observed in the Patient Global Impression of Change Scale in favor of the FE group compared to the AE group, and quality of life reached the minimal clinically important difference for both groups. The ease of use of the telerehabilitation tool was rated excellent in both groups.
Both telerehabilitation exercise modalities are effective at improving stress symptoms and quality of life in patients with long COVID-19. For improving fatigue and functional performance, FE shows more promising results.
FE or AE may be recommended depending on patients' symptoms, and both may improve quality of life and stress symptoms in patients with long COVID-19. Telerehabilitation may be an optimal intervention modality for the prescription of physical exercise in patients with long COVID-19.
本研究旨在比较两种远程康复方案，即功能锻炼和有氧运动（AE），均结合呼吸技术，在改善长期 COVID-19 症状方面的短期临床效果。
进行了一项随机对照试验。参与者随机分配到功能锻炼（FE）组或 AE 组，两组均包括呼吸技术。干预持续 8 周，每周 3 次，通过 Fisiotrack 手机应用程序进行。在基线和治疗后进行评估，包括疲劳测试（疲劳评估量表）、呼吸困难（伦敦日常活动呼吸困难量表）、功能表现（30 秒站立测试）、感知压力（感知压力量表）、焦虑和抑郁（医院焦虑和抑郁量表）以及生活质量（欧洲生活质量量表）。治疗后还评估了治疗后的感知变化（患者整体变化印象量表）、应用程序的可用性（系统可用性量表）和治疗依从性。
共有 43 名参与者（FE 组，n=21；AE 组，n=22；平均年龄 42.4[6.5]岁）完成了研究。在组内比较中，FE 组的疲劳（-6.7 分；95%CI=-11.9 至-1.3）、功能能力（2.6 次重复；95%CI=0.3 至 4.9）和感知压力（-4.9 分；95%CI=-9.1 至 0.8）均得到改善，而 AE 组的感知压力（-6.2 分；95%CI=-10.3 至-2.1）得到改善。两组间在研究变量方面无显著的组间效应差异。在患者整体变化印象量表中，FE 组优于 AE 组，差异有统计学意义，且两组的生活质量均达到了最小临床重要差异。两组对远程康复工具的易用性评价均为优秀。
两种远程康复运动方式均能有效改善长期 COVID-19 患者的应激症状和生活质量。对于改善疲劳和功能表现，FE 显示出更有希望的结果。
可根据患者症状推荐 FE 或 AE，两者均可改善长期 COVID-19 患者的生活质量和应激症状。远程康复可能是为长期 COVID-19 患者开具体育锻炼处方的最佳干预方式。
