Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
Pos-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
PLoS One. 2024 Feb 2;19(2):e0296707. doi: 10.1371/journal.pone.0296707. eCollection 2024.
Pulmonary rehabilitation (PR) is recommended in people with post-acute COVID-19 syndrome (PACS), although there is a lack of studies evaluating its benefits via the most commonly used primary endpoint: the six-minute walk test (6MWT). This study evaluated the effects of PR on the dynamics of ventilation measured during the 6MWT in patients with PACS and, secondarily, evaluated the association of these findings with measures of lung function and structure.
This was an observational cross-sectional study of patients with PACS, in which 33 had undergone PR (PR-PACS group) and 32 had not undergone PR (NPR-PACS group). These patients underwent Spiropalm®-equipped 6MWT with measurement of inspiratory capacity (IC) to evaluate dynamic hyperinflation (DH). In addition, they performed spirometry, impulse oscillometry (IOS) and lung ultrasound (LUS).
Spirometry was abnormal in 21.2% and 31.3% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.36). IOS was abnormal in 28.6% and 66.7% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.003). LUS was altered in 39.4% and 43.8% of the participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.72). The 6-min walk distance (6MWD) was greater in the PR-PACS group than in the NPR-PACS group (p = 0.001]. HD was observed in 6.1% and 37.5% of participants in the PR-PACS and NPR-PACS groups, respectively, with a significant difference in ΔIC (p<0.001). The 6MWD correlated significantly with several IOS parameters and with ΔIC.
Patients with PACS undergoing PR perform better in the 6MWT, with a higher 6MWD and less HD. In these patients, IOS is able to distinguish the effects of PR that are not differentiated by spirometry or LUS. Furthermore, the better the respiratory mechanics assessed by IOS and the less DH there was, the higher the performance in the 6MWT.
肺康复（PR）被推荐用于患有急性新冠后综合征（PACS）的患者，尽管缺乏通过最常用的主要终点（六分钟步行测试（6MWT））评估其益处的研究。本研究评估了 PR 对 PACS 患者 6MWT 期间测量的通气动力学的影响，其次，评估了这些发现与肺功能和结构测量值的相关性。
这是一项对 PACS 患者的观察性横断面研究，其中 33 名患者接受了 PR（PR-PACS 组），32 名患者未接受 PR（NPR-PACS 组）。这些患者进行了配备 Spiropalm®的 6MWT，测量吸气量（IC）以评估动态过度充气（DH）。此外，他们还进行了肺功能检查、脉冲震荡（IOS）和肺部超声（LUS）。
PR-PACS 和 NPR-PACS 组患者中分别有 21.2%和 31.3%的患者肺功能检查异常（p=0.36）。PR-PACS 和 NPR-PACS 组患者分别有 28.6%和 66.7%的患者 IOS 异常（p=0.003）。PR-PACS 和 NPR-PACS 组患者中分别有 39.4%和 43.8%的患者 LUS 改变（p=0.72）。PR-PACS 组的 6 分钟步行距离（6MWD）大于 NPR-PACS 组（p=0.001）。DH 分别见于 PR-PACS 和 NPR-PACS 组患者的 6.1%和 37.5%，PR-PACS 组的ΔIC 差异显著（p<0.001）。6MWD 与 IOS 多个参数和ΔIC 显著相关。
接受 PR 的 PACS 患者在 6MWT 中表现更好，6MWD 更高，DH 更少。在这些患者中，IOS 能够区分肺功能检查或 LUS 无法区分的 PR 效果。此外，IOS 评估的呼吸力学越好，DH 越低，6MWT 表现越好。
