新冠康复者远程康复（TERCOV）：一项由研究者发起的、前瞻性的、多中心的真实世界研究。

Tele-rehabilitation in COVID-19 survivors (TERCOV): An investigator-initiated, prospective, multi-center, real-world study.

机构信息

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.

Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Physiother Res Int. 2024 Oct;29(4):e2137. doi: 10.1002/pri.2137.

DOI:10.1002/pri.2137

PMID:39425529

Abstract

INTRODUCTION

Center-based rehabilitation is limited by COVID-19 infectivity and social distancing policy. We hypothesized that discharged patients benefit from 8-week home-based tele-rehabilitation (tele-PR) using mobile phones and low-cost instruments.

METHODS

The TERCOV (Tele-rehabilitation in COVID-19 survivors) is an investigator-initiated, prospective, multi-center, real-world study. After proper assessment, 186 discharge patients received tele-PR by smartphone, including breathing exercise, respiratory muscle training, aerobic exercise, and resistance training. Physicians, physiotherapists, and nurses provided guidance through smartphone applications. The primary outcome was six-minute walk distance (6MWD). The secondary outcomes included hand grip, short physical performance battery, maximal inspiratory pressure, maximal expiratory pressure, self-rating anxiety/depression scale (SAS/SDS), 36-item short-form health survey (SF-36) and international physical activity questionnaire.

RESULTS

Dyspnea subgroups were more functionally impaired. After tele-PR, improvements were observed in exercise capacity(∆6MWD: 16.80 m, 95% CI 1.18-32.42, p < 0.0001), limb muscle function (∆SPPB 0.25 points, 95% CI 0.05-0.46), respiratory muscle strength (∆MIP 16.50 cm H2O, 95% CI 9.22-23.78, p < 0.0001; ∆MEP: 12.09 cm H2O, 95% CI 3.48-20.70, p = 0.0002), health-related quality of life (∆SF-36 49.85, 95% CI: 21.01-78.69, p < 0.0001), physical activity(∆HEPA 13.01%, p = 0.0029). Anxiety reduced in patients with mMRC ≥ 2 (∆SAS = -4.19 points, CI -8.16 to -0.22, p = 0.03). Greater change was seen in dyspnea patients.

IMPLICATIONS ON PHYSIOTHERAPY PRACTICE

Supervised/semi-supervised tele-PR is a promising option during the pandemic. Patients with Dyspnea benefit more.

摘要

简介

以中心为基础的康复受到 COVID-19 传染性和社交距离政策的限制。我们假设出院患者可以从使用手机和低成本仪器的 8 周家庭远程康复（远程 PR）中受益。

方法

TERCOV（COVID-19 幸存者的远程康复）是一项由研究人员发起的、前瞻性的、多中心的真实世界研究。经过适当评估，186 名出院患者通过智能手机接受远程 PR，包括呼吸练习、呼吸肌训练、有氧运动和阻力训练。医生、物理治疗师和护士通过智能手机应用程序提供指导。主要结果是 6 分钟步行距离（6MWD）。次要结果包括握力、简短身体表现电池、最大吸气压力、最大呼气压力、焦虑/抑郁自评量表（SAS/SDS）、36 项简短健康调查问卷（SF-36）和国际体力活动问卷。

结果

呼吸困难亚组的功能受损更严重。远程 PR 后，运动能力（∆6MWD：16.80 米，95%置信区间 1.18-32.42，p<0.0001）、四肢肌肉功能（∆SPPB 0.25 分，95%置信区间 0.05-0.46）、呼吸肌力量（∆MIP 16.50cm H2O，95%置信区间 9.22-23.78，p<0.0001；∆MEP：12.09cm H2O，95%置信区间 3.48-20.70，p=0.0002）、健康相关生活质量（∆SF-36 49.85，95%置信区间：21.01-78.69，p<0.0001）、体力活动（∆HEPA 13.01%，p=0.0029）均有所改善。mMRC≥2 的患者焦虑减轻（∆SAS=-4.19 分，CI-8.16 至-0.22，p=0.03）。呼吸困难患者的变化更大。