Sánchez-Romero Eleuterio A, García-Barredo-Restegui Teresa, Martínez-Rolando Lidia, Villafañe Jorge Hugo, Galán-Fraguas Andrea, Jurado-Molina Rebeca, Cuenca-Zaldívar Juan Nicolás, Soto-Goñí Xabier A, Martínez-Lozano Pedro
Faculty of Medicine, Health and Sports, Department of Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Spain.
Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, Villaviciosa de Odón, Spain.
Medicine (Baltimore). 2025 Mar 7;104(10):e41583. doi: 10.1097/MD.0000000000041583.
The coronavirus disease (COVID-19) pandemic has led to a global health crisis with significant long-term consequences, including musculoskeletal symptoms such as fatigue, myalgia, and chronic pain. These issues, often linked to altered nociceptive processing, impair quality of life and are exacerbated in severe cases by intensive care unit-acquired weakness from immobilization and mechanical ventilation. Early rehabilitation, particularly pulmonary rehabilitation (PR), is crucial for mitigating these effects. Telerehabilitation, leveraging telemedicine, offers an innovative, accessible alternative, providing personalized programs that improve adherence and recovery. Recent studies highlight telerehabilitation's benefits alongside traditional methods, underscoring its potential for managing post-COVID-19 musculoskeletal sequelae. This study aimed to evaluate the effects of PR and an eHealth education tool (ET) on pain, functionality, quality of life, and psychological factors in post-COVID-19 patients with musculoskeletal symptoms and to compare telerehabilitation versus face-to-face approaches regarding treatment adherence.
This pilot randomized controlled trial included 12 patients with musculoskeletal symptoms of COVID-19. The participants were randomly assigned to a PR program with or without an evidence-based eHealth ET. Primary outcomes included pain reduction and improvements in functional capacity, quality of life, and psychological factors measured over a 45-week period. The secondary outcome was adherence to rehabilitation.
A significant reduction in kinesiophobia was found in the eHealth ET group (P = .048), although no significant differences were observed in pain, Barthel index, or 6-minute walk test results between the groups. Clinically relevant improvements were observed in the telemedicine group.
An evidence-based eHealth ET was effective in reducing kinesiophobia, highlighting its potential to address psychological aspects of post-COVID-19 recovery. However, further studies are needed to assess its long-term effects on physical recovery.
冠状病毒病（COVID-19）大流行引发了一场全球健康危机，产生了重大的长期后果，包括疲劳、肌痛和慢性疼痛等肌肉骨骼症状。这些问题通常与伤害性感受处理改变有关，会损害生活质量，在重症病例中，因固定不动和机械通气导致的重症监护病房获得性肌无力会使这些问题更加严重。早期康复，尤其是肺康复（PR），对于减轻这些影响至关重要。远程康复借助远程医疗，提供了一种创新的、可及的替代方案，能提供个性化项目，提高依从性并促进康复。近期研究凸显了远程康复与传统方法相比的益处，强调了其在管理COVID-19后肌肉骨骼后遗症方面的潜力。本研究旨在评估PR和一种电子健康宣教工具（ET）对有肌肉骨骼症状的COVID-19后患者的疼痛、功能、生活质量和心理因素的影响，并比较远程康复与面对面治疗方式在治疗依从性方面的差异。
这项试点随机对照试验纳入了12名有COVID-19肌肉骨骼症状的患者。参与者被随机分配到接受或不接受基于证据的电子健康ET的PR项目中。主要结局包括在45周期间测量的疼痛减轻以及功能能力、生活质量和心理因素的改善。次要结局是康复治疗的依从性。
电子健康ET组的运动恐惧显著降低（P = 0.048），尽管两组在疼痛、巴氏指数或6分钟步行试验结果方面未观察到显著差异。远程医疗组观察到了具有临床意义的改善。
基于证据的电子健康ET在降低运动恐惧方面有效，凸显了其在解决COVID-19后恢复的心理方面问题的潜力。然而，需要进一步研究来评估其对身体恢复的长期影响。
