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远程康复对新冠后长期呼吸困难患者的影响:一项随机对照研究。

Effect of telerehabilitation on post-COVID-19 individuals with long-term dyspnea: A randomized controlled study.

作者信息

Demir Canan, Aksoy Cihan Caner, Gokmen Gulhan Yilmaz, Durmaz Dilber

机构信息

Department of Cardiopulmonary Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma/Balikesir, Türkiye.

Department of Orthopedic Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Science University, Merkez/Kutahya, Türkiye.

出版信息

J Telemed Telecare. 2025 May 5:1357633X251333903. doi: 10.1177/1357633X251333903.

Abstract

ObjectiveThis study aimed to determine the effectiveness of telerehabilitation in managing ongoing dyspnea and associated issues following coronavirus disease 2019 (COVID-19), and observe changes over time.DesignThe study included 36 participants who previously had COVID-19 but continued to experience dyspnea (mean age, 42.44 ± 15.51 years). The participants were randomly allocated into three groups: telerehabilitation (TRG), home exercise (HEG), and control (CG). Dyspnea level, exercise capacity, muscle oxygenation, respiratory function, and fatigue were evaluated at baseline, at 6th, and at 12th weeks. Telerehabilitation was performed supervised and synchronously via video-calls.ResultsAt the 6-week assessment, TRG showed significant improvements in dyspnea, fatigue (p < 0.001), exercise capacity (p = 0.001), and respiratory muscle strength (p < 0.001). By the 12th week, these gains were maintained, with no further changes from week 6. In HEG, dyspnea and fatigue improved at weeks 6 and 12 (p < 0.001), with no additional changes between these time points. In CG, only dyspnea improved at both assessments (p < 0.001); other parameters remained unchanged. TRG achieved greater benefits compared to CG in reducing dyspnea and fatigue at week 6 (p = 0.001 and p = 0.003, respectively), but no group differences were found at week 12 (p > 0.05). No changes in muscle oxygenation were observed in any groups or evaluation points (p > 0.05).ConclusionsTelerehabilitation effectively improved and sustained dyspnea, fatigue, respiratory muscle strength, and exercise capacity in patients with post-COVID, while home-based exercises only reduced dyspnea and fatigue. Supervised and structured telerehabilitation may be a viable approach to managing post-COVID-19 symptoms.

摘要

目的

本研究旨在确定远程康复对管理2019冠状病毒病(COVID-19)后持续存在的呼吸困难及相关问题的有效性,并观察随时间的变化。

设计

该研究纳入了36名曾感染COVID-19但仍有呼吸困难症状的参与者(平均年龄42.44±15.51岁)。参与者被随机分为三组:远程康复组(TRG)、家庭锻炼组(HEG)和对照组(CG)。在基线、第6周和第12周评估呼吸困难程度、运动能力、肌肉氧合、呼吸功能和疲劳情况。通过视频通话对远程康复进行监督和同步实施。

结果

在第6周评估时,TRG在呼吸困难、疲劳(p<0.001)、运动能力(p=0.001)和呼吸肌力量(p<0.001)方面有显著改善。到第12周时,这些改善得以维持,与第6周相比无进一步变化。在HEG中,呼吸困难和疲劳在第6周和第12周有所改善(p<0.001),在这两个时间点之间无其他变化。在CG中,仅在两次评估时呼吸困难有所改善(p<0.001);其他参数保持不变。与CG相比,TRG在第6周减轻呼吸困难和疲劳方面取得了更大益处(分别为p=0.001和p=0.003),但在第12周未发现组间差异(p>0.05)。在任何组或评估点均未观察到肌肉氧合的变化(p>0.05)。

结论

远程康复有效改善并维持了COVID后患者的呼吸困难、疲劳、呼吸肌力量和运动能力,而居家锻炼仅减轻了呼吸困难和疲劳。有监督的结构化远程康复可能是管理COVID-19后症状的一种可行方法。

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