Application of a home-based exercise program combined with tele-rehabilitation in previously hospitalized patients with COVID-19: A feasibility, single-cohort interventional study
Eleni Kortianou, Dimitrios Tsimouris, Aspasia Mavronasou, Sotirios Lekkas, Nikolaos Kazatzis, Zoi Apostolara, Maria Isakoglou, Georgia Dimakou, Zafeiria Barmparessou, Stamatoula Tsikrika, Vissaria Sakka, Angelos Liontos, Maria Christaki, Haralampos Milionis, Ioannis Kalomenidis
Abstract
should include evaluation of any rehabilitative needs and prioritizing effective and comprehensive interventions, in order to improve patients' physical, functional, and psychological status 6 . As tele-rehabilitation provides effective clinical services from a distance, it could be an appropriate intervention at the post-acute period, in order to achieve basic gains in physical capacity, symptoms and quality of life in patients with SARS-CoV-2 infection 7 . In this context, we aimed to deliver a short-term home-exercise ABSTRACT INTRODUCTION Telehealth for COVID-19 patients is still limited. We aimed to assess the clinical effects of a home-based tele-rehabilitation exercise program following hospital discharge during the first lockdown in Greece, April to July 2020. METHODS A pre-and post-intervention design was applied in two stages. Firstly, patients were instructed to use a specially designed for COVID-19, e-book during four tele-health sessions. Afterwards, a 2-month home-based program consisted of self-practice exercise and one-hour supervised telerehabilitation exercise sessions every 10 days, was delivered. At baseline and at the end of the program, participants were interviewed about their physical, psychological status and quality of life (QoL) during the posthospitalization period. The IPAQ-Gr, the HADS and the SF-36 questionnaires were used, respectively, and the participants were functionally assessed via teleconferences, using the 60 sec Sit to Stand Test (60secSTS), the Short Physical Performance Battery (SPPB) and the 3 min Step Test (3MST). RESULTS Seventy-four patients, median age 52.5 (IQR: 43-61) years were included at the first stage. From those, only 22 patients, mean SD age 50.1 13.2 years completed the 2-month exercise program. The training program was well tolerated by all 22 patients. The mean number of unsupervised exercise sessions was 18.4 3.5. No adverse effects were observed either during initial and follow-up assessment via tele-communication or during home-exercise sessions. Training improved significantly (p<0.001) lower limb muscle performance [median (IQR) 60secSTS: 22 (20-26) to 31 (25-36)], anxiety [median (IQR) HADS: 9 (6-13) to 4.3 (3.2-9.6)], depression [median (IQR) HADS: 5 (3-8) to 1.8 (0.9-3.7)], QoL [mean SD SF-36pcs: 37.5 10.3 to 52.1 6, and mean SD SF-36mcs: 42.9 11.6 to 45.5 12.3]. CONCLUSIONS Tele-rehabilitation may be feasible and may improve physical and psychological status of COVID-19 patients after hospital discharge.