Effects of a cardiopulmonary telerehabilitation using functional exercises in individuals after COVID-19 hospital discharge: A randomized controlled trial
Marcela Maria Carvalho da Silva, Daiane Roberta Viana, Maria Gabriela Colucci, Luana Aprecida Gonzaga, Juliano Ferreira Arcuri, Maria Cecília Moraes Frade, Carina Araujo de Facio, Lívia Maria Petilli Zopelari, Tathyana Emília Neves de Figueiredo, Francisco José Barbosa Zörrer Franco, Aparecida Maria Catai, Valéria Amorim Pires Di Lorenzo
Abstract
Introduction Individuals with severe coronavirus disease 2019 (COVID-19) may present respiratory and motor complications, requiring rehabilitation programs (RP) for long periods. However, access to cardiopulmonary rehabilitation is poor. Cardiopulmonary telerehabilitation is an alternative for cardiopulmonary dysfunction, improving functional capacity, dyspnea, and quality of life. Moreover, few clinical trials verified the effectiveness of telerehabilitation using functional exercise for post-COVID symptoms. Thus, the present study aimed to verify the effects of cardiopulmonary telerehabilitation using functional and accessible exercises in individuals after COVID-19 hospital discharge. Methods This blinded, randomized, and controlled clinical trial and included 67 adult individuals after COVID-19 hospital discharge. Participants were randomized into the groups of telerehabilitation (TG; n = 33) and control (CG; n = 34). TG underwent an individualized exercise program (functional and accessible exercises) supervised by a physical therapist (videoconference), and CG received guidance on general care and self-monitoring of vital signs (videoconference). The primary outcome was performance and physiological responses on the 6-minute step test (6MST). Secondary outcomes were performance on the 2-minute stationary walk test (2MSWT), 30-second chair stand test (30CST), and quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire physical functioning concept (PF). Results Functional capacity (6MST) improved by 28 ± 17 steps in TG and 15 ± 26 in CG ( p = 0.04). For secondary outcomes, performance on 2MSWT increased by 39 ± 6 steps in TG and 10 ± 6 in CG ( p = 0.00); 30CST by 3 ± 1 repetitions in TG and 1.5 ± 0.5 in CG ( p = 0.05); and PF (SF-36) by 17 ± 4 points in TG and 12 ± 4 in CG ( p = 0.00). Also, peak oxygen uptake VO 2peak (6MST) improved by 3.8 ± 1 mL min −1 kg −1 in TG and 4.1 ± 1 in CG ( p = 0.6), and heart rate demand (6MST) by 11 ± 37% in TG and −4 ± 19% in CG ( p = 0.04). Conclusions Cardiopulmonary telerehabilitation using functional exercises improved the exercise and functional capacity assessed using 6MST, 30CST, and 2MSWT and the quality of life of individuals after COVID-19 hospital discharge.