IntroductionPulmonary rehabilitation (PR) is a programme of individually prescribed physical exercise, education and self-management activities. PR is recommended in international guidelines for managing chronic obstructive pulmonary disease (COPD) and other chronic respiratory diseases. PR is still under-recognised in tuberculosis (TB) guidelines and PR is not available in many low and middle-income countries and for people with post-TB lung disease (PTBLD). The main aims of the study are to adapt and define a culturally appropriate PR programme in Kyrgyzstan for people living with PTBLD and to test, in a fully powered randomised controlled trial (RCT), the effectiveness of PR in improving exercise capacity for people living with PTBLD.Methods and analysisThe study will be divided into three stages: stage 1: focus group discussions with patients living with PTBLD and interviews with PR referrers will be conducted to explore initial perceptions and inform the cultural adaptation, structure and content of PR. Stage 2a: a single-blind RCT evaluating the effectiveness of a culturally adapted 6-week PR programme on maximal exercise capacity, assessed by the incremental shuttle walking test, before and after PR. Participants will be additionally followed-up 12 weeks postbaseline. Additional outcomes will include health-related quality of life, respiratory symptoms, psychological well-being and physical function. Stage 2b: participants’ experience of PR will be collected through interviews and using a log book and a patient evaluation form. Staff delivering PR will be interviewed to explore their experience of delivering the intervention and refining the delivery for future implementation.Ethics and disseminationThe study was approved 22/07/2019 by Ethics Committee National Center for Cardiology and Internal Medicine (reference number 17) and by University of Leicester ethics committee (reference number 22293). Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, social media, and through patient and public involvement events in Kyrgyzstan and in the UK.Trial registration numberISRCTN11122503.

Background: After the acute period from SARS-CoV-2 infection, many COVID-19 survivors continue to have ongoing symptoms. There is a need to render assistance to such COVID-19 survivors in Kyrgyzstan but it is unclear how support should be designed. This study aimed to examine what this support should look like, specifically the persisting post-COVID symptoms, views on the optimal timing, suitable delivery methods, content of the support, and obstacles to implementation. Methods: This study was conducted by using two cross-sectional online surveys in the Russian language. The first group included clinical workers of various specialties who worked in the places of treatment for patients with COVID-19. The second group consisted of patients aged ≥18 years who had recovered from COVID-19 who were recruited from family medicine centers using the database of COVID-19 survivors. The survey was conducted anonymously and voluntarily, and consisted of 16 questions. Results: 85 clinical workers and 132 COVID-19 survivors took part in the survey. COVID-19 survivors reported they would be willing to devote 1-3 sessions per a week (84%) with a duration of no more than 1 hour (90%) to post-COVID interventions. Respondents identified the Internet (43%) and separate smartphone applications (42%) as the best media via which to receive support at home. The greatest barrier to accepting help was the risk of re-infection (43%). According to clinical workers, the main goal of post-COVID-19 support should be the amelioration of breathing problems (70%), increased physical exercise (57%) and elements of psychological support (57%). Clinical workers reported that support should begin during treatment for COVID-19 (65%), or immediately after returning from the hospital (59%). Respondents stated that it would be better to carry out support at home via video conference (65%), or by means of telephone calls (47%). The cost of treatment (47%) and the individual’s employment at work (43%) were deemed potential barriers to COVID-19 survivors participating in support interventions.Conclusions: Clinical workers and COVID-19 survivors deemed post-COVID-19 support necessary. Our results will directly inform the development and delivery of post-COVID support interventions in Kyrgyzstan and Central Asia, in combination with the views and needs identified directly from people with persisting post-COVID symptoms.

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