Effect of a home-based inspiratory muscular training programme on functional capacity in patients with chronic COVID-19 after a hospital discharge: protocol for a randomised control trial (InsCOVID trial)

Palau, Patricia; Domínguez, Eloy; Sastre, Clara; Martínez, Maria Luz; González, Cruz; Bondía, Elvira; Albiach, Crtstina; Núñez, Julio; López, Laura

doi:10.1136/bmjresp-2022-001255

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…The exercise programs that combine aerobic and anaerobic exercise [41,44], inspiratory muscle training [22,41], and diaphragmatic breathing [42] contributed to significant improvements in the exercise group after inspiratory muscle training programs [47]. On the contrary, when inspiratory muscle training was only applied, no significant improvement was reported for the intervention group compared to the control group [41,48].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Michalas,

Katsaras,

Spetsioti

et al. 2024

JPM

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Background: Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome. Methods: The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups. Results: No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02). Conclusions: Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Michalas,

Katsaras,

Spetsioti

et al. 2024

JPM

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“…Supplementary Digital Material 3 (Supplementary Table III) 39 - 91 shows the characteristics of the included studies. More than half of the studies (57%, N=30, 2075 participants) included adults with PCC, 42 - 46 , 48 - 51 , 53 , 56 , 57 , 59 - 62 , 64 , 66 , 67 , 70 - 72 , 74 - 76 , 81 , 83 , 85 , 88 , 89 followed by adults with non-severe (34%, N.=18, 1489 participants), severe (6%, N.=3, 230 participants) 39 , 63 , 86 and critical COVID-19 (4%, N.=2, 88 participants). 41 , 90 …”

Section: Evidence Synthesismentioning

confidence: 99%

“…Only 11 RCTs 46 , 55 , 61 , 62 , 64 , 66 , 67 , 74 , 79 , 80 , 85 were similar enough to be grouped within the same comparisons, but the risk of bias across these studies was high and unclear in most of the bias domains. Consequently, we did not pool the data in a meta-analysis but synthesized the evidence narratively.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Consequently, we did not pool the data in a meta-analysis but synthesized the evidence narratively. Four of these studies 46 , 61 , 74 , 85 reported that no adverse events occurred during the study period, while the others did not report any information on adverse events. The remaining 42 studies did not have similar PICO characteristics, and consequently, we categorized them by outcomes and synthesized them narratively.…”

Section: Evidence Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Rehabilitation and COVID-19: systematic review by Cochrane Rehabilitation

ARIENTI,

LAZZARINI,

ANDRENELLI

et al. 2024

Eur J Phys Rehabil Med

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INTRODUCTION Until the last update in February 2022, the Cochrane Rehabilitation COVID-19 Evidence-based Response (REH-COVER) action identified an increasing volume of evidence for the rehabilitation management of COVID-19. Therefore, our aim was to identify the best available evidence on the effectiveness of interventions for rehabilitation for COVID-19-related limitations of functioning of rehabilitation interest in adults with COVID-19 or post COVID-19 condition (PCC). EVIDENCE ACQUISITION We ran the searches on February 17 th , 2023, in the following databases: PubMed, EMBASE, CENTRAL, CINHAL, and the Cochrane COVID-19 Study Register, applying a publication date restriction to retrieve only papers published in 2022. To retrieve papers published before 2022, we screened the reference lists of previous publications included in the REH-COVER action, covering papers from early 2020 to the end of 2022. This current review includes only randomised controlled trials and concludes the rapid living systematic reviews of the Cochrane Rehabilitation REH-COVER action. The risk of bias and certainty of evidence were evaluated in all studies using the Cochrane Risk of Bias tool and GRADE, respectively. We conducted a narrative synthesis of the evidence. PROSPERO registration number: CRD42022374244. EVIDENCE SYNTHESIS After duplicate removal, we identified 18,950 individual records and 53 RCTs met the inclusion criteria. Our findings suggest that the effect of breathing and strengthening exercise programs on dyspnea and physical exercise capacity compared to no treatment in non-severe COVID-19 patients is uncertain. Multicomponent telerehabilitation may slightly increase physical exercise capacity compared to educational intervention in adults with PCC. There is, however, uncertainty about its effect on lung function and physical exercise capacity when compared to no treatment. Finally, the effect of inspiratory muscle training on maximal inspiratory pressure compared to no treatment in adults with PCC is uncertain. CONCLUSIONS Interventions that are part of comprehensive pulmonary rehabilitation approaches may benefit dyspnea and exercise tolerance in adults with COVID-19 and PCC. The available evidence has several methodological limitations that limit the certainty of evidence and the clinical relevance of findings. Therefore, we cannot provide robust suggestions for practice. While high-quality RCTs are being conducted, clinicians should consider using high-quality evidence from other pulmonary conditions to rehabilitate patients with COVID-19 or PCC using context-specific interventions.

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“…Improvement in QoL, exercise tolerance and haemodynamic function was also reported following a home-based physical activity intervention in middle-aged to older individuals with heart failure [ 25 ]. More recently, studies have shown that home-based physical activity intervention improves exercise capacity and enhances recovery and QoL in COVID-19 survivors [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular implications and physical activity in middle-aged and older adults with a history of COVID-19 (CV COVID): a protocol for a randomised controlled trial

Rahman,

Russell,

Okwose

et al. 2023

Trials

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Background The clinical manifestation of COVID-19 is associated with infection and inflammation of the lungs, but there is evidence to suggest that COVID-19 may also affect the structure and function of the cardiovascular system. At present, it is not fully understood to what extent COVID-19 impacts cardiovascular function in the short- and long-term following infection. The aim of the present study is twofold: (i) to define the effect of COVID-19 on cardiovascular function (i.e. arterial stiffness, cardiac systolic and diastolic function) in otherwise healthy individuals and (ii) to evaluate the effect of a home-based physical activity intervention on cardiovascular function in people with a history of COVID-19. Methods This prospective, single-centre, observational study will recruit 120 COVID-19-vaccinated adult participants aged between 50 and 85 years, i.e. 80 with a history of COVID-19 and 40 healthy controls without a history of COVID-19. All participants will undergo baseline assessments including 12-lead electrocardiography, heart rate variability, arterial stiffness, rest and stress echocardiography with speckle tracking imaging, spirometry, maximal cardiopulmonary exercise testing, 7-day physical activity and sleep measures and quality of life questionnaires. Blood samples will be collected to assess the microRNA expression profiles, cardiac and inflammatory biomarkers, i.e. cardiac troponin T; N-terminal pro B-type natriuretic peptide; tumour necrosis factor alpha; interleukins 1, 6 and 10; C-reactive protein; d-dimer; and vascular endothelial growth factors. Following baseline assessments, COVID-19 participants will be randomised 1:1 into a 12-week home-based physical activity intervention aiming to increase their daily number of steps by 2000 from baseline. The primary outcome is change in left ventricular global longitudinal strain. Secondary outcomes are arterial stiffness, systolic and diastolic function of the heart, functional capacity, lung function, sleep measures, quality of life and well-being (depression, anxiety, stress and sleep efficiency). Discussion The study will provide insights into the cardiovascular implications of COVID-19 and their malleability with a home-based physical activity intervention. Trial registration ClinicalTrials.gov NCT05492552. Registered on 7 April 2022.

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Effect of a home-based inspiratory muscular training programme on functional capacity in patients with chronic COVID-19 after a hospital discharge: protocol for a randomised control trial (InsCOVID trial)

Cited by 11 publications

References 28 publications

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Rehabilitation and COVID-19: systematic review by Cochrane Rehabilitation

Cardiovascular implications and physical activity in middle-aged and older adults with a history of COVID-19 (CV COVID): a protocol for a randomised controlled trial

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