Effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors: a randomized controlled clinical study

Şahin, Hülya; Naz, İlknur; Karadeniz, Gülistan; Süneçli, Onur; Polat, Gülru; Ediboğlu, Özlem

doi:10.36416/1806-3756/e20220107

Cited by 11 publications

(34 citation statements)

References 27 publications

(56 reference statements)

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“…Ao ler o artigo de Şahın et al (1) (Efeitos de um programa de reabilitação pulmonar domiciliar com e sem telecoaching nos desfechos relacionados à saúde em sobreviventes da COVID-19: estudo clínico controlado randomizado) publicado nesta edição do Jornal Brasileiro de Pneumologia, identificamos elementos que poderiam ter explorado melhor os resultados, com grandes implicações clínicas.…”

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“…Partindo da questão central da pesquisa, os resultados da Tabela 3 (1) mostraram que não houve grandes efeitos nos desfechos investigados entre os grupos. No entanto, haveria um efeito exclusivo de tempo, caso em que seria aplicado aos dois grupos indiferentemente, ou haveria um efeito de interação tempo-grupo, caso em que um dos grupos teria um comportamento diferente ao longo do tempo.…”

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“…A interpretação isolada do eta parcial permite apenas medir o poder explicativo do modelo construído e não os efeitos específicos dos fatores que o d de Cohen permite para grupos balanceados. (1) Esses achados interessantes revelam inconsistências identificadas nas medidas dos desvios-padrão dos grupos apresentados na Tabela 3 e na distribuição dos grupos na Figura 2 no estudo de Şahın et al (1) A Tabela 3 (1) mostra que os desvios-padrão dos grupos de estudo e controle foram os mesmos antes e depois da intervenção para quase todos os resultados. Isso é minimamente estranho para intervenções quando a variabilidade individual segue progressões distintas.…”

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“…Isso é minimamente estranho para intervenções quando a variabilidade individual segue progressões distintas. Por outro lado, na figura 2, (1) os desfechos distância percorrida no teste de caminhada de seis minutos, pontuação da escala modificada Medical Research Council e percepção de dispneia e fadiga revelam variabilidades distintas, o que pode levar à invalidação da aplicação da ANOVA fatorial. (2) Sugere-se que os autores explicitem a real variabilidade dos desfechos a fim de se obter valores precisos para as medidas de efeito clínico.…”

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“…(3) Agradecemos aos autores o interesse em nosso estudo comparando os efeitos de um programa de reabilitação pulmonar domiciliar com e sem telecoaching nos resultados relacionados à saúde em sobreviventes de COVID-19. (1) Agradecemos os valiosos comentários sobre nosso manuscrito e estamos felizes em responder aos seus comentários.…”

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Does virtual professional support improve the effectiveness of home pulmonary rehabilitation?

et al. 2023

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Does virtual professional support improve the effectiveness of home pulmonary rehabilitation?

et al. 2023

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Rehabilitation Interventions for Physical Capacity and Quality of Life in Adults With Post–COVID-19 Condition

Pouliopoulou,

Macdermid,

Saunders

et al. 2023

JAMA Netw Open

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ImportanceCurrent rehabilitation guidelines for patients with post–COVID-19 condition (PCC) are primarily based on expert opinions and observational data, and there is an urgent need for evidence-based rehabilitation interventions to support patients with PCC.ObjectiveTo synthesize the findings of existing studies that report on physical capacity (including functional exercise capacity, muscle function, dyspnea, and respiratory function) and quality of life outcomes following rehabilitation interventions in patients with PCC.Data SourcesA systematic electronic search was performed from January 2020 until February 2023, in MEDLINE, Scopus, CINAHL, and the Clinical Trials Registry. Key terms that were used to identify potentially relevant studies included long-covid, post-covid, sequelae, exercise therapy, rehabilitation, physical activity, physical therapy, and randomized controlled trial.Study SelectionThis study included randomized clinical trials that compared respiratory training and exercise-based rehabilitation interventions with either placebo, usual care, waiting list, or control in patients with PCC.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A pairwise bayesian random-effects meta-analysis was performed using vague prior distributions. Risk of bias was assessed using the Cochrane risk of bias tool version 2, and the certainty of evidence was evaluated using the GRADE system by 2 independent researchers.Main Outcomes and MeasuresThe primary outcome was functional exercise capacity, measured at the closest postintervention time point by the 6-minute walking test. Secondary outcomes were fatigue, lower limb muscle function, dyspnea, respiratory function, and quality of life. All outcomes were defined a priori. Continuous outcomes were reported as standardized mean differences (SMDs) with 95% credible intervals (CrIs) and binary outcomes were summarized as odds ratios with 95% CrIs. The between-trial heterogeneity was quantified using the between-study variance, τ2, and 95% CrIs.ResultsOf 1834 identified records, 1193 were screened, and 14 trials (1244 patients; 45% female participants; median [IQR] age, 50 [47 to 56] years) were included in the analyses. Rehabilitation interventions were associated with improvements in functional exercise capacity (SMD, −0.56; 95% CrI, −0.87 to −0.22) with moderate certainty in 7 trials (389 participants). These improvements had a 99% posterior probability of superiority when compared with current standard care. The value of τ2 (0.04; 95% CrI, 0.00 to 0.60) indicated low statistical heterogeneity. However, there was significant uncertainty and imprecision regarding the probability of experiencing exercise-induced adverse events (odds ratio, 1.68; 95% CrI, 0.32 to 9.94).Conclusions and RelevanceThe findings of this systematic review and meta-analysis suggest that rehabilitation interventions are associated with improvements in functional exercise capacity, dyspnea, and quality of life, with a high probability of improvement compared with the current standard care; the certainty of evidence was moderate for functional exercise capacity and quality of life and low for other outcomes. Given the uncertainty surrounding the safety outcomes, additional trials with enhanced monitoring of adverse events are necessary.

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Rehabilitative interventions in patients with persistent post COVID-19 symptoms—a review of recent advances and future perspectives

Gloeckl

Leitl

Schneeberger

et al. 2023

Eur Arch Psychiatry Clin Neurosci

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The SARS-CoV-2 pandemic has not only caused millions of deaths but left also millions of people with persistent symptoms behind. These long-term COVID-19 sequelae cause a considerable burden on individuals´ health, healthcare systems, and economies worldwide given the high rate of SARS-CoV-2 infections. Therefore, rehabilitative interventions and strategies are needed to counteract the post COVID-19 sequelae. The importance of rehabilitation for patients with persistent COVID-19 symptoms has been recently also highlighted in a Call for Action by the World Health Organisation. Based on previously published research, but also in line with clinical experience, COVID-19 is not one specific disease but rather presents in different phenotypes that vary in their pathophysiological mechanisms, symptomatic manifestations, and potential interventional approaches. This review provides a proposal for differentiating post COVID-19 patients in non-organ-specific phenotypes that may help clinicians to evaluate patients and to plan therapeutic options. Furthermore, we present current unmet needs and suggest a potential pathway for a specific rehabilitation approach in people with persistent post-COVID symptoms.

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Effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors: a randomized controlled clinical study

Cited by 11 publications

References 27 publications

Does virtual professional support improve the effectiveness of home pulmonary rehabilitation?

Does virtual professional support improve the effectiveness of home pulmonary rehabilitation?

Rehabilitation Interventions for Physical Capacity and Quality of Life in Adults With Post–COVID-19 Condition

Rehabilitative interventions in patients with persistent post COVID-19 symptoms—a review of recent advances and future perspectives

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