Rehabilitation Interventions for Post-Acute COVID-19 Syndrome: A Systematic Review

Abstract

Increasing numbers of individuals suffer from post-acute COVID-19 syndrome (PACS), which manifests with persistent symptoms, the most prevalent being dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. This systematic review investigated the effectiveness of rehabilitation interventions for individuals with PACS. We searched the MEDLINE, Embase, Cochrane Register of Controlled Trials, CINHAL, Scopus, Prospero, and PEDro databases and the International Clinical Trials Registry Platform for randomized controlled trials (RCTs) up to November 2021. We screened 516 citations for eligibility, i.e., trials that included individuals with PACS exposed to exercise-based rehabilitation interventions. Five RCTs were included, accounting for 512 participants (aged 49.2–69.4 years, 65% males). Based on the revised Cochrane risk-of-bias tool (RoB 2.0), two RCTs had “low risk of bias”, and three were in the “some concerns” category. Three RCTs compared experimental rehabilitation interventions with no or minimal rehabilitation, while two compared two active rehabilitation interventions. Rehabilitation seemed to improve dyspnea, anxiety, and kinesiophobia. Results on pulmonary function were inconsistent, while improvements were detected in muscle strength, walking capacity, sit-to-stand performance, and quality of life. Pending further studies based on qualitatively sound designs, these first findings seem to advocate for rehabilitation interventions to lessen disability due to PACS.

The Impact of COVID-19 Infection on Cognitive Function and the Implication for Rehabilitation: A Systematic Review and Meta-Analysis

“…Different rehabilitation strategies have been proposed to improve the functions and the quality of life of patients suffering from COVID-19 infection both in the acute [68] and the chronic phase [69]. In the acute phase, rehabilitation seemed to improve dyspnoea, anxiety, and kinesiophobia.…”

“…In the acute phase, rehabilitation seemed to improve dyspnoea, anxiety, and kinesiophobia. Results on pulmonary function were inconsistent, while improvements were detected in muscle strength, walking capacity, sit-to-stand performance, and quality of life, no information was available for cognitive functions [68].…”

Clinical practice guidelines and expert consensus statements on rehabilitation for patients with COVID-19: protocol for a systematic review

“…A systematic review of five randomised controlled trials confirmed that rehabilitation could improve dyspnoea, muscle strength, walking capacity, sit-to-stand performance, anxiety and quality of life of patients with COVID-19 13. Rehabilitation therapies should be carried out as early as possible to reduce the complications and disability rate and improve the patients’ overall function at different stages of COVID-19 5 14 15.…”

Development of a Medium Care Unit Using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic

“…Early intervention has indeed been shown to be effective to reduce the risk of long COVID [ 19 ]. Different rehabilitation strategies have been proposed to enhance the function and quality of life of COVID-19-infected patients in the acute phase [ 20 ]. Rehabilitation appeared to improve dyspnea, anxiety, and kinesiophobia during the acute phase.…”

“…Rehabilitation appeared to improve dyspnea, anxiety, and kinesiophobia during the acute phase. Inconsistent results were observed for pulmonary function, whereas improvements were observed in muscle strength, walking capacity, sit-to-stand performance and quality of life [ 20 ].…”