The effect of exercise rehabilitation on COVID-19 outcomes: a systematic review of observational and intervention studies

Halabchi, Farzin; Selk-Ghaffari, Maryam; Tazesh, Behnaz; Mahdaviani, Behnaz

doi:10.1007/s11332-022-00966-5

Cited by 21 publications

(23 citation statements)

References 49 publications

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“…To our knowledge, this is the first clinical study of patients with COVID-19 sequelae followed for 8 weeks to investigate the effects of physical exercise on physical and cognitive performance in this population. A recent systematic review 24 showed that nine observational studies (n=957) and 14 intervention studies (n=469) on rehabilitation in subjects with COVID-19 had been published. In most studies, rehabilitation was carried out during hospitalization and the acute phase of the disease (within the first 4 weeks after the onset of symptoms), or in the post-acute phase (after 4 weeks of the onset of symptoms) lasting 1 42 , 4 43 , and 6 weeks 25 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Rehabilitation improves symptoms, increases cardiorespiratory fitness, enhances the quality of life, and reduces morbidity and mortality in patients with respiratory diseases 23 . In COVID-19 patients, rehabilitation programs can mitigate the sequelae and burden of the disease 24 . Increased functional capacity, improved lung function, improved quality of life, and reduced anxiety, but not depression, were described after a 6-week rehabilitation program in 36 elderly COVID-19 survivors (69.4 ± 8.0 years) compared to the control group (n=36; 68.9±7.6 years) 25 .…”

Section: Introductionmentioning

confidence: 99%

“…The effects of rehabilitation in treating patients with persistent symptoms of COVID-19 have not been fully elucidated 24 . In addition, evidence has shown an effect on physical function in elderly 25 or hospitalized subjects 24,26,27 , with few references to cognitive aspects 28 . In this sense, the present study aimed to evaluate the effects of a face-to-face physical exercise rehabilitation program in patients with persistent symptoms of COVID-19 on fatigue and dyspnea, exercise capacity, pulmonary function, functional status, cognitive function, symptoms of anxiety and depression, and peripheral muscle strength.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

Campos

Nery

Speck

et al. 2022

Preprint

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The sequelae of coronavirus disease-2019 (COVID-19) are another socio-economic problem of the pandemic. Fatigue and dyspnea are the most prevalent symptoms. It is not known whether exercise can be used to treat long COVID-19. This study aimed to investigate the effects of an 8-week face-to-face rehabilitation program on COVID-19 compared to a remote monitoring group. A total of 37 participants (24.3% hospitalized) were assessed before and after rehabilitation (n=22; 40.8 sd 10.0 years) or remote monitoring (n=15; 45.4 sd 10.5 years). The participants were allocated according to their preferences. Both groups showed improved fatigue and exercise capacity (Incremental Shuttle Walk Test). Participants in the face-to-face rehabilitation group showed improved dyspnea (Pulmonary Functional Status and Dyspnea Questionnaire), anxiety (Hospital Anxiety and Depression Scale), attention, and short-term memory (d2-R and Rey's Auditory-Verbal Learning Test). Of the main sequelae, fatigue improves naturally, whereas dyspnea requires rehabilitation. Our results demonstrated the benefits of exercise for COVID-19 sequelae.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

Campos

Nery

Speck

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In another 6-week aerobic and strength exercise rehabilitation study for critically ill COVID-19 survivors reduced dyspnea and increased exercise capacity were observed for the rehabilitation group (n = 13; 57.6 ± 10.1 years) and for the control group (n = 13; 56.8 ± 8.7 years), which did not exercise 27 .The effects of rehabilitation in treating patients with persistent symptoms of COVID-19 have not been fully elucidated 24 . In addition, evidence has shown an effect on physical function in elderly 25 or hospitalized subjects 24,26,27 , with few references to cognitive aspects 28 . In this sense, the present study aimed to evaluate the effects of a face-to-face physical exercise rehabilitation program in patients with persistent symptoms of COVID-19 on fatigue and dyspnea, exercise capacity, pulmonary function, functional status, cognitive function, symptoms of anxiety and depression, and peripheral muscle strength.…”

mentioning

confidence: 99%

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

Campos

Nery

Speck

et al. 2022

Preprint

View full text Add to dashboard Cite

The sequelae of coronavirus disease-2019 (COVID-19) are another socio-economic problem of the pandemic. Fatigue and dyspnea are the most prevalent symptoms. It is not known whether exercise can be used to treat long COVID-19. This study aimed to investigate the effects of an 8-week face-to-face rehabilitation program on COVID-19 compared to a remote monitoring group. A total of 37 participants (24.3% hospitalized) were assessed before and after rehabilitation (n = 22; 40.8 ± 10.0 years) or remote monitoring (n = 15; 45.4 ± 10.5 years). The participants were allocated according to their preferences. Both groups showed improved fatigue and exercise capacity (Incremental Shuttle Walk Test). Participants in the face-to-face rehabilitation group showed improved dyspnea (Pulmonary Functional Status and Dyspnea Questionnaire), anxiety (Hospital Anxiety and Depression Scale), attention, and short-term memory (d2-R and Rey's Auditory-Verbal Learning Test). Of the main sequelae, fatigue improves naturally, whereas dyspnea requires rehabilitation. Our results demonstrated the benefits of exercise for COVID-19 sequelae.

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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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The effect of exercise rehabilitation on COVID-19 outcomes: a systematic review of observational and intervention studies

Cited by 21 publications

References 49 publications

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

Rehabilitation in Survivors of COVID-19 (RE2SCUE): a non-randomized, controlled and open study

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

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