Background: Coronavirus disease (COVID-19) is a viral disease that mostly affects the respiratory system and leads to respiratory failure. Alongside, pulmonary rehabilitation is one of the most important components in the management of respiratory system diseases and can rehabilitate persons after lung-damaged disease.
Objectives: The present study aimed to determine the efficiency of Home-Based Pulmonary Rehabilitation in pulmonary function in patients with COVID-19
Methods: This simple randomized interventional study was conducted on 70 COVID-19 patients in Kerman, Iran. They were assigned to two equal groups of control and intervention. In the control group, patients received only routine post-discharge care, and in the intervention group, patients received home-based pulmonary rehabilitation procedures containing some movements to improve pulmonary function for four weeks after discharge.
Results: Forced expiratory volume in 1 second (P<0.001), vital capacity (P<0.001) and these two parameters ratio (P<0.02), peak expiratory flow (P<0.001), in four weeks after discharge from the hospital in the intervention group was significantly higher than in the control group. Moreover, 6-min walk distance (P<0.001) was significantly increased, and the severity of dyspnea (P<0.001) was significantly reduced in the intervention group. As well, the number of patients with severe dyspnea decreased significantly (P<0.001).
Conclusion: It seems that our home-based program can result in a marked improvement in vital capacity and other pulmonary function tests, as well as a reduction in dyspnea after discharge. In conclusion, this rehabilitation procedure is effective in pulmonary recovery in COVID-19 patients and can be used as a treatment procedure for recovery in these patients.
Song, F., et al., Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology, 2020. 295(1): p. 210-217.
Remuzzi, A. and G. Remuzzi, COVID-19 and Italy: what next? Lancet (London, England), 2020. 395(10231): p. 1225-1228.
Zangrillo, A., et al., Fast reshaping of intensive care unit facilities in a large metropolitan hospital in Milan, Italy: facing the COVID-19 pandemic emergency. Crit Care Resusc, 2020. 22(2): p. 91-94.
Çakır Edis, E., Chronic Pulmonary Diseases and COVID-19. Turkish thoracic journal, 2020. 21(5): p. 345-349.
Lai, C.C., et al., Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents, 2020. 55(3): p. 105924.
Wu, Z. and J.M. McGoogan, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama, 2020. 323(13): p. 1239-1242.
Ni, W., et al., Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care, 2020. 24(1): p. 422.
Shang, J., et al., Structural basis of receptor recognition by SARS-CoV-2. Nature, 2020. 581(7807): p. 221-224.
Bahadori, M., et al., Pathogenesis of COVID-19; Acute Auto-inflammatory Disease (Endotheliopathica & Leukocytoclastica COVIDicus). 2021. 24(5): p. 419-426.
Huang, C., et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020. 395(10223): p. 497-506.
Ojo, A.S., et al., Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulm Med, 2020. 2020: p. 6175964.
Santana, A.V., A.D. Fontana, and F. Pitta, Pulmonary rehabilitation after COVID-19. J Bras Pneumol, 2021. 47(1): p. e20210034.
Vestbo, J., et al., Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 2013. 187(4): p. 347-65.
Abdolvahab, M., et al., The effect of constraint-induced therapy on Activity of Daily Living of adults hemiplegic patients %J Modern Rehabilitation. 2009. 3(1): p. 28-32.
Román, M., et al., Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial. BMC Fam Pract, 2013. 14: p. 21.
Jokar, Z., et al., Effect of Home-based Pulmonary Rehabilitation on Fatigue in Patients with COPD %J Hayat. 2013. 18(5): p. 64-72.
Liu, K., et al., Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract, 2020. 39: p. 101166.
Hajiro, T., et al., Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1998. 158(4): p. 1185-9.
Mahler, D.A. and C.K. Wells, Evaluation of clinical methods for rating dyspnea. Chest, 1988. 93(3): p. 580-6.
Nishiyama, O., et al., A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J, 2010. 36(5): p. 1067-72.
ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 2002. 166(1): p. 111-7.
Standardized lung function testing. Official statement of the European Respiratory Society. Eur Respir J Suppl, 1993. 16: p. 1-100.
Gloeckl, R., et al., Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study. ERJ open research, 2021. 7(2): p. 00108-2021.
Hermann, M., et al., Feasibility and Efficacy of Cardiopulmonary Rehabilitation After COVID-19. Am J Phys Med Rehabil, 2020. 99(10): p. 865-869.
Neves, L.F., M.H. Reis, and T.R. Gonçalves, Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Cad Saude Publica, 2016. 32(6).
Rochester, C.L., et al., An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med, 2015. 192(11): p. 1373-86.
Wuytack, F., et al., Comparison of outpatient and home-based exercise training programmes for COPD: A systematic review and meta-analysis. Respirology, 2018. 23(3): p. 272-283.
Holland, A.E., et al., Home-based or remote exercise testing in chronic respiratory disease, during the COVID-19 pandemic and beyond: A rapid review. Chron Respir Dis, 2020. 17: p. 1479973120952418.
Oh, E.G., The effects of home-based pulmonary rehabilitation in patients with chronic lung disease. Int J Nurs Stud, 2003. 40(8): p. 873-9.
Me'marian, R., I. Mohammadi, and N. Mirbagheri, The Effect of Planning Regular Walking as Rehabilitation in Chronic Obstructive Pulmonary Patients Clinical Status %J Archives of Rehabilitation. 2009. 10(2): p. 0-0.
Pitta, F., et al., Are patients with COPD more active after pulmonary rehabilitation? Chest, 2008. 134(2): p. 273-280.
Vilarinho, R., et al., Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study. Healthcare (Basel), 2021. 9(5).
José, A., et al., Does home-based pulmonary rehabilitation improve functional capacity, peripheral muscle strength and quality of life in patients with bronchiectasis compared to standard care? Brazilian journal of physical therapy, 2017. 21(6): p. 473-480.