Educational, Exercise, and Occupational Therapy-Based Telerehabilitation Program Versus "Wait-and-See" for Improving Self-perceived Exertion in Patients With Post-COVID Fatigue and Dyspnea: A Randomized Clinical Trial.

OBJECTIVE: The aim of the study was to compare the effectiveness of a telerehabilitation exercise program versus "wait-and-see" on physical exertion, quality of life, dyspnea severity, heart rate, and oxygen saturation in patients with post-COVID fatigue and dyspnea. DESIGN: Sixty-four patients were enrolled in this randomized clinical trial. A telerehabilitation program based on patient education, physical activity, airway clearing, and breathing exercise interventions was conducted. Self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life and physiological outcomes, and the 6-min walking test were assessed at baseline, after the program and at 1- and 3-mo follow-up periods. RESULTS: The experimental group experienced greater improvements in self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life, and 6-min walking test (all, P < 0.001). In addition, patients undergoing the telerehabilitation program reported lower exertion scores at rest and after the 6-min walking test (both, P < 0.001). Between-group oxygen saturation differences were found at rest ( P < 0.001), but not after the 6-min walking test ( P = 0.024). Finally, significant between-group differences were found for heart rate after the 6-min walking test ( P < 0.001). CONCLUSIONS: Although both groups showed a significant improvement after 3 mos of follow-up, the group receiving the telerehabilitation program described a greater improvement compared with the group receiving no intervention.

A tele-health primary care rehabilitation program improves self-perceived exertion in COVID-19 survivors experiencing Post-COVID fatigue and dyspnea: A quasi-experimental study.

BACKGROUND: Current evidence suggests that up to 70% of COVID-19 survivors develop post-COVID symptoms during the following months after infection. Fatigue and dyspnea seem to be the most prevalent post-COVID symptoms. OBJECTIVE: To analyze whether a tele-rehabilitation exercise program is able to improve self-perceived physical exertion in patients with post-COVID fatigue and dyspnea. METHODS: Sixty-eight COVID-19 survivors exhibiting post-COVID fatigue and dyspnea derived to four Primary Health Care centers located in Madrid were enrolled in this quasi-experimental study. A tele-rehabilitation program based on patient education, physical activity, airway clearing, and breathing exercise interventions was structured on eighteen sessions (3 sessions/week). Self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life and distance walked and changes in oxygen saturation and heart rate during the 6-Minute walking test were assessed at baseline, after the program and at 1- and 3-months follow-up periods. RESULTS: Daily living activities, dyspnea severity and quality of life improved significantly at all follow-ups (p<0.001). Additionally, a significant increase in oxygen saturation before and after the 6-Minute Walking test was found when compared with baseline (P<0.001). Heart rate adaptations at rest were found during the follow-up periods (P = 0.012). Lower perceived exertion before and after the 6-Minute Walking test were also observed, even if larger distance were walked (P<0.001). CONCLUSION: Tele-rehabilitation programs could be an effective strategy to reduce post-COVID fatigue and dyspnea in COVID-19 survivors. In addition, it could also reduce the economic burden of acute COVID-19, reaching a greater number of patients and releasing Intensive Unit Care beds for prioritized patients with a severe disease. STUDY REGISTRATION: The international OSF Registry registration link is https://doi.org/10.17605/OSF.IO/T8SYB.