Rehabilitation Improves Persistent Symptoms of COVID-19: A Nonrandomized, Controlled, Open Study in Brazil.

OBJECTIVE: This study aimed to investigate the effects of an 8-wk face-to-face rehabilitation program on subjects with persistent symptoms of COVID-19 compared with a remote monitoring group. DESIGN: This is clinical, nonrandomized, controlled, and open study. The face-to-face supervised rehabilitation lasted eight consecutive weeks, twice a week. The remote monitoring group received health guidance. The allocation was carried out by preference because of the emergency period without vaccination during the pandemic. Fatigue, dyspnea (Pulmonary Functional Status and Dyspnea Questionnaire), and exercise capacity (Incremental Shuttle Walk Test) were the primary outcome measures. Lung function, functional status (Post-COVID-19 Functional Status), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), attention (d2-R), memory (Rey's Auditory-Verbal Learning Test), handgrip strength, and knee extensor strength were secondary outcome measures. RESULTS: Thirty-seven subjects (24.3% hospitalized) completed the baseline and final assessment, rehabilitation ( n = 22, 40.8 [SD, 10.0] yrs, 54.5% female), or remote guidance ( n = 15, 45.4 [SD, 10.5] yrs, 40% female). Both groups showed improved fatigue and exercise capacity. Exercise rehabilitation improved dyspnea, anxiety, attention, and short-term memory. CONCLUSIONS: Rehabilitation is essential for dyspnea in subjects with persistent symptoms of COVID-19 while fatigue naturally reverses.

Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment.

Coronavirus 2 is responsible for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), and the main sequela is persistent fatigue. Post-viral fatigue is common and affects patients with mild, asymptomatic coronavirus disease-2019 (COVID-19). However, the exact mechanisms involved in developing post-COVID-19 fatigue remain unclear. Furthermore, physical and cognitive impairments in these individuals have been widely described. Therefore, this review aims to summarize and propose tools from a multifaceted perspective to assess COVID-19 infection. Herein, we point out the instruments that can be used to assess fatigue in long-term COVID-19: fatigue in a subjective manner or fatigability in an objective manner. For physical and mental fatigue, structured questionnaires were used to assess perceived symptoms, and physical and cognitive performance assessment tests were used to measure fatigability using reduced performance.

Propriedades psicométricas de questionários de atividade física na adolescência: revisão sistemática / Psychometric properties of physical activity questionnaires in adolescence: systematic review

O objetivo desta revisão foi recuperar e sumarizar os estudos que avaliaram as propriedades psi-cométricas (validade, confiabilidade e responsividade) de questionários utilizados para mensurar a atividade física (AF) em adolescentes. Trata-se de uma revisão sistemática realizada de acordo com o protocolo PRISMA. A busca foi realizada nas bases de dados: MEDLINE (via Ovid), CINAHL, LILACS, Cochrane, SciELO, PsycINFO, Web of Science e SPORTDiscus, utilizando descritores específicos. O risco de viés foi avaliado por meio do Checklist COSMIN. Foram incluídos 26 estu-dos na revisão e, destes, apenas cinco foram realizados no Brasil. A qualidade dos estudos variou de fraca a boa. Dos 25 questionários que foram avaliados quanto à confiabilidade teste-reteste, 11 apre-sentaram coeficientes de correlação intraclasse ≥ 0,70, incluindo o Questionário de Atividade Física para Adolescentes (QAFA). No que se refere à validade, apenas um dos 32 questionários avaliados quanto a esta propriedade apresentou coeficiente de correlação ≥ 0,70 e cinco apresentaram coefi-cientes de magnitude moderada (0,56 a 0,69), sendo dois de nacionalidade brasileira. Porém, ambos foram comparados a medidas subjetivas de AF. A responsividade dos questionários não foi avaliada em nenhum dos estudos. Os questionários de AF incluídos nesta revisão apresentaram melhores índices de confiabilidade do que validade e não foram investigados quanto à sua responsividade. Esses resultados reforçam a necessidade de realização de novos estudos com qualidade metodológica mais adequada, que investiguem principalmente a validade e a responsividade desses instrumentos

The aim of this review was to retrieve and identify studies that evaluated the psychometric properties (va-lidity, reliability and responsiveness) of questionnaires used to measure physical activity (PA) in adolescents. It is a systematic review carried out according to the PRISMA protocol. Searches were performed in: MED-LINE (via Ovid), CINAHL, LILACS, Cochrane, SciELO, PsycINFO, Web of Science and SPORTDiscus, using specific terms. The risk of bias was assessed through the COSMIN Checklist. Twenty-six studies were included in the review, of which only five were performed in Brazil. The quality of the studies ranged from poor to good. Of the 25 instruments that were evaluated for test-retest reliability, 11 presented intraclass correlation coefficients ≥ 0.70, including the Physical Activity Questionnaire for Adolescents (QAFA). Re-garding validity, only one instrument of the 32 evaluated for this property presented coefficient correlation ≥ 0.70 and five presented coefficients of moderate magnitude (0.56 a 0.69), two of them from Brazil. How-ever, both were compared to subjective criterion measures. The responsiveness of the questionnaires was not assessed in any of the studies. The PA questionnaires included in this review had better reliability indexes than validity and were not investigated for their responsiveness. These results reinforce the need to carry out new studies with more adequate methodological quality that investigate mainly the validity and respon-siveness of these instruments