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European Journal of Physical and Rehabilitation Medicine 2023 February;59(1):103-10

DOI: 10.23736/S1973-9087.22.07702-4

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

language: English

Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients

Jean-Marc VALLIER 1 , Charles SIMON 2, Antoine BRONSTEIN 3, Maxence DUMONT 1, Asmaa JOBIC 4, Nicolas PALEIRON 3, Laurent MELY 2

1 Laboratoire Impact de l’Activité Physique sur la Santé IAPS, University of Toulon, Toulon, France; 2 Service des Maladies Respiratoires, Renée Sabran Hôpital, Hospices Civils de Lyon, Giens, France; 3 Service de Pneumologie, HIA Sainte-Anne, Service des Santé des Armées, Toulon, France; 4 Centre Hospitalier Intercommunal of Toulon-La Seyne sur Mer (CHITS), Toulon, France

BACKGROUND: Between 30% and 60% of people who have been infected with COVID-19 still had symptoms 3 months after the start of the disease. Prescribing a pulmonary rehabilitation program in rehabilitation facilities for post COVID-19 patients could help alleviate the symptoms. However, rehabilitation facilities known to provide good quality care to COVID-19 patients and all other patients, could become saturated by the rise in cases. Home-based rehabilitation is a potential solution that could be sustainable in the long term to avoid this saturation and/or a very long waiting list for patients.
AIM: The aim of this study was to investigate whether home-based rehabilitation would have similar effects compared to inpatient rehabilitation on physical and respiratory variables in post COVID-19 patients.
DESIGN: This is a randomized controlled trial.
SETTING: Pulmonary rehabilitation facility.
POPULATION: Seventeen post COVID-19 patients were randomized into two groups: inpatient pulmonary rehabilitation (IPR) or home-based pulmonary rehabilitation (HPR).
METHODS: The comparison of the two rehabilitation methods relied on questionnaires, physical tests and the evaluation of several respiratory parameters. A 2-way Analysis of Variance (ANOVA) with repeated measures was performed to assess the effects of time (pre- vs. post-rehabilitation), group (IPR vs. HPR) and their interaction for all parameters.
RESULTS: The main result of this study is that distance covered in the 6MWT (6MWD) shows significant improvements, between pre- and postrehabilitation program in both groups (+95 m in IPR group vs.+72 m in HPR group, P<0.001) with no significant interaction between time and group (P=0.420).
CONCLUSIONS: These results suggest that home-based pulmonary rehabilitation would be as efficient as IPR to decrease physical sequelae in post COVID-19 patients.
CLINICAL REHABILITATION IMPACT: It is possible to suggest both methods (home-based rehabilitation or inpatient pulmonary rehabilitation) according to the specificities of each patient and depending on hospital saturation. The choice of one or the other method should not be made to the detriment of the patient.

KEY WORDS: Lung diseases; Rehabilitation; Telerehabilitation; COVID-19

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