Physical Rehabilitation Interventions Could Aid Individuals with Post-COVID-19 Condition

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Functional exercise resulted in more improvements for individuals with PCC compared to standard treatment, although individuals must be monitored for adverse events.

Nearly 65 million individuals who were infected with COVID-19 have been reported to have post-COVID-19 condition (PCC), with ranging symptoms that include mild impairment to severe systemic disease and multiple symptoms involving various organ systems.

Image credit: Studio Romantic - stock.adobe.com

Image credit: Studio Romantic - stock.adobe.com

However, this number is increasing and is believed to be higher due to undocumented cases of infection. Published in JAMA Network, researchers conducted an analysis of 14 randomized clinical trials that examined different rehabilitation intervention programs for individuals with PCC that found improvements in PPC with functional exercise.

According to The World Health Organization, PCC is defined as a progression or development of new symptoms within 3 months of the initial diagnose of the SARS-CoV-2 infection that last for 2 months without signs of other illness. The press release noted that the most commonly observed symptoms include fatigue, headache, attention disorder, hair loss, and dyspnea.

An increased risk of PCC was found in women who reported a lower income. This is due to the challenge of attaining adequate rest in the early weeks after being infected with COVID-19, according to the researchers.

“There is an urgent need for evidence-based rehabilitation interventions to support people affected by PCC because current guidelines are primarily based on expert opinion and observational data,” said the study authors. “The purpose of this meta-analysis is to assess whether rehabilitation interventions are associated with improvements in physical capacity (functional exercise capacity, muscle function, dyspnea, and respiratory function) and quality of life in adults with PCC.”

Data searches were completed from January 2020 to February 2023 from MEDLINE, Scopus, CINAHL, and the Clinical trials Registry to find eligible clinical trials. The researchers used 14 randomized clinical trials that compared rehabilitation interventions with placebo, usual care, waitlist, or control in individuals with PCC. The rehabilitation interventions included respiratory training, aerobic exercises, and resistance exercises.

The researchers used eligible data from 1244 individuals with a median age of 50 years and 45% of female participants. Six of the trials included individuals who were hospitalized for COVID-19 infection and 5 of the trials included hospitalized individuals who were not hospitalized with COVID-19 infection.

Using a 6-minute walking test, the researchers’ primary outcome was the measure of functional exercise capacity with the closest postintervention time point. The individuals had a 6-week follow up that found an improvement in functional exercise capacity compared to usual care. The secondary outcomes involved fatigue, lower limb muscle function, dyspnea, respiratory function, and quality of life.

“The analysis consistently showed that rehabilitation interventions had a greater probability of being superior to usual care across all outcomes, with probabilities ranging between 85% and 99%. Additionally, rehabilitation interventions were associated with higher probability of reaching the predefined between-group MID threshold for functional aerobic capacity, functional lower limb strength and endurance, dyspnea, and quality of life, with probabilities ranging between 84% and 95%,” said the study authors.

However, due to a lack of data on safety outcomes, individuals should be closely monitored for adverse events and more trials must be conducted to assess results.

Reference

Rehabilitation Interventions for Physical Capacity and Quality of Life in Adults With Post–COVID-19 Condition. JAMA Network. News release. September 19, 2023. Accessed September 25, 2023. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809670.

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