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An 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 [with consumer summary]
Calvo-Paniagua J, Diaz-Arribas MJ, Valera-Calero JA, Ramos-Sanchez M, Fernandez-de-Las-Penas C, Navarro-Santana MJ, Del Corral T, Plaza-Manzano G
American Journal of Physical Medicine & Rehabilitation 2024 Jan 31:Epub ahead of print
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare the effectiveness of a tele-rehabilitation 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 tele-rehabilitation 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-minute walking test (6MWT) were assessed at baseline, after the program and at 1- and 3-months 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 6MWT (all, p < 0.001). Additionally, patients undergoing the tele-rehabilitation program reported lower exertion scores at rest and after the 6MWT (both, p < 0.001). Between-group oxygen saturation differences were found at rest (p < 0.001), but not after the 6MWT (p = 0.024). Finally, significant between-group differences were found for heart rate after the 6MWT (p < 0.001). CONCLUSION: Although both groups showed a significant improvement after 3 months of follow-up, the group receiving the tele-rehabilitation program described a greater improvement compared with the group receiving no intervention.

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