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Home-based respiratory muscle training on quality of life and exercise tolerance in long-term post-COVID-19: randomized controlled trial [with consumer summary] |
Del Corral T, Fabero-Garrido R, Plaza-Manzano G, Fernandez-de-Las-Penas C, Navarro-Santana M, Lopez-de-Uralde-Villanueva I |
Annals Physical and Rehabilitation Medicine 2023 Feb;66(1):101709 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; 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 evaluate the effects of a home-based respiratory muscle training programme (inspiratory (IMT) or inspiratory/expiratory muscles (RMT)) supervised by telerehabilitation on quality of life and exercise tolerance in individuals with long-term post-COVID-19 symptoms. The secondary objective was to evaluate the effects of these programmes on respiratory muscle function, physical and lung function, and psychological state. METHODS: 88 individuals with long-term symptoms of fatigue and dyspnoea after COVID-19 diagnosis were randomly (1:1 ratio) assigned to IMT, IMT(sham), RMT or RMT(sham) groups for an 8-week intervention (40min/day, 6 times/week). Primary outcomes were quality of life (EuroQol-5D questionnaire) and exercise tolerance (Ruffier test). Secondary outcomes were respiratory muscle function (inspiratory/expiratory muscle strength; inspiratory muscle endurance), physical function (lower and upper limb strength (1-min Sit-to-Stand and handgrip force)), lung function (forced spirometry), and psychological status (anxiety/depression levels and post-traumatic stress disorder). All outcomes were measured pre-, intermediate- (4th week), and post-intervention. RESULTS: At post-intervention, there was a statistically significant and large (d > 0.90) improvement in quality of life, but not in exercise tolerance, in the RMT group compared with the RMT(sham) group. Both of the real training groups produced a statistically significant and large increase in inspiratory muscle strength and endurance (d >= 0.80) and in lower limb muscle strength (d >= 0.77) compared with the 2 sham groups. Expiratory muscle strength and peak expiratory flow showed a statistically significant and large (d >= 0.87) increase in the RMT group compared with the other 3 groups. CONCLUSION: Only an 8-week supervised home-based RMT programme was effective in improving quality of life, but not exercise tolerance, in individuals with long-term post-COVID-19 symptoms. In addition, IMT and RMT programmes were effective in improving respiratory muscle function and lower limb muscle strength, but had no impact on lung function and psychological status.
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