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| Effects of pulmonary rehabilitation on respiratory function and thickness of the diaphragm in patients with post-COVID-19 syndrome: a randomized clinical trial | 
| Pietranis KA, Izdebska WM, Kuryliszyn-Moskal A, Dakowicz A, Ciolkiewicz M, Kaniewska K, Dzieciol-Anikiej Z, Wojciuk M | 
| Journal of Clinical Medicine 2024 Jan;13(2):425 | 
| clinical trial | 
| 7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* | 
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                     BACKGROUND: Rehabilitation is an effective method for improving the overall health of patients who have experienced the long-term effects of COVID-19. METHODS: The double-blind, randomized prospective study assessed the effectiveness of a 6-week rehabilitation program among post-COVID-19 patients. A total of 59 patients under treatment following COVID-19 were randomly divided into two groups. Both groups completed the same six-week comprehensive exercise training program supported by a respiratory muscle trainer (Threshold IMT) during out-patient sessions. The control group performed placebo IMT. Respiratory muscle strength, chest wall expansion, spirometry, and diaphragm ultrasonography measurements were taken before and after the six weeks. RESULTS: The applied rehabilitation program improved respiratory muscle strength in both the study and control groups (p < 0.001). There was a significant chest circumference increase in the study group (p < 0.001). Spirometric parameters improved in both groups, with the study group showing a greater improvement: 8.02% in FEV1 (p < 0.001), 13.24% in FVC EX (p < 0.001) and 9.67% in PEF (p < 0.001). Rehabilitation also increased diaphragm thickness during maximum inhalation in both groups. CONCLUSIONS: Based on the study findings, the specialized outpatient rehabilitation program developed for post-COVID-19 patients has proven to be effective and safe.  
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