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Effects of cardiopulmonary rehabilitation on cardiorespiratory fitness and clinical symptom burden in long COVID: results from the COVID-rehab randomized controlled trial [with consumer summary]
Besnier F, Malo J, Mohammadi H, Clavet S, Klai C, Martin N, Berube B, Lecchino C, Iglesies-Grau J, Vincent T, Gagnon C, Gaudreau-Majeau F, Juneau M, Simard F, L'Allier P, Nigam A, Gayda M, Bherer L
American Journal of Physical Medicine & Rehabilitation 2025 Feb;104(2):163-171
clinical trial
7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; 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 investigate the effectiveness of an eight-week cardiopulmonary rehabilitation program on cardiorespiratory fitness (VO2peak) and key cardiopulmonary exercise test measures, quality of life, and symptom burden in individuals with Long COVID. DESIGN: Forty individuals with Long COVID (mean age 53 +/- 11 years), were randomized into 2 groups: (1) Rehabilitation group: centre-based individualized clinical rehabilitation program (8 weeks, 3 sessions per week of aerobic and resistance exercises, and daily inspiratory muscle training) and (2) control group: individuals maintained their daily habits during an eight-week period. RESULTS: There was a significant difference between groups in mean VO2peak improvement (p = 0.003). VO2peak improved significantly in the rehab group (plus 2.7 mL/kg/min, 95%IC 1.6 to 3.8, p < 0.001) compared to the control group (plus 0.3 mL/kg/min, 95%CI -0.8 to 1.3, p = 0.596), along withVE/VCO2 slope (p = 0.032) (-2.4, 95%CI -4.8 to 0.01, p = 0.049 and plus 1.3, 95%CI -1.0 to +3.6, p = 0.272 respectively) and VO2 at first ventilatory threshold (p = 0.045). Furthermore, all symptom impact scales improved significantly in the rehabilitation group compared to the control group (p < 0.05). CONCLUSION: An individualized and supervised cardiopulmonary rehabilitation program was effective in improving cardiorespiratory fitness, ventilatory efficiency, and symptom burden in individuals with Long COVID. Careful monitoring of symptoms is important to appropriately tailor and adjust rehabilitation sessions.

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