Effects of An Individualized Pulmonary Rehabilitation Program in Post-COVID Fibrosis: A Case Report

Abstract

Long COVID-19 Syndrome, in addition to symptoms such as chronic cough, exertional dyspnea and fatigue, pulmonary fibrosis is presented as specific respiratory system problems. Post-COVID fibrosis is characterized by radiographic abnormalities consistent with pulmonary fibrosis. Patients with post-COVID fibrosis may benefit from pulmonary rehabilitation programs. This case report aimed to investigate the effects of an individualized pulmonary rehabilitation (PR) program on selected clinical parameters in a 46-year-old male who was diagnosed with post-COVID fibrosis. Spirometry and diffusion tests were investigated. Six-minute walk and shuttle walk tests for exercise capacity, hand-held dynamometer for quadriceps muscle strength, mMrc dyspnea scale for dyspnea, Fatigue Severity Scale for fatigue and London Chest Activity of Daily Living for activities of daily living were evaluated. An individualized PR program included breathing exercises, single-leg cycle training (for the right leg, 10 to 30 min) and bilateral neuromuscular electrical stimulation for quadriceps muscles (30 min) was prescribed 3 days a week for 8 weeks. Small but promising improvements were observed in FEV1, FVC, FEV1/FVC, DLCO, 6MWD, shuttle walk tests walking distance and time, quadriceps muscle strength, mMRC and FSS scores. PR program combined with antifibrotic therapy has the potential to improve respiratory functions, exercise capacity, muscle strength, dyspnea, fatigue, and participation in ADL in patient with post-COVID fibrosis.