Exercise reconditioning in the post-acute phase of COVID-19 rehabilitation in patients with chronic respiratory insufficiency: a retrospective observational study

Abstract

INTRODUCTION: The COVID-19 pandemic has had a profound impact on a global scale, affecting various aspects of society, health, and well-being. It has strained healthcare systems and led to social and welfare repercussions. In the context of post-acute COVID-19 rehabilitation, there is a need to explore effective interventions for individuals, particularly those with chronic respiratory insufficiency. This study aims to evaluate the effectiveness of exercise reconditioning as a rehabilitation strategy in this specific population METHODS: A retrospective observational study was conducted at the Rehabilitation Unit in an Italian hospital between March 2020 and May 2022. The study included individuals who had been diagnosed with COVID-19 pneumonia, required hospitalization in the COVID-19 unit or intensive care unit (ICU) due to severe respiratory failure and with “post-COVID pathology syndrome” (PCS) picture. Various assessments, including the 6 Minutes Walking Test (6MWT), were conducted to determine exercise capacity. A personalized reconditioning program based on international guidelines was designed for each patient, focusing on aerobic training. Measurements of vital signs were taken during training sessions. RESULTS: A total of 24 individuals, with a mean age of 65.41 years, were included in the study. The average duration of hospitalization in the rehabilitation department was 53.17 days. Most participants had pre-existing respiratory and non-respiratory pathologies. All individuals developed COVID-19 interstitial pneumonia, and some required intensive interventions such as intubation or ECMO support. Pulmonary fibrosis and Critical Illness Myopathy (CIM) were observed in a significant portion of the participants. Significant improvements were observed in the 6MWT distance traveled, Functional Independence Measure (FIM) scale score, fraction of inhaled oxygen (FiO2), and dyspnea scores. Perceived exerction measures also showed positive changes. DISCUSSION AND CONCLUSION: The findings of this study indicate that personalized reconditioning plan is effective in improving the functional capacity and overall condition and quality of life of individuals with post-COVID pathology syndrome. These findings highlight the importance of an interdisciplinary approach and tailored rehabilitation programs in this population. Further research is needed to explore the long-term effects of exercise reconditioning in this population.