Feasibility of an Outpatient Training Program after COVID-19.

Martina Betschart,Harriet Shannon,Ines Unger,Swantje Beyer,David Gisi,Cornel Sieber,Spencer Rezek

doi:10.3390/ijerph18083978

Abstract

Long-term physical consequences of coronavirus disease 2019 (COVID-19) are currently being reported. As a result, the focus is turning towards interventions that support recovery after hospitalization. To date, the feasibility of an outpatient program for people recovering from COVID-19 has not been investigated. This study presents data for a physiotherapy-led, comprehensive outpatient pulmonary rehabilitation (PR) program. Patients were recruited after hospital discharge. Training consisted of twice weekly, interval-based aerobic cycle endurance (ACE) training, followed by resistance training (RT); 60–90 min per session at intensities of 50% peak work rate; education and physical activity coaching were also provided. Feasibility outcomes included: recruitment and dropout rates, number of training sessions undertaken, and tolerability for dose and training mode. Of the 65 patients discharged home during the study period, 12 were successfully enrolled onto the program. Three dropouts (25%) were reported after 11–19 sessions. Tolerability of interval-based training was 83% and 100% for exercise duration of ACE and RT, respectively; 92% for training intensity, 83% progressive increase of intensity, and 83% mode in ACE. We tentatively suggest from these preliminary findings that the PR protocol used may be both feasible, and confer benefits to a small subgroup of patients recovering from COVID-19.

Highlights

IntroductionIt has been predicted that approximately 45% of patients discharged from hospital after suffering coronavirus disease 2019 (COVID-19) will require further support from the healthcare system [1]
Patients were not able to conduct the 6-min walking test (6MWT) due to orthopedic limitations (n = 4), four patients did not wish to return to the hospital for assessments and provided the health-related quality of life (HRQoL), Post-COVID-19 Functional Status scale (PCFS) and fatigue questionnaire completed at home, and four did not provide consent for data use
The 48 patients assessed for physical performance (6MWT) presented with mild (n = 9), moderate (n = 23), severe (n = 11) and critical (n = 5) manifestations of pneumonia according to the interim guidance of the World Health Organization [41]

Summary

Introduction

It has been predicted that approximately 45% of patients discharged from hospital after suffering coronavirus disease 2019 (COVID-19) will require further support from the healthcare system [1]. Limitations in physical performance could be inferred, according to a recent review on long-term consequences observed in patients after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) [6]. Two observational studies reported that approximately a third of patients had low physical performance at discharge [7] and after three months [8] following hospitalization for COVID-19. Distance covered during the 6MWT was found to be significantly reduced after four months in survivors of COVID19 with severe and critical disease, compared to those with a mild or moderate course (p = 0.001; not-adjusted for age and gender) [9]

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