Effectiveness of Functional or Aerobic Exercise Combined With Breathing Techniques in Telerehabilitation for Patients With Long COVID: A Randomized Controlled Trial

Abstract

Objective

The aim of this study was to compare the short-term clinical effects of 2 telerehabilitation programs, functional versus aerobic exercises (AEs), both combined with breathing techniques, regarding the improvement of long coronavirus disease 2019 (COVID-19) symptoms.

Methods

A randomized controlled trial was conducted. The participants were assigned randomly to either the functional exercise (FE) group or AE group, both including breathing techniques. The interventions lasted for 8 weeks with 3 sessions per week, and they were conducted through the Fisiotrack mobile phone application. Assessments were performed at baseline and after treatment, including testing fatigue (Fatigue Assessment Scale), dyspnea (London Chest Activity of Daily Living Scale), functional performance (30 Seconds Standing Test), perceived stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Questionnaire), and quality of life (European Quality of Life Scale). The perceived change after treatment (Patient Global Impression of Change Scale), the usability of the application (System Usability Scale), and the adherence to treatment were also examined after treatment.

Results

In total, 43 participants (FE group, n = 21; AE group, n = 22; mean age = 42.4 [SD = 6.5] years) completed the study. In the intragroup comparison, the FE group showed improved fatigue (−6.7 points; 95% CI = −11.9 to −1.3), functional capacity (2.6 repetitions; 95% CI = 0.3 to 4.9), and perceived stress (−4.9 points; 95% CI = −9.1 to 0.8), while the AE group showed improved perceived stress (−6.2 points; 95% CI = −10.3 to −2.1). No significant differences in the intergroup effect were identified for the studied variables. Significant differences were observed in the Patient Global Impression of Change Scale in favor of the FE group compared to the AE group, and quality of life reached the minimal clinically important difference for both groups. The ease of use of the telerehabilitation tool was rated excellent in both groups.

Conclusions

Both telerehabilitation exercise modalities are effective at improving stress symptoms and quality of life in patients with long COVID-19. For improving fatigue and functional performance, FE shows more promising results.

Impact

FE or AE may be recommended depending on patients’ symptoms, and both may improve quality of life and stress symptoms in patients with long COVID-19. Telerehabilitation may be an optimal intervention modality for the prescription of physical exercise in patients with long COVID-19.