A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

Abstract

Objectives To investigate superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to exercise capacity, lower limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL) and dyspnoea. Design Parallel-group randomised controlled trial with 1:1 block randomisation. Setting Three major hospitals from Jiangsu and Hubei provinces, China. Participants 120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO. Intervention Unsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry. Outcomes Primary outcome was 6\u2009min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up). Results Adjusted between-group difference in change in 6MWD was 65.45 m (95%\u2009CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95%\u2009CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12\u2009s (95%\u2009CI 12.34 to 27.9; p<0.001) post-treatment and 22.23\u2009s (95%\u2009CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up. Conclusions This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL. Trial registration number ChiCTR2000031834.