Might a short-term telerehabilitation program improve effort tolerance, dyspnea, and effort desaturation in patients discharged after COVID-19 pneumonia?

Abstract

Covid-19 pneumonia could result in a reduction in functional capacity, exercise tolerance and muscle strength and the execution of rehabilitation programs at home, in the form of tele-rehabilitation (TR), has been suggested as a viable option.

The aim of our retrospective pilot study was to investigate the safety, feasibility and effort tolerance change by 1-month of TR program proposed immediately after discharge to subjects recovering from COVID-19 pneumonia. Secondary objectives was to evaluate the impact on dyspnea and exercise induced desaturation (EID).

This pilot study was performed at ICS Maugeri Institute in Lumezzane (BS), Italy. At disharge, we enrolled 25 stable patients who had at least one of these criteria: a) at rest and /or oxyhemoglobin desaturation; b) moderate or severe intolerance to exertion defined as 6MWT < 70% predicted value. The duration of the program was 1 month and it comprehend a nurse telemonitoring (phone calls) and home telerehabilitation program (reconditioning and strenghening exercises, educational). Patients performed exercise sessions of 1 hour, 6 days/week and received 2 videocalls/week from a respiratory physiotherapist that monitored and adjusted the program. Oxygen saturation and heart rate were monitored by a pulso-oximeter. After 1-month of TR, patients improved exercise tolerance and dyspnea. However, about 20% of patients not improved effort tolerance and 50% effort desaturation, describing a specific phenotype with residual rehabilitation needs. The adherence was very high (96%) and no adverse event was found describing a good feasibility and acceptability of this intervention.