Telerehabilitation program for COVID-19 survivors (TERECO) - Randomized controlled trial

Objectives To investigate superiority of a telerehabilitation program 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 program 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-minute walking distance (6MWD)
in metres. Secondary outcomes were squat time in seconds; pulmonary
function assessed by spirometry; HRQOL measured with 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 metres (95% CI 43.8, 87.1; p<0.001) at
post-treatment and 68.62 metres (95% CI 46.39, 90.85; p<0.001) at
follow-up. Treatment effects for LMS were 20.12 seconds (95% CI 12.34,
27.9; p<0.001) post-treatment and 22.23 seconds (95% CI 14.24,
30.21; p<0.001) at follow-up. No group differences were found for
lung function except post-treatment MVV. Increase in SF-12 physical
component was greater in the TERECO group with treatment effects estimated
as 3.79 (95% CI 1.24, 6.35; p=0.004) at post-treatment and 2.69 (95% CI
0.06, 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: ChiCTR2000031834, URL:
http://www.chictr.org.cn/showproj.aspx?proj=52216