EFFECT OF CORE MUSCLE TRAINING THROUGH TELE-REHAB ON PEAK EXPIRATORY FLOW RATE AND FUNCTIONAL CAPACITY IN POST-COVID-19 SURVIVORS

M. Purohit¹, M. Sheth¹

¹SBB College of Physiotherapy, Ahmedabad, India

Background: Illness-related fatigue and breathlessness is prevalent post-hospital discharge in COVID-19 survivors. Respiratory muscle fatigue has negative influence on exercise performance. It is seen that diaphragmatic dysfunction could play an important role in respiratory symptoms in COVID-19 survivors.Practice guidelines for management of impairments seen following COVID are available. However they do not include core muscle training. It is found that diaphragm is recruited actively in many resistance exercises.Synchrony of core muscles with breathing is important and it is seen that core muscle training can improve pulmonary parameters. Tele-rehab is a newer concept and safe for physiotherapist as well as patient, as patients can perform exercises at their comfort zone.

Purpose: This study aims to find the effect of pulmonary rehabilitation and core muscle training through tele-rehab on functional capacity and peak expiratory flow rate in patients post-COVID-19.

Methods: An experimental study was conducted in the community of Ahmedabad, Gujarat on 40 individuals, belonging to age group of 18-65 years, with history of hospitalisation due to COVID-19. They were equally divided in to two groups, Group A (Exercise group) and Group B (Control group) by simple random sampling technique. Wright’s peak flow meter was used to measure peak expiratory flow rate (PEFR) and functional capacity was measured by six-minute walk test, by keeping American Thoracic Society (ATS) guidelines in the centre. Individuals were explained the study protocol on first meeting, process of AEET (assessment, explanation, execution and termination) was followed. Exercise included 3 phases,warm-up (generalised bodily movements), main exercise (core muscle training) and cool down (stretching of muscles). Total20 sessions of core muscle training (5 days/week) were given. Individuals could join online treatment sessions by various applications available and at comfortable time. Before and after intervention, the outcome measures were documented. Data analysis was done using Microsoft Excel 2019 and SPSS version 20.0. Shapiro-Wilk test was applied to check normality and data was found to be not normally distributed.

Results: All 40 participants completed at least 80% of the sessions. Mean difference of PEFR in exercise group was (103.70 ± 46.48) L/min and for control group (8.80 ± 13.8) L/min. Mean difference of six-minute walk test in exercise group (50.9 ± 32.11) meters, and in control group (14.60 ± 21.03) meters.Using Mann-Whitney U test, results of between group comparison of means showed (U= 0.0001, p= 0.0001) statistically significant results for peak expiratory flow rate (PEFR) and functional capacity (U= 50, p= 0.0001).

Conclusions: Core muscle training can be incorporated in pulmonary rehabilitation to improve functional capacity (walking) and pulmonary function assessed by peak flow rate in COVID-19 survivors. Excellent adherence rate to the protocol was also observed with tele-rehabilitation.

Implications: Core muscle training can be a part in treating pulmonary dysfunction associated with COVID-19. Further studies which evaluate this effect based on severity of disease or measure illness-related symptoms can be proposed. Core muscle training can be made more effective incorporating a biofeedback device for the patients. In addition, tele-rehab can be adopted to treat various other disorders.

Funding acknowledgements: None

Keywords:
Core muscle training
COVID-19
Functional capacity

Topics:
COVID-19
Cardiorespiratory
Community based rehabilitation

Did this work require ethics approval? Yes

Institution: SBB College of Physiotherapy

Committee: Institutional Review Board of SBB College of Physiotherapy

Ethics number: PT-1/MP/MS/Covid/2021-22