This study aimed to determine the effectiveness of adapted physical activity and therapeutic exercise programs through hospital-based rehabilitation compared to telerehabilitation on fatigue, physical functioning, and episodic disability in patients with long COVID.
The study was a three-armed randomized controlled trial that randomly included 145 participants from a population-based inception cohort of 129,25 cases of COVID-19, interventions administered in five hospitals, and their sister concern from eight administrative divisions in Bangladesh. The criteria for inclusion in the study were being over 18 years old and having a diagnosis of CFS. The participants were allocated into three groups (Hospital-based rehabilitation [HBR], telerehabilitation [TR], and home programs group [HP]) using a computer-generated, simple random technique. The intervention involved a personalized approach to adhere to a regular exercise routine under the guidance of a physiotherapist through a hospital setting and telerehabilitation. The treatment sessions lasted 45 minutes and took place once a week on two specific days for 8 weeks. The primary outcome measure of fatigue was measured by the Chalder Fatigue Scale (CFS), and secondary outcome measures were SF-36, Disability-adjusted Life Years (DALYs), cardiorespiratory parameters (Blood pressure, Pulse rate, Oxygen saturation and lung capacity). The data was analyzed by using the IBM SPSS 23.0 version.
Between 1st July 2023 and 31st December 2023, a total of 145 participants, including both males and females, participated in this study with a mean age of 46.1 ± 6.7 years. The ultimate analysis comprises 137 (HBR=46, TR=45) and HP=46) individuals after drop-out (n=8). Following eight weeks of intervention, among group comparison showed a significant difference in fatigue level (F = 262.27; p0.001) and there was no significant difference in systolic (F = 0.614, p = 0.614) and diastolic (F = 2.27, p = 0.108) blood pressure among the groups. But significant differences were found in pulse rate (F = 7.67, p0.001), SaO2 (F = 7.61, p0.001), functional residual capacity (F = 5.76, p = 0.004), and total lung capacity (F = 27.16, p0.001). This study found a highly significant difference among the three groups on fatigue (p0.001), cardiorespiratory parameters (p0.01) except blood pressure (p>0.05), physical functioning (p0.001), and episodic disability (p0.001).
This study reveals that hospital-based and telerehabilitation interventions are equally effective in reducing fatigue, improving physical function, and enhancing cardiorespiratory health in long COVID patients. The findings highlight the potential for significant health improvements in those undergoing rehabilitation.
There's a research gap in objectively evaluating the effectiveness of physiotherapy rehabilitation in long COVID across different settings in Bangladesh. The cost-effectiveness, return to daily activities, and recurrence rates need further examination. Integrating physiotherapy rehabilitation into Bangladesh's health system is crucial, as it is a safe and effective approach for managing long COVID.
Telerehabilitation
RCT
