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Abstract
Background Long-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a home-based exercise training (HBET) programme on HRQoL and health-related outcomes in survivors of severe/critical COVID-19.
Methods This was a single-centre, single-blinded, parallel-group, randomised controlled trial. Fifty survivors of severe/critical COVID-19 (5±1 months after intensive care unit discharge) were randomly allocated (1:1) to either a 3 times a week (~60–80 min/session), semi-supervised, individualised, HBET programme or standard of care (CONTROL). Changes in HRQoL were evaluated through the 36-Item Short-Form Health Survey, and physical component summary was predetermined as the primary outcome. Secondary outcomes included cardiorespiratory fitness, pulmonary function, functional capacity, body composition and persistent symptoms. Assessments were performed at baseline and after 16 weeks of intervention. Statistical analysis followed intention-to-treat principles.
Results After the intervention, HBET showed greater HRQoL score than CONTROL in the physical component summary (estimated mean difference, EMD: 16.8 points; 95% CI 5.8 to 27.9; effect size, ES: 0.74), physical functioning (EMD: 22.5 points, 95% CI 6.1 to 42.9, ES: 0.83), general health (EMD: 17.4 points, 95% CI 1.8 to 33.1, ES: 0.73) and vitality (EMD: 15.1 points, 95% CI 0.2 to 30.1, ES: 0.49) domains. 30-second sit-to-stand (EMD: 2.38 reps, 95% CI 0.01 to 4.76, ES: 0.86), and muscle weakness and myalgia were also improved in HBET compared with CONTROL (p<0.05). No significant differences were seen in the remaining variables. There were no adverse events.
Conclusion HBET is an effective and safe intervention to improve physical domains of HRQoL, functional capacity and persistent symptoms in survivors of severe/critical COVID-19.
Trial registration number NCT04615052.
- Physical activity
- Rehabilitation
- Covid-19
- Quality of life
- Fatigue
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
Footnotes
Twitter @ilong_usp, @Appl_Phys_Nutr
Contributors Designed research: IL, KG, DCOdA, SG, FRL, BG and HR. Conducted the research: IL and KG. Contributed to data collection: IL, KG, GNdOJ, DMLdP, JVPS, MMM and JASdOB. Analysed data/statistical analysis: IL and HR. Drafted the manuscript: IL, BG and HR. Guarantor: HR. All authors reviewed the manuscript critically and approved the final version. The corresponding author attests that all listed authors meet authorship criteria.
Funding This study was supported by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo (#2021/13580-1, #2019/18039-7, #2020/15678-6, #2020/07540-4, #2020/08091-9 and #2017/13552-2 for IL, KG, MMM, GNOJ, SG and BG) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; #308307/2021-6 for HR).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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