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

<p><b>Objectives</b></p> <p>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.</p> <p><b>Design</b></p> <p>Parallel-group randomised controlled-trial with 1:1 block-randomisation.</p> <p><b>Setting</b></p> <p>Three major hospitals from Jiangsu and Hubei provinces, China.</p> <p><b>Participants</b></p> <p>120 formerly hospitalised Covid-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO.</p> <p><b>Intervention</b></p> <p>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.</p> <p><b>Outcomes</b></p> <p>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).</p> <p><b>Results</b></p> <p>Adjusted between-group difference in change in 6MWD was 65.45 metres (95% CI 43.8, 87.1; p&lt;0.001) at post-treatment and 68.62 metres (95% CI 46.39, 90.85; p&lt;0.001) at follow-up. Treatment effects for LMS were 20.12 seconds (95% CI 12.34, 27.9; p&lt;0.001) post-treatment and 22.23 seconds (95% CI 14.24, 30.21; p&lt;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.</p> <p><b>Conclusions</b></p> <p>This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL.</p> <p><b>Trial registration</b>: ChiCTR2000031834, URL: <a href="http://www.chictr.org.cn/showproj.aspx?proj=52216">http://www.chictr.org.cn/showproj.aspx?proj=52216</a></p>