ABSTRACT
IntroductionDyspnoea is one of several ongoing symptoms experienced by those recovering from COVID-19 (Arnold et al, 2021). It can impact people for numerous weeks and months following the initial infection. Post COVID-19 rehabilitation may help;however, little is known about the effects of rehabilitation on dyspnoea and the related emotional response. This study aims to explore the impact of an outpatient hospital-based rehabilitation programme on dyspnoea and its emotional burden in those recovering from COVID-19.MethodPeople experiencing ongoing symptoms of COVID-19, both post-hospitalisation and community managed, were referred for assessment of their rehabilitation needs prior to commencing the programme. Consent and ethical approval was gained to allow data collection and analysis for a longitudinal cohort study. The COVID-19 hospital-based programme was twice weekly for 6-weeks. The Multidimensional Dyspnoea Profile (MDP) (Banzett et al, 2015) was completed pre and post-rehabilitation. Data was analysed using a paired t-test. For the MDP, data was explored to understand the most prevalent sensation of dyspnoea. Data is presented as the immediate perception (A1+SQ) and emotional domain (A2).ResultsNineteen people completed the MDP pre-rehabilitation (74% female, mean [SD] age 53.21 [9.99] years). Hospital admissions were 5 (26.3%) and the mean [SD] length of hospital stay was 8.8 [12.66] days. The mean [SD] unpleasantness (A1) score was 5.21 [1.69]. Chest tightness was the most severe and prevalent sensation (SQ). Frustrated was the most severe emotion (A2).Fourteen people completed the MDP Post-rehabilitation. The mean [SD] unpleasantness (A1) score was 4.29 [2.46]. Hyperventilating was the most severe and prevalent sensation (SQ). Frustrated was the most severe emotion (A2). There was no statistically significant difference between the immediate perception pre and post-rehabilitation (-3.37 [10.40]), p=0.22). There was a statistically significant difference between the emotional domain pre and post-rehabilitation (4.36 [5.32]), p< 0.01.ConclusionThese results demonstrate rehabilitation did improve the immediate perception of dyspnoea but this was not statistically significant. Unpleasantness of dyspnoea reduced following rehabilitation. Furthermore, the sensation of dyspnoea changed following the rehabilitation programme. The emotional domain statistically significantly increased following rehabilitation. Further research is required due to the multifactorial nature of dyspnoea.
ABSTRACT
IntroductionCOVID-19 leads to persistent symptoms and in some instances oxygen desaturation (>3%) (Greenhalgh et al, 2020). Field walking tests are used in respiratory diseases to assess oxygen desaturation and exercise capacity due to their high reliability (Hernandes et al, 2014). However, under COVID-19 restrictions these tests became problematic to perform due to limitations of space, time, and equipment. This project aims to investigate sit to stand test’s (1STS & 5STS) in comparison to the Incremental shuttle walk test (ISWT) to assess function and oxygen desaturation (SpO2) in patients following COVID19 infection. In addition, to investigate if there is a difference in results to patients who received hospital care during the acute stage of COVID-19, to those who were managed in the community.MethodsPatients attending out-patient COVID-19 rehabilitation comprised of those hospitalised for acute COVID-19 and community managed referrals. Oxygen saturation was recorded directly before and after the tests. An independent T- test was used to measure group means for statistical difference and Pearson’s correlation was used to compare 5STS, 1STS and ISWT performance outcomes.ResultsTwenty-nine patients were eligible for analysis, mean (SD) age 54 (7.8) years (65.5% female and 69% White British) 7 (24%) participants had hospital admissions with a mean time from discharge to assessment of 347 days. There were desaturations of >3% in 3 (10%) participants during the 1STS and 9 (38%) in the ISWT and no desaturations of >3% during the 5STS. The difference between patient groups and SPO2 desaturations are non-significant at 0.559 for ISWT, 0.447 for 1STS and 0.447 5STS. There was no significant difference between SpO2, RPE and BORG for patient groups in each test condition. There was a strong correlation (R=-0.88) between the 1STS repetitions and 5STS time. There was a moderate correlation between ISWT and both STS tests (5STS R=-0.53 and 1STSR=-0.66).ConclusionsThe 5STS does not detect desaturation, whilst the ISWT detected meaningful desaturation in 38% of the population. There was a strong correlation with respect to performance on both STS tests, but not with the ISWT.