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Effect of Inpatient Pulmonary Rehabilitationonpulmonaryoutcomes Inindividuals with Covid-19: A Systematic Review
Cardiopulmonary Physical Therapy Journal ; 34(1):a27, 2023.
Article in English | EMBASE | ID: covidwho-2222815
ABSTRACT
PURPOSE/

HYPOTHESIS:

Given the economic and health impact of COVID-19, it is critical to develop optimal inpatient programs to prevent its long term sequalae.1,2 Current guidelines advocate the use of pulmonary rehabilitation (PR) in patients with COVID-19.3 However, there is a lack of concrete information on PR in an inpatient setting for COVID-19. Therefore, we synthesized literature on the safety, feasibility and efficacy of inpatient PR on pulmonary outcomes and quality of life (QoL) in individuals with COVID-19. We hypothesized that inpatient PR would improve outcomes in this population. NUMBER OF

SUBJECTS:

The pooled sample consisted of 718 participants (F=35.2%, age=36-71 y). MATERIALS AND

METHODS:

Using PubMed, Web of Science, Cochrane Library and Embase, 3 researchers screened 474 articles for eligibility with the search terms (covid-19 or coronavirus or 2019-ncov or sars-cov-2 or cov-19 *) AND (respiratory or pulmonary) AND (physical therapy or physiotherapy or rehabilitation). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. Nine articles were finalized using the inclusion criteria publication date >2019, age >18 y, inpatient setting, and English language. Subsequently, reviewers extracted relevant information and appraised using the Physiotherapy Evidence Database (PEDro) score. RESULT(S) Studies were mainly retrospective (retrospective chart review=5, prospective observational=4);and had PEDro score of 4/10. Inpatient PR ranged from 2 to 12 weeks. The primary outcomes included six-minute walk distance (6MWD), pulmonary function and QoL. Within group analyses (n = 9) showed that inpatient PR improved 6MWD statistically and clinically (mean improvement 111-204.7 m). In all the studies (n = 3) that offered comparisons with a no PR group (n = 3), inpatient PR offered a statistically significantly benefit in this population. Further analysis showed improvements in exercise capacity were in a dose-response fashion and were related to disease severity (n = 2). Within group changes were noted in FEV1 and FVC values (n = 3). For QoL data (n = 6), within group improvements were noted only in 3 studies. Inpatient PR was reported to be safe by all studies that reported adverse events (n = 4). CONCLUSION(S) Current review suggests that inpatient PR was safe, feasible and induced large improvements in exercise capacity in individuals with COVID-19. These findings concur with data on the use of PR in chronic pulmonary diseases.4 This is important as exercise capacity is regarded as a strong predictor of cardiovascular mortality.5 The divergent results on pulmonary function and QoL may be due to the heterogeneity of PR duration, QoL measures and disease severity.6,7 Limitations included retrospective designs, small sample size and variance in protocols. Future research should be directed on improving methodological rigor of studies. CLINICAL RELEVANCE Our study provides valuable evidence that inpatient PR is safe and may accelerate improvement in exercise capacity in individuals with COVID-19.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies / Reviews / Systematic review/Meta Analysis Language: English Journal: Cardiopulmonary Physical Therapy Journal Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies / Reviews / Systematic review/Meta Analysis Language: English Journal: Cardiopulmonary Physical Therapy Journal Year: 2023 Document Type: Article