A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial.
A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial.
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DOI：
10.1136/thoraxjnl-2021-217382
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发表时间：
2022-07
期刊：
影响因子：
10
通讯作者：
Reinhardt JD
中科院分区：
文献类型：
--
作者：
Li J;Xia W;Zhan C;Liu S;Yin Z;Wang J;Chong Y;Zheng C;Fang X;Cheng W;Reinhardt JD
研究COVID-19远程康复计划（TERECO）在运动能力、下肢肌力（LMS）、肺功能、健康相关生活质量（HRQOL）和呼吸困难方面相对于无康复的优效性。1：1区组随机化的平行组随机对照试验。来自中国江苏省和湖北省的三家大医院。将120名之前住院治疗的COVID-19幸存者（仍有呼吸困难投诉）随机分配，其中61名分配至对照组，59名分配至TERECO组。为期6周的无监督家庭运动计划，包括呼吸控制和胸廓扩张，有氧运动和LMS运动，通过智能手机提供，并通过心率遥测进行远程监控。主要结局是6分钟步行距离（6 MWD）（以米为单位）。次要结局为深蹲时间（单位：秒）;肺功能（通过肺量测定法评估）; HRQOL（通过健康调查简表-12（SF-12）和mMRC-呼吸困难测量）。在6周（治疗后）和28周（随访）时评估结局。治疗后6 MWD变化的校正组间差异为65.45 m（95% CI 43.8至87.1; p<0.001），随访时为68.62 m（95% CI 46.39至90.85; p<0.001）。LMS的治疗效果为治疗后20.12 s（95% CI 12.34至27.9; p<0.001），随访时22.23 s（95% CI 14.24至30.21; p<0.001）。除治疗后最大自主通气量外，未发现肺功能的组间差异。TERECO组SF-12身体成分的增加更大，治疗后的治疗效应估计为3.79（95% CI 1.24至6.35; p=0.004），随访时为2.69（95% CI 0.06至5.32; p=0.045）。该试验证明了TERECO在6 MWD、LMS和身体HRQOL方面优于未进行康复。ChiCTR 2000031834。
To investigate superiority of a telerehabilitation programme 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. Parallel-group randomised controlled trial with 1:1 block randomisation. Three major hospitals from Jiangsu and Hubei provinces, China. 120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO. Unsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry. Primary outcome was 6 min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up). Adjusted between-group difference in change in 6MWD was 65.45 m (95% CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12 s (95% CI 12.34 to 27.9; p<0.001) post-treatment and 22.23 s (95% CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up. This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL. ChiCTR2000031834.
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