- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04895371
Tele-Physiotherapy After COVID-19 Hospitalization
The Efficacy of Tele-Physiotherapy in Patients After COVID-19 Hospitalization: The PPTCOVID Study
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), is a multisystem infectious disease which has led to a global pandemic.
Tele-medicine is a tool to connect patients and health care professions while maintaining social distancing and restrictions. Tele-physiotherapy is a field of physiotherapy which has the advantage of providing therapy.
Since some months ago, different organizations have started the tele-physiotherapy/tele-rehabilitation program to manage the patients' complications after COVID-19. This research team have developed a tele-rehabilitation guideline for physiotherapists to help them how to use tele-physiotherapy program for patients after COVID-19 hospitalization. The aim of this study is to evaluate the efficacy of tele-physiotherapy program in patients discharged after COVID-19.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), is a multisystem infectious disease which has led to a global pandemic.
Due to multisystem nature of this disease, it can cause a variety of early and late complications. New studies have revealed some of the long-term sequelae of this disease, such as neurological injuries, arterial or venous thrombosis, cardiac, brain strokes, etc. which need to be taken into consideration during management of patients. Many COVID-19 survivors who require critical care may also develop psychological, physical and cognitive impairments. These patients may develop various impairments because of hospitalization owing to extended immobilization and many hours bed ridden; these include neuromuscular complications, severe muscle weakness and fatigue, joint stiffness, dysphagia, psychological problems, reduced mobility, low quality of life, frequent falls, and even quadriparesis.
Given impacts of COVID-19 on global health care system, innovative approaches in managing patients are needed. This is the reason that tele-medicine is becoming a trendy title for researchers . Tele-medicine is a tool to connect patients and health care professions while maintaining social distancing and restrictions . Digital health interventions can help provide self-monitoring tools, field updates, exercise protocols, and psychological support. Depending on the funding and facilities provided by the health care system, tele-medicine can be designed and employed in each country uniquely.
Physiotherapy interventions can be also delivered through modern digital communication tools. Tele-physiotherapy is a field of physiotherapy which has the advantage of providing therapy wherever is most convenient for the patient through the use of modern digital communication.
Based on the evidences from other outbreak of viruses in the coronavirus strain epidemics, many of the discharged patients after COVID-19 pneumonia are likely to have residual impairment even some years after hospitalization. Not only discharged COVID-19 patients, but also other members of the society might need physiotherapy in this crisis. Despite this need, social distancing should be taken into account and human lives can't be put in danger. Tele-physiotherapy provides a great opportunity for therapists to communicate with their patients, assess and treat them.
Since some months ago, different organizations have started the tele-physiotherapy/tele-rehabilitation program to manage the patients' complications after COVID-19. This research team have developed a tele-rehabilitation guideline for physiotherapists to help them how to use tele-physiotherapy program for patients after COVID-19 hospitalization. The aim of this study is to evaluate the efficacy of tele-physiotherapy program in patients discharged after COVID-19.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Tehran, Iran, Islamic Republic of
- Imam Khomeini Hospital Complex
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Discharged patients with Covid-19 pneumonia,
- Having at least one rT-PCR Covid test,
- Duration of hospitalization > 10 days,
- Ability to walk,
- Totally oriented,
- Ability to use smartphone,
- Ability to read and write in Persian.
Exclusion Criteria:
- Having any kind of musculoskeletal disorder causing inability to participate in physiotherapy sessions,
- Severe cardiovascular impairments.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Tele-physiotherapy group
Allocated participants to this group will receive 18 physiotherapy sessions (three sessions per week) during six weeks.
in these sessions, physiotherapist will prescribe aerobic, resistive, breathing and functional exercises and airway clearance techniques (if needed) based on result of assessment of patients at the discharge phase.
the physiotherapist will use some educational contents for the patient and call him/her to guide the patient about how exercises should be performed (determining frequency, time, intensity and type of exercise).
the patient should do exercises until next session and provide a feedback.
The patient will be assessed weekly using a pre-designed questionnaire remotely.
the progression of interventions will be based on the results of weekly assessment.
|
Allocated participants to this group will receive 18 physiotherapy sessions (three sessions per week) during six weeks.
in these sessions, physiotherapist will prescribe aerobic, resistive, breathing and functional exercises and airway clearance techniques (if needed) based on result of assessment of patients at the discharge phase.
the physiotherapist will use some educational contents for the patient and call him/her to guide the patient about how exercises should be performed (determining frequency, time, intensity and type of exercise).
the patient should do exercises until next session and provide a feedback.
The patient will be assessed weekly using a pre-designed questionnaire remotely.
the progression of interventions will be based on the results of weekly assessment.
|
Active Comparator: Control group
Allocated participants to control group will receive one consultation session by the physiotherapist.
At this session, patients will be educated about how to perform their daily activities, breathing exercises, walking, using oxygen cylinder and dietary.
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Allocated participants to control group will receive one consultation session by the physiotherapist.
At this session, patients will be educated about how to perform their daily activities, breathing exercises, walking, using oxygen cylinder and dietary.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
6-Minute Walk Test (6MWT)
Time Frame: Baseline
|
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity.
The distance which patient can walk during 6 minutes will be measured.
|
Baseline
|
6-Minute Walk Test (6MWT)
Time Frame: After six weeks
|
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity.
The distance which patient can walk during 6 minutes will be measured.
|
After six weeks
|
6-Minute Walk Test (6MWT)
Time Frame: After 10 weeks
|
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity.
The distance which patient can walk during 6 minutes will be measured.
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After 10 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Five Times Sit to Stand test (5TST)
Time Frame: Baseline
|
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times.
it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
|
Baseline
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Five Times Sit to Stand test (5TST)
Time Frame: After six weeks
|
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times.
it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
|
After six weeks
|
Five Times Sit to Stand test (5TST)
Time Frame: After 10 weeks
|
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times.
it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
|
After 10 weeks
|
Fatigue Severity Scale (FSS)
Time Frame: Baseline
|
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals.
the questionnaire asks the individuals to rate the level of their fatigue.
FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
|
Baseline
|
Fatigue Severity Scale (FSS)
Time Frame: After six weeks
|
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals.
the questionnaire asks the individuals to rate the level of their fatigue.
FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
|
After six weeks
|
Fatigue Severity Scale (FSS)
Time Frame: After 10 weeks
|
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals.
the questionnaire asks the individuals to rate the level of their fatigue.
FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
|
After 10 weeks
|
International Physical Activity Questionnaire (IPAQ)
Time Frame: Baseline
|
The IPAQ is a 27-item subjective measure of physical activity.
This instrument is repetitively used instrument to assess the physical activity.
This instrument was developed to assess physical activity in adults aged 18-65 years.
The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
|
Baseline
|
International Physical Activity Questionnaire (IPAQ)
Time Frame: After six weeks
|
The IPAQ is a 27-item subjective measure of physical activity.
This instrument is repetitively used instrument to assess the physical activity.
This instrument was developed to assess physical activity in adults aged 18-65 years.
The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
|
After six weeks
|
International Physical Activity Questionnaire (IPAQ)
Time Frame: After 10 weeks
|
The IPAQ is a 27-item subjective measure of physical activity.
This instrument is repetitively used instrument to assess the physical activity.
This instrument was developed to assess physical activity in adults aged 18-65 years.
The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
|
After 10 weeks
|
Level of dyspnea
Time Frame: Baseline
|
Level of dyspnea is assessed by modified Borg scale.
the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
|
Baseline
|
Level of dyspnea
Time Frame: After six weeks
|
Level of dyspnea is assessed by modified Borg scale.
the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
|
After six weeks
|
Level of dyspnea
Time Frame: After 10 weeks
|
Level of dyspnea is assessed by modified Borg scale.
the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
|
After 10 weeks
|
Short From-36
Time Frame: Baseline
|
Short Form-36 is a self report instrument which evaluate eight domains of health.
it is commonly used as a person or population's quality of life.
|
Baseline
|
Short From-36
Time Frame: After six weeks
|
Short Form-36 is a self report instrument which evaluate eight domains of health.
it is commonly used as a person or population's quality of life.
|
After six weeks
|
Short From-36
Time Frame: After 10 weeks
|
Short Form-36 is a self report instrument which evaluate eight domains of health.
it is commonly used as a person or population's quality of life.
|
After 10 weeks
|
Strength of shoulder abduction muscle group
Time Frame: Baseline
|
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
Baseline
|
Strength of shoulder abduction muscle group
Time Frame: After six weeks
|
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After six weeks
|
Strength of shoulder abduction muscle group
Time Frame: After 10 weeks
|
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After 10 weeks
|
Strength of hip abduction muscle group
Time Frame: Baseline
|
Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
Baseline
|
Strength of hip abduction muscle group
Time Frame: After six weeks
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Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
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After six weeks
|
Strength of hip abduction muscle group
Time Frame: After 10 weeks
|
Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After 10 weeks
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Strength of knee extension muscle group
Time Frame: Baseline
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Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
Baseline
|
Strength of knee extension muscle group
Time Frame: After six weeks
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Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After six weeks
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Strength of knee extension muscle group
Time Frame: After 10 weeks
|
Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After 10 weeks
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Strength of elbow flexion muscle group
Time Frame: Baseline
|
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
Baseline
|
Strength of elbow flexion muscle group
Time Frame: After six weeks
|
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After six weeks
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Strength of elbow flexion muscle group
Time Frame: After 10 weeks
|
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
|
After 10 weeks
|
Collaborators and Investigators
Investigators
- Study Director: Mohsen Nasiri-toosi, MD., Tehran University of Medical Sciences
- Study Director: Behrouz Attarbashi Moghadam, Ph.D., Tehran University of Medical Sciences
Publications and helpful links
General Publications
- Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W; China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-733. doi: 10.1056/NEJMoa2001017. Epub 2020 Jan 24.
- Enright PL. The six-minute walk test. Respir Care. 2003 Aug;48(8):783-5.
- Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381-95. doi: 10.1249/01.MSS.0000078924.61453.FB.
- Vasheghani-Farahani A, Tahmasbi M, Asheri H, Ashraf H, Nedjat S, Kordi R. The Persian, last 7-day, long form of the International Physical Activity Questionnaire: translation and validation study. Asian J Sports Med. 2011 Jun;2(2):106-16. doi: 10.5812/asjsm.34781.
- Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995 Feb;80(1):163-6. doi: 10.2466/pms.1995.80.1.163.
- Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989 Oct;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022.
- Azimian M, Farahani AS, Dadkhah A, Fallahpour M, Karimlu M. Fatigue severity scale: the psychometric properties of the persian-version in patients with multiple sclerosis. Res J Biol Sci. 2009;4(9):974-7.
- Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.
- Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005 Apr;14(3):875-82. doi: 10.1007/s11136-004-1014-5.
- Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, Hodgson C, Jones AY, Kho ME, Moses R, Ntoumenopoulos G, Parry SM, Patman S, van der Lee L. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020 Apr;66(2):73-82. doi: 10.1016/j.jphys.2020.03.011. Epub 2020 Mar 30.
- World Health Organization. COVID-19 clinical management: living guidance, 25 January 2021. World Health Organization; 2021.
- SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. Arch Acad Emerg Med. 2021 Jan 20;9(1):e14. doi: 10.22037/aaem.v9i1.1058. eCollection 2021. No abstract available.
- Portnoy J, Waller M, Elliott T. Telemedicine in the Era of COVID-19. J Allergy Clin Immunol Pract. 2020 May;8(5):1489-1491. doi: 10.1016/j.jaip.2020.03.008. Epub 2020 Mar 24. No abstract available.
- Salawu A, Green A, Crooks MG, Brixey N, Ross DH, Sivan M. A Proposal for Multidisciplinary Tele-Rehabilitation in the Assessment and Rehabilitation of COVID-19 Survivors. Int J Environ Res Public Health. 2020 Jul 7;17(13):4890. doi: 10.3390/ijerph17134890.
- Cortés-Telles A, López-Romero S, Figueroa-Hurtado E, Pou-Aguilar YN, Wong AW, Milne KM, Ryerson CJ, Guenette JA. Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea. Respir Physiol Neurobiol. 2021 Jun;288:103644. doi: 10.1016/j.resp.2021.103644. Epub 2021 Feb 27.
- Jenkins SC. 6-Minute walk test in patients with COPD: clinical applications in pulmonary rehabilitation. Physiotherapy. 2007 Sep 1;93(3):175-82.
- Javaherian M, Shadmehr A, Keshtkar A, Beigmohammadi MT, Dabbaghipour N, Syed A, Moghaddam BA. Safety and efficacy of Pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID): A prospective, randomised, single-blind, controlled trial. medRxiv. 2021 Jan 1.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 99-2-246-49892
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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