Home-Based Exercise Tele-Rehabilitation After COVID-19 (BOOST)

Home-Based Exercise Tele-Rehabilitation in High-Risk Veterans: Impact of COVID-19 Exposure and Socioeconomic Factors

The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in catastrophic infections and fatalities across the nation. Many older Veterans with comorbidities are especially vulnerable to complications and poor recovery. This award will investigate the effect of a novel, home-based, supervised, group exercise tele-rehabilitation in Veterans recovered from COVID-19 on cardiopulmonary and physical function.

Study Overview

• Status: Recruiting
• Conditions: Post SARS-CoV2 (COVID-19)
• Intervention / Treatment: Other: Tele-exercise

Detailed Description

There is an urgent need to understand the lasting impact of COVID-19 on the cardiopulmonary system to improve physical function and prevent long-lasting disability. Pertinent knowledge gaps regarding the post-recovery physiology driving any impairments need to be addressed to improve the quality of life in Veterans with prior SARS-CoV-2 infection. Further, it is important to devise successful rehabilitation strategies that can be safely conducted in a Veteran's home. Hence, the investigators propose to utilize VA Video Connect to deliver a home based, supervised group exercise program to Veteran COVID-19 survivors. The objective of this exercise trial is to determine the influence of COVID-19 on cardiorespiratory fitness, pulmonary and physical function and to investigate the effect of a home-based exercise tele-rehabilitation on these outcomes. The study design includes rural and urban sites and investigators with a history of VA rehabilitation collaboration. Moreover, the investigators will explore healthcare disparities related to COVID-19 which are associated with functional decline and may affect sustainability of exercise rehabilitation strategies deployed, if necessary, under social distancing restrictions.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alice S Ryan, PhD; Phone Number: (410) 605-7851; Email: Alice.Ryan@va.gov

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21201
      • Recruiting
      • Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
      • Principal Investigator: Alice S. Ryan, PhD
      • Contact: Kristina Marcus, MS; Phone Number: (410) 605-7000; Email: kristina.marcus@va.gov

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Veteran
• documented COVID-19 > 90 days ago
• diagnosis of 2 of following conditions: hypertension, diabetes, cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease OR 1 condition and BMI > 30 kg/m2

Exclusion Criteria:

• myocardial infarction (within 3 months)
• exertional or unstable angina (chest pain that limits activity)
• severe congestive heart failure (EF < 20% in last year or NYHA Classification III or IV)
• uncontrolled hypertension (SBP >180 &/or DBP > 110 mm Hg at screening)
• screening EKG with ischemia, complex arrhythmia, or high-grade block (per Minnesota Code)
• poorly controlled diabetes mellitus (FBS>200 mg/dl, RBS > 299 mg/dl, or HbA1C > 10)
• treatment for cancer except skin cancer (within 3 months)
• peripheral vascular disease with claudication
• severe arthritis limiting ambulation
• neurologic disease limiting ambulation (weakness requiring assist device; severe neuropathy)
• end stage liver disease (decompensated liver disease)
• End stage renal failure (dialysis)
• severe pulmonary disease (home O2, admission for dyspnea or pneumonia within 1 month)
• high fall risk (history of falls, bone fracture)
• dementia (based on Evaluation to Consent)
• signs or symptoms of any medical comorbidity that would preclude exercise testing or training
• exercises on routine basis (structured aerobic exercise > 3 time per week)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tele-exercise; Exercise training 2x/week at home. Sessions include circuit exercises of aerobic and resistive training stations which are led remotely.	Other: Tele-exercise; Exercise training 2x/week at home. Sessions include circuit exercises of aerobic and resistive training stations which are led remotely.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in VO2peak	physical fitness, units are ml/kg/min	Baseline and after 12 weeks tele-exercise

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in 2-minute step test	physical function, units are number of times	Baseline and after 12 weeks tele-exercise
chair stands	muscular strength, units are number of times	Baseline and after 12 weeks tele-exercise

Collaborators and Investigators

• Sponsor: VA Office of Research and Development
• Collaborators: Baltimore VA Medical Center; Salem Veterans Affairs Medical Center
• Investigators: Principal Investigator: Alice S. Ryan, PhD, Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Study record dates

Study Major Dates

• Study Start (Actual): June 29, 2023
• Primary Completion (Estimated): January 30, 2027
• Study Completion (Estimated): January 30, 2028

Study Registration Dates

• First Submitted: June 16, 2022
• First Submitted That Met QC Criteria: June 16, 2022
• First Posted (Actual): June 21, 2022

Study Record Updates

• Last Update Posted (Estimated): November 7, 2025
• Last Update Submitted That Met QC Criteria: November 5, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Exercise; COVID-19; Cardiopulmonary
• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Lung Diseases; Pneumonia, Viral; Pneumonia; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; Behavior; COVID-19; Motor Activity
• Other Study ID Numbers: F3639-R

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No