Teletechnology-assisted Home-based Exercise Program for Severe COVID-19

Efficacy of Teletechnology-assisted Home-based Exercise Program for Severe COVID-19

The aim of this study was to investigate the efficacy of a home-based pulmonary rehabilitation program with the support of teletechnology in COVID-19 survivors. The main questions it aims to answer were:

• The change of six-minute walk distance
• The change of time of one-minute sit-to-stand test
• The change of maximal strength of upper-limb, lower-limb and respiratory muscle
• The change of quality of life Participants in the home-based pulmonary rehabilitation group received teletechnology-assisted consultations (either by videotelephony or telephone calls) for every 1-2 weeks during the intervention period, and participants in the usual care group did not receive teletechnology-assisted consultations during the intervention period.

Study Overview

• Status: Completed
• Conditions: COVID-19; Telerehabilitation
• Intervention / Treatment: Behavioral: Teletechnology-assisted home-based pulmonary rehabilitation

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 100
    • National Taiwan University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients are 20 years or more with severe (severe pneumonia) to critical (acute respiratory distress syndrome, sepsis, or septic shock) COVID-19 during hospitalization after deisolation.
• Patients are 65 years or more, or ever receiving oral antiviral treatment after deisolation.
• Patient have the ability to ambulate on level surface without direct contact of another person, have telecommunication device(s), and provide consent to receive teletechnology-assisted rehabilitation.

Exclusion Criteria:

• Patients are pregnant or planning for pregnancy.
• Patients have cognitive dysfunction, learning disability, uncontrolled arrhythmia or hypertension, or any medical diagnosis other than COVID-19 that would prominently influence their ability to follow instructions and perform exercise.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Usual care group; The usual care group will receive breathing exercise instructions using online learning materials soon after randomization. The participants will also receive general exercise education and exercise safety principles but not any consultation about their physical activity/exercise during the study period.	Behavioral: Teletechnology-assisted home-based pulmonary rehabilitation; The accuracy and safety of home-based pulmonary rehabilitation will be checked regularly through technology devices such as smart watch and via videotelephony (or telephone calls if indicated).
Experimental: Home-based pulmonary rehabilitation group; The home-based pulmonary rehabilitation group received breathing exercise instructions using online learning materials soon after randomization. The participants received a home-based exercise plan, which comprised aerobic exercise and resistance exercise with instruction sheets. Teletechnology was incorporated into home-based pulmonary rehabilitation via videotelephony (or telephone calls if indicated). Time points for these teletechnology-assisted consultations were at day 7, day 14 after randomization and every 2 weeks after that until the completion of the study (week 12).	Behavioral: Teletechnology-assisted home-based pulmonary rehabilitation; The accuracy and safety of home-based pulmonary rehabilitation will be checked regularly through technology devices such as smart watch and via videotelephony (or telephone calls if indicated).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Six-minute walk distance	The distance of six-minute walk test	Week 0
Six-minute walk distance	The distance of six-minute walk test	Week 4
Six-minute walk distance	The distance of six-minute walk test	Week 8
Six-minute walk distance	The distance of six-minute walk test	Week 12
Six-minute walk distance	The distance of six-minute walk test	Week 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximal upper limb strength	Hand grip strength	Week 0
Maximal upper limb strength	Hand grip strength	Week 4
Maximal upper limb strength	Hand grip strength	Week 8
Maximal upper limb strength	Hand grip strength	Week 12
Maximal upper limb strength	Hand grip strength	Week 24
Maximal lower limb strength	Leg press strength	Week 0
Maximal lower limb strength	Leg press strength	Week 4
Maximal lower limb strength	Leg press strength	Week 8
Maximal lower limb strength	Leg press strength	Week 12
Maximal lower limb strength	Leg press strength	Week 24
Maximal respiratory muscle strength	Inspiratory and expiratory pressure of respiratory muscle	Week 0
Maximal respiratory muscle strength	Inspiratory and expiratory pressure of respiratory muscle	Week 4
Maximal respiratory muscle strength	Inspiratory and expiratory pressure of respiratory muscle	Week 8
Maximal respiratory muscle strength	Inspiratory and expiratory pressure of respiratory muscle	Week 12
Maximal respiratory muscle strength	Inspiratory and expiratory pressure of respiratory muscle	Week 24
Quality of life score	Quality of life assessed by Short-form 12 questionnaire	Week 0
Quality of life score	Quality of life assessed by Short-form 12 questionnaire	Week 4
Quality of life score	Quality of life assessed by Short-form 12 questionnaire	Week 8
Quality of life score	Quality of life assessed by Short-form 12 questionnaire	Week 12
Quality of life score	Quality of life assessed by Short-form 12 questionnaire	Week 24

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Principal Investigator: Ping-Lun Hsieh, National Taiwan University Hospital

Publications and helpful links

General Publications

• Felten-Barentsz KM, van Oorsouw R, Klooster E, Koenders N, Driehuis F, Hulzebos EHJ, van der Schaaf M, Hoogeboom TJ, van der Wees PJ. Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19. Phys Ther. 2020 Aug 31;100(9):1444-1457. doi: 10.1093/ptj/pzaa114.
• Gloeckl R, Leitl D, Jarosch I, Schneeberger T, Nell C, Stenzel N, Vogelmeier CF, Kenn K, Koczulla AR. Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study. ERJ Open Res. 2021 May 31;7(2):00108-2021. doi: 10.1183/23120541.00108-2021. eCollection 2021 Apr.
• Betschart M, Rezek S, Unger I, Beyer S, Gisi D, Shannon H, Sieber C. Feasibility of an Outpatient Training Program after COVID-19. Int J Environ Res Public Health. 2021 Apr 9;18(8):3978. doi: 10.3390/ijerph18083978.

Study record dates

Study Major Dates

• Study Start (Actual): April 12, 2023
• Primary Completion (Actual): May 24, 2024
• Study Completion (Actual): May 24, 2024

Study Registration Dates

• First Submitted: March 13, 2023
• First Submitted That Met QC Criteria: March 20, 2023
• First Posted (Actual): March 21, 2023

Study Record Updates

• Last Update Posted (Estimated): September 11, 2025
• Last Update Submitted That Met QC Criteria: September 4, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Pulmonary Rehabilitation
• 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; COVID-19
• Other Study ID Numbers: 202106133RIND

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