Feasibility of an Outpatient Training Program after COVID-19

Martina Betschart, Spencer Rezek, Ines Unger, Swantje Beyer, David Gisi, Harriet Shannon, Cornel Sieber, Martina Betschart, Spencer Rezek, Ines Unger, Swantje Beyer, David Gisi, Harriet Shannon, Cornel Sieber

Abstract

Long-term physical consequences of coronavirus disease 2019 (COVID-19) are currently being reported. As a result, the focus is turning towards interventions that support recovery after hospitalization. To date, the feasibility of an outpatient program for people recovering from COVID-19 has not been investigated. This study presents data for a physiotherapy-led, comprehensive outpatient pulmonary rehabilitation (PR) program. Patients were recruited after hospital discharge. Training consisted of twice weekly, interval-based aerobic cycle endurance (ACE) training, followed by resistance training (RT); 60-90 min per session at intensities of 50% peak work rate; education and physical activity coaching were also provided. Feasibility outcomes included: recruitment and dropout rates, number of training sessions undertaken, and tolerability for dose and training mode. Of the 65 patients discharged home during the study period, 12 were successfully enrolled onto the program. Three dropouts (25%) were reported after 11-19 sessions. Tolerability of interval-based training was 83% and 100% for exercise duration of ACE and RT, respectively; 92% for training intensity, 83% progressive increase of intensity, and 83% mode in ACE. We tentatively suggest from these preliminary findings that the PR protocol used may be both feasible, and confer benefits to a small subgroup of patients recovering from COVID-19.

Keywords: COVID-19/SARS-CoV-2; feasibility; outpatient pulmonary rehabilitation; physiotherapy.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart of patient recruitment. PR = pulmonary rehabilitation; * aftercare program = a standard follow-up program developed independently of the research and included testing and counseling of patients post-COVID-19 primarily by specialized physiotherapists and pulmonologists.
Figure 2
Figure 2
Illustration of clinical data with changes in physical performance: Group mean changes in (a) 6MWD (meter), (b) difference to the gender-specific lower limit of normal (LLN), (c) change in age-gender specific norm expressed in percentages. Statistically significant changes are indicated with the * with p ≤ 0.001; Difference Norm of 6MWD (%) was obtained from Wilcoxon-sign rank test.

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