Effectiveness of rehabilitation interventions on adults with COVID-19 and post COVID-19 condition. A systematic review with meta-analysis
Author: Elisa Pollini1, Stefano G Lazzarini2, Claudio Cordani3, Matteo J Del Furia4, Carlotte Kiekens4, Stefano Negrini5, Chiara Arienti6
Affiliation:
1 University of Brescia, Brescia, Italy.
2 IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. Electronic address: slazzarini@dongnocchi.it.
3 Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy and IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
4 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
5 Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Ital.
6 Postdoctoral Fellow and Cochrane Rehabilitation Coordinator, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Conference/Journal: Arch Phys Med Rehabil
Date published: 2023 Oct 4
Other:
Pages: S0003-9993(23)00516-6 , Special Notes: doi: 10.1016/j.apmr.2023.08.023. , Word Count: 293
Objective:
To evaluate the effectiveness of rehabilitation interventions for adults with COVID-19 and post COVID-19 condition (PCC) in all settings.
Data sources:
PubMed, EMBASE, CINAHL, Scopus, Web of Science and Physiotherapy Evidence Database were searched from inception to 31st December 2021. PROSPERO registration number: CRD42021258553.
Study selection:
We included randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSI) according to the University of Alberta Evidence-based Practice Center.
Data extraction:
One author extracted data using a predetermined Excel form.
Data synthesis:
The meta-analysis indicates uncertain evidence about the effect of pulmonary rehabilitation and self-activities on exercise capacity (MD 65.06, 95% CI 42.87 to 87.25), respiratory function (FEV1: MD 0.16, 95% CI 0.05 to 0.28; FEV1/FVC: MD 0.05, 95% CI 0.01 to 0.09; FVC: MD 0.19, 95% CI -0.03 to 0.42) and anxiety (MD -12.03, 95% CI -21.16 to -2.90) in mild COVID-19 and PCC patients. According to the narrative synthesis, including RCTs and NRSI, prone positioning seems to show improvements in vital parameters in severe COVID-19 post ICU discharge, pulmonary rehabilitation in activities of daily living, and qigong exercise and acupressure rehabilitation program, and "twist and raise" walking technique in reducing dyspnea and weakness in any degree of severity of COVID-19 and PCC. FES-cycling or early rehabilitation programs seem to support a faster recovery in patients with moderate COVID-19 after ICU discharge. Yoga and naturopathy, Mandala coloring, and respiratory exercise seem to reduce anxiety and depression in patients with moderate and mild COVID-19. Cognitive motor training seems to improve cognitive function in PCC patients.
Conclusions:
There is very uncertain evidence about the effect of pulmonary rehabilitation on exercise capacity and respiratory function in patients with mild COVID-19 and PCC. Further high-quality research is required to improve the certainty of evidence available to support rehabilitation's crucial role in managing COVID-19.
Keywords: COVID-19; Meta-analysis; Rehabilitation; Systematic review.
PMID: 37802177 DOI: 10.1016/j.apmr.2023.08.023
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