Cardiovascular, Respiratory, and Functional Effects of Home-Based Exercise Training after COVID-19 Hospitalization

  1. VANESSA TEIXEIRA DO AMARAL
  2. ARIANE APARECIDA VIANA
  3. ALESSANDRO DOMINGUES HEUBEL
  4. STEPHANIE NOGUEIRA LINARES
  5. BRUNO MARTINELLI
  6. PEDRO HENRIQUE CAMPRIGHER WITZLER
  7. GUSTAVO YUDI ORIKASSA DE OLIVEIRA
  8. GABRIEL DE SOUZA ZANINI
  9. AUDREY BORGHI SILVA
  10. RENATA GONÇALVES MENDES
  11. EMMANUEL GOMES CIOLAC

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Abstract

Introduction

The present randomized, single-center, and single-blinded clinical trial tested the hypothesis that tele-supervised home-based exercise training (exercise) is an effective strategy for improving cardiovascular, respiratory, and functional capacity parameters in individuals who were hospitalized due to coronavirus disease 2019 (COVID-19).

Methods

Thirty-two individuals (52 ± 10 yr; 17 were female) randomly assigned to exercise ( n = 12) or control groups ( n = 20) had their anthropometric (weight, body mass index), hemodynamic (brachial and central blood pressure), vascular (arterial stiffness), ventilatory (pulmonary function and respiratory muscle strength), and functional parameters (handgrip strength, five-time sit to stand, timed up and go test, and 6-min walking test) assessed at baseline (30–45 d of hospital discharged) and after 12 wk of follow-up.

Results

Both groups similarly increased ( P < 0.001) forced vital capacity (absolute and percent of predicted), forced expiratory volume in the first second (absolute and percent of predicted), and handgrip strength during follow-up. However, only the exercise group reduced carotid–femoral pulse wave velocity (−2.0 ± 0.6 m·s −1 , P = 0.048) and increased ( P < 0.05) resting oxygen saturation (1.9% ± 0.6%), mean inspiratory pressure (24.7 ± 7.1 cm H 2 O), mean expiratory pressure (20.3 ± 5.8 cm H 2 O), and percent of predicted mean expiratory pressure (14% ± 22%) during follow-up. No significant changes were found in any other variable during follow-up.

Conclusions

Present findings suggest that tele-supervised home-based exercise training can be a potential adjunct therapeutic to rehabilitate individuals who were hospitalized due to COVID-19.

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  1. Version published to 10.1249/mss.0000000000002977
  2. ScreenIT

    SciScore for 10.1101/2022.01.24.22269745: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The Ethics Committee of the São Paulo State University (School of Sciences) approved all procedure (CAAE: 32134720.4.1001.5398) and all volunteers provided written informed consent. 2.2.
    Consent: The Ethics Committee of the São Paulo State University (School of Sciences) approved all procedure (CAAE: 32134720.4.1001.5398) and all volunteers provided written informed consent. 2.2.
    Sex as a biological variablePregnant or lactating women, individuals with contraindications for physical activity (i.e., recent myocardial infarction, unstable angina or arrhythmias or other uncontrolled heart disease), and individuals with decompensated metabolic, pulmonary, hepatic or renal diseases were not included.
    RandomizationStudy Design and population: This is a randomized, single center and single-blinded clinical trial (Brazilian Register of Clinical Trials identifier: RBR-9y32yy) that analyzed the effect of a 12-week tele-supervised home-based exercise training on anthropometric, respiratory, cardiovascular and functional parameters in individuals hospitalized due COVID-19.
    BlindingAll measurements were performed in a controlled room temperature (20-22ºC) by the same and experienced evaluator, who was blinded to participant’s group assignment.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Vital signs measurements were performed at seated position, after 10 min of rest, and included pulse oxygen saturation (SpO2) (G-Tech™ Led finger oximeter; Accumed Produtos Médico Hospitalares Ltda., Duque de Caxias-RJ, Brazil), respiratory rate, BP (Omron HEM 7200™, Omron Healthcare Inc., Dalian, China) and HR (Polar™ H10 heart rate sensor; Polar Electro Inc, Kempele, Finland).
    Omron Healthcare
    suggested: None
    Statistical analysis: Statistical analysis was performed using the Statistical Package for the Social Sciences version 19.0 (SPSS Inc., Chicago, IL, USA) for Windows.
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The high drop-out rate is also a limitation that should be addressed. When asked by phone, the main reasons for dropping-out included lack of time, to work overtime (to replace co-workers infected by SARS-CoV-2), to take care of family members, and fear of leaving their house and being re-infected by SARS-CoV-2. Future studies and exercise programs addressing to overcome these barriers are thus welcome.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2022.01.24.22269745v1 on medRxiv