Early Bedside Pulmonary Rehabilitation in COVID-19 Pneumonia: Safety, Feasibility, and Functional Evaluation in Isolation

Background/Objectives: During the Coronavirus Disease 2019 (COVID-19) pandemic, patients with COVID-19 pneumonia experienced significant reductions in activity of daily living due to isolation-related physical inactivity and muscle deconditioning. This study aimed to assess the safety and feasibility of early pulmonary rehabilitation (PR) for isolated patients with COVID-19 pneumonia and to evaluate their functional status and health-related quality of life. Methods: We implemented a bedside PR program—comprising flexibility, strength, mobilization, and breathing exercises—safely deliverable within isolation rooms. Assessments included the 1-minute sit-to-stand test (1MSTST), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Hospital Anxiety and Depression Scale (HADS), conducted at baseline and discharge. Results: In this single-arm study conducted during the third to fifth pandemic waves, 23 hospitalized patients (mean age 61 ± 11 years, 78% male) completed the program with a session adherence rate of 71%. No adverse events occurred. The 1MSTST repetitions improved significantly (mean change +7.6; p < 0.001), with significant increases in SpO₂ nadir and peak heart rate (p = 0.013 and p < 0.001, respectively). Higher attendance was correlated with greater increase in 1MSTST (r = 0.626, p = 0.010), and lower baseline 1MSTST scores predicted larger gains (r = −0.662, p = 0.005). CAT total score and items related to cough and chest tightness significantly decreased (p = 0.014, 0.002, and 0.013, respectively). However, HADS depression scores worsened at discharge. Conclusions: Early bedside PR was safely and feasibly delivered to isolated patients with COVID-19 pneumonia. The 1MSTST and CAT were useful tools for functional evaluation during the acute phase. This approach may help mitigate physical deconditioning even under isolation constraints.