Trial Report Effect of respiratory rehabilitation on quality of life in individuals with post-COVID-19 symptoms: A RCT, 2025, Del Corral Núñez-Flores

https://www.sciencedirect.com/science/article/pii/S1877065724001039


Annals of Physical and Rehabilitation Medicine
Volume 68, Issue 1, February 2025, 101920
Original article
Effect of respiratory rehabilitation on quality of life in individuals with post-COVID-19 symptoms: A randomised controlled trial

https://doi.org/10.1016/j.rehab.2024.101920

Highlights

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  We evaluated combined respiratory muscle training + aerobic exercise.
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  Combined training increases respiratory endurance and strength.
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  Combined training has no additional impact on quality of life or exercise tolerance.
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  Combined training has no additional impact on lung function or psychological status.
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  Combined training is indicated in individuals with respiratory muscle weakness.

Abstract

Background
Inspiratory and expiratory muscle training (RMT) has been shown to have beneficial effects in individuals with long-term post-COVID-19 symptoms.

Objective
To assess the effects of adding RMT to an aerobic exercise (AE) training program for health-related quality of life (HRQoL) and exercise tolerance in individuals with long-term post-COVID-19 symptoms, and to evaluate the effects on physical and lung function, and psychological status.

Methods
64 individuals with long-term post-COVID-19 symptoms of fatigue and dyspnoea were randomly assigned to AE+RMT or AE+RMTsham groups for an 8-wk intervention (AE: 50min/day, 2 times/wk; RMT: 40min/day, 3 times/wk). Primary outcomes were HRQoL (EuroQol-5D questionnaire) and exercise tolerance (cardiopulmonary exercise test). Secondary outcomes were physical function: respiratory muscle function (inspiratory/expiratory muscle strength and inspiratory muscle endurance), lower and upper limb strength (1-min Sit-to-Stand and handgrip force); lung function: spirometry testing and lung diffusing capacity; and psychological status (anxiety/depressive levels).

Results
Postintervention, there were no statistically significant improvements in HRQoL or exercise tolerance in the AE+RMT compared with the AE+RMTsham group. In the AE+RMT group, large improvements in respiratory muscle function (d = 0.7 to 1.3) and low-moderate improvements in peak expiratory flow (d = 0.4) occurred compared with the AE+RMTsham group. Lung function outcomes, lower and upper limb strength and psychological status did not increase more in the AE+RMT group than in the AE+RMTsham group.

Conclusion
For individuals with long-term post-COVID-19 symptoms, combining RMT with an AE training program resulted in improvements in respiratory muscle strength, inspiratory muscle endurance and peak expiratory flow; however, the differences between groups were not statistically significant for HRQoL, exercise tolerance, psychological distress, and lung diffusing capacity.