1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for 'CFS'.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 15th July 2024 is here.
    Dismiss Notice
  3. Welcome! Read the Core Purpose and Values of our forum.
    Dismiss Notice

Effects of a concurrent training, respiratory muscle exercise and self-management recommendations on recovery from post-COVID-19 2022 Jimeno-Almazán

Discussion in 'Long Covid research' started by Andy, Dec 9, 2022.

Tags:
  1. Andy

    Andy Committee Member

    Messages:
    22,406
    Location:
    Hampshire, UK
    Full title: Effects of a concurrent training, respiratory muscle exercise and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial

    Abstract

    The aim of this study was to determine the effectiveness of physical exercise, respiratory muscle training and the self-management WHO recommendations leaflet on the recovery of physical fitness, quality of life and symptom status in people with post COVID-19 conditions.

    Eighty non-hospitalized adults with a post-COVID-19 condition were randomly assigned to one of four 8-week parallel intervention groups: multicomponent exercise program based on concurrent training- CT (n= 20; 3 resistance and endurance supervised sessions per week at low-moderate intensity); b) inspiratory muscle training- RM (n= 17; 2 standardized daily sessions); c) a combination of both of the above- CTRM (n= 23); d) control group- CON (n= 20; following the WHO guidelines for post-COVID-19 related illness rehabilitation). No significant differences between groups were detected at baseline.

    While no significant differences between interventions were detected in the VO2max, significant individual improvements were identified in the CT (7.5%; ES=0.38) and CTRM (7.8%; ES=0.28) groups. Lower body muscle strength significantly improved in the CT and CTRM (14.5-32.6%; ES=0.27-1.13) groups compared to RM and CON (-0.3-11.3%; ES=0.19-0.00). The CT and CTRM groups improved significantly for dyspnea and fatigue, as did the health status. In addition, significant differences between interventions were described in fatigue and depression scales favouring CT and CTRM interventions.

    An individualized and supervised concurrent training with or without respiratory muscle training was safer and more effective than self-care recommendations and inspiratory muscle training alone, to regain cardiovascular and muscular fitness, improve symptom severity and health status in outpatients with post-COVID-19 conditions.

    Open access, https://journals.physiology.org/doi/abs/10.1152/japplphysiol.00489.2022
     
    Andy, Dec 9, 2022
    #1
    RedFox, Hutan, Peter Trewhitt and 1 other person like this.
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    27,999
    Location:
    Aotearoa New Zealand
    Selection
    There was a high level of self-selection of participants, via social media and GP referral, so only those participants who were comfortable with the idea of physical training would have signed up. Participants needed to have had symptoms for 3 months, but that means that still a lot of participants were in the stage where a high level of recovery could be expected.

    Dropouts
    If the 80 patients, it is reported that "Three patients dropped out of the study for reasons unrelated to symptom worsening: on due to moderate SARS CoV2 infection (CTRM), one due to instability of psychiatric pathology and adherence problems (CTRM) and one due to a lack of commitment to the programme (CT)."
    Well, that wording doesn't actually rule out some participants starting a therapy and dropping out due to symptom worsening, and then not being included in the analysis. The wording in the methods section about compliance reinforces the possibility that some participants may have been excluded from the analysis due to inadequate levels of participation e.g.
    CT and CTRM "Attendance >=85% (at least 20 of the 24 scheduled sessions) was mandatory to continue in the study."
     
    Hutan, Dec 9, 2022
    #2
    Sean, alktipping, Peter Trewhitt and 4 others like this.
  3. Hutan

    Hutan Moderator Staff Member

    Messages:
    27,999
    Location:
    Aotearoa New Zealand
    Health-related quality of life and functional limitations after Covid-19
    "Health-related quality of life by the 12-item short form survey (SF-12), calculating the mental component (MH) and PA domain scores."
    [PA is physical health]
    "Functional limitations after Covid-19 were calculated using the Post-COVID-19 Functional Status (PCFS) scale."

    "After (sic) 8-week intervention period, no significant differences in the mMRC (dyspnea), GAD-7 (anxiety), PCFS (functional status), and SF-12 PA and MH (health related quality of life).


    I think there are issues with the data too, relating to numbers of participants assessed. For example, in Table 2 PCFS<2,
    Controls Pre 4 (20%); Post 9 (45%)
    CTRM Pre 7 (17%); Post 8 (35%)
    This implies that for the PCFS measurement, Controls had 20 participants before and 20 after, while CTRM had 41 participants before (7 participants = 17%) and 23 participants after (8 participants = 35%). Table 1 suggests that there were 23 participants in CTRM before and after. Unless I have misinterpreted something, that's looking pretty dodgy.

    Screen Shot 2022-12-10 at 8.56.30 am.png

    I think further poking around in this report would find other concerns and different interpretations of the data from those presented.
     
    Last edited: Dec 9, 2022
    Hutan, Dec 9, 2022
    #3
    Sean, alktipping, Peter Trewhitt and 1 other person like this.

Share This Page