Review Pulmonary Rehabilitation for individuals with persistent symptoms following COVID-19 2024 Daynes et al

Abstract

Topic importance
COVID-19 can cause ongoing and persistent symptoms (such as breathlessness and fatigue) that lead to reduced functional capacity. There are parallels in symptoms and functional limitations in adults with post-COVID symptoms and adults with chronic respiratory diseases. Pulmonary Rehabilitation is a key treatment for adults with chronic respiratory diseases with the aims to improve symptom management, increase functional capacity. Given the similarities in presentation and aims, a Pulmonary Rehabilitation programme may be optimally placed to meet the needs of those with ongoing symptoms following COVID-19.

Review findings
Aerobic and strength training has shown benefit for adults living with Long COVID though there is little evidence on structured education in this population. Breathing pattern disorder is common in adults with Long COVID and considerations to treatment prior to rehabilitation, or alongside rehabilitation are necessary. Considerations to Post Exertional Malaise is important in this population and evidence from the Chronic Fatigue Syndrome literature supports the need for individualisation of exercise programmes, and considerations for those that have an adverse reaction to activity and/or exercise.

Summary
This narrative review summarises the current evidence of Pulmonary Rehabilitation programmes in a long COVID population. Where the evidence is lacking in long COVID the supporting evidence of these programmes in chronic respiratory diseases has highlighted the importance of aerobic and strength training, considerations for fatigue, potential mechanism for immunology improvement and management of breathing pattern disorders in these programmes.

Paywall, https://journal.chestnet.org/article/S0012-3692(24)00040-0/pdf#

 

Yikes. The main takeaway from papers like this is that such claims:

are probably just as suspicious as the rest, and that those treatments don't actually make any difference. For sure neither clinicians nor researchers can tell the difference. Maybe they aren't, but when you find a batch of clearly broken items in the "passed quality control" bin, you have to be dubious about not just the rest of the items, but the entire quality control process.

Especially BS like:

This idea that people aren't breathing right as the cause of unexplained breathlessness has been there from the start, and somehow is still around. Just because. No explanation needed.

At least they're not promoting the use of smoke inhalation therapy for chronic respiratory diseases, because that's basically their level of understanding of exercise rehabilitation programs and PEM. The download link doesn't work so I can't check, but I'd be surprised if ye old chestnut of deconditioning isn't in there as well.

It's been 4 years, and there are still takes like this. About all the things that have already been tried and failed. And are presented as a "hey, maybe this could work?!". Amazing.