Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial

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Longobardi, Igor ; Goessler, Karla ; de Oliveira Jr, Gersiel Nascimento ; do Prado, Danilo Marcelo Leite ; Santos, Jhonnatan Vasconcelos Pereira ; Meletti, Matheus Molina ; de Andrade, Danieli Castro Oliveira ; Gil, Saulo ; Boza, Joao Antonio Spott de Oliveira ; Lima, Fernanda Rodrigues ; Gualano, Bruno ; Roschel, Hamilton

• Document type: Journal article
• Source: BRITISH JOURNAL OF SPORTS MEDICINE; v. N/A, p. 10-pg., 2023-05-09.

Abstract

Background Long-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a home-based exercise training (HBET) programme on HRQoL and health-related outcomes in survivors of severe/critical COVID-19. Methods This was a single-centre, single-blinded, parallel-group, randomised controlled trial. Fifty survivors of severe/ critical COVID-19 (5 +/- 1 months after intensive care unit discharge) were randomly allocated (1:1) to either a 3 times a week (similar to 60-80min/session), semi-supervised, individualised, HBET programme or standard of care (CONTROL). Changes in HRQoL were evaluated through the 36-Item Short-Form Health Survey, and physical component summary was predetermined as the primary outcome. Secondary outcomes included cardiorespiratory fitness, pulmonary function, functional capacity, body composition and persistent symptoms. Assessments were performed at baseline and after 16 weeks of intervention. Statistical analysis followed intention-to-treat principles. Results After the intervention, HBET showed greater HRQoL score than CONTROL in the physical component summary (estimated mean difference, EMD: 16.8 points; 95% CI 5.8 to 27.9; effect size, ES: 0.74), physical functioning (EMD: 22.5 points, 95% CI 6.1 to 42.9, ES: 0.83), general health (EMD: 17.4 points, 95%CI 1.8 to 33.1, ES: 0.73) and vitality (EMD: 15.1 points, 95%CI 0.2 to 30.1, ES: 0.49) domains. 30-second sit-to-stand (EMD: 2.38 reps, 95%CI 0.01 to 4.76, ES: 0.86), and muscle weakness and myalgia were also improved in HBET compared with CONTROL (p<0.05). No significant differences were seen in the remaining variables. There were no adverse events. Conclusion HBET is an effective and safe intervention to improve physical domains of HRQoL, functional capacity and persistent symptoms in survivors of severe/critical COVID-19. Trial registration number NCT04615052. (AU)

• FAPESP's process: 20/08091-9 - Muscle mass and strength as predictors of time to medical discharge and mortality in patients hospitalized with SARS-CoV-2: a prospective observational study
• Grantee: Saulo dos Santos Gil
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 19/18039-7 - Reducing sedentary time in bariatric patients: a randomized controlled trial
• Grantee: Karla Fabiana Goessler
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
• Grantee: Bruno Gualano
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/13580-1 - Effects of home-based exercise training on quality of life and general health of severe COVID-19 survivors
• Grantee: Igor Longobardi Amin
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 20/15678-6 - Effects of a home-based exercise-training program on functional capacity among COVID-19 surviors: a randomized controlled clinical trial
• Grantee: Matheus Molina Meletti
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 20/07540-4 - Effects of exercise training associated with protein supplementation on bone parameters in older people with sarcopenic obesity under caloric restriction: a randomized controlled clinical trial
• Grantee: Gersiel Nascimento de Oliveira Júnior
• Support Opportunities: Scholarships in Brazil - Doctorate