Tele-rehabilitation following Covid-19: a sub analysis dependant on level of respiratory intervention during hospitalisation

Hyde, Lucy Emilia

Abstract

Introduction: Tele-rehabilitation has been shown to be effective in improving exercise capacity, quality of life, fatigue and mood in patients discharged from hospital following Covid-19 infection. It remains unknown however whether the level intervention received during hospitalisation is associated with the response to tele-rehabilitation. The aims of this research were therefore to identify the effect tele-rehabilitation in individuals that received high, low and no respiratory intervention during hospitalisation. Methods: Forty patients (Female; n=17, Male; n=23) discharged from two University Teaching Hospitals in the North of England following Covid-19 infection participated in a single centre, mixed methods, fast-track, randomised control trial of tele-rehabilitation. Participants completed a 6-week tele-rehabilitation programme, with exercise sessions occurring twice a week and weekly education events and peer support. Data analysis and outcome measures: Participants were split by the level of intervention they received during hospitalisation, which were high respiratory intervention (Ventilation, Continuous Positive Airway Pathway), low respiratory intervention (High Flow Nasal Oxygen, Oxygen) and no respiratory intervention. The primary outcome measures were exercise capacity (1 minute sit-to-stand), Quality of life, [EuroQol -Visual Analogue Scale (EQ-VAS)], Fatigue [Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)] and mood [Hospital Anxiety and Depression Scale (HADS)]. Results: Improvements in exercise capacity, respiratory symptoms, and quality-of-life were seen. Sit-to-stand scores improved from 19 (14-24) at baseline to 26 (23-28) following telerehabilitation (p<0.01). The change was numerically bigger in the high respiratory intervention group (15 at baseline to 24 post intervention, (p<0.01)) compared to the low intervention group (21 at baseline to 24 post-intervention (p<0.01)). MRC Dyspnoea scores improved from 3.5 (3-4) at baseline to 3 (3-4) following in the high intervention group (p<0.05) and 2 (2-4) at baseline to 2 (1.5-3.5) ppst-intervention in the low intervention group (p<0.05). Anxiety scores however no improvement the high intervention group (P>0.05), however improved in the low respiratory intervention group from 11 (4.75-13.75) at baseline to 7 (6-11) post-rehabilitation (p<0.05).
Conclusion: Our results show that tele-rehabilitation is a successful method of providing rehabilitation in patients regardless of the level of intervention during hospitalisation. However, data indicates the need for more psychological support in individuals that received intensive hospital treatment, which should be considered during the development of long-covid treatment strategies.

Citation

Hyde, L. E. (2022). Tele-rehabilitation following Covid-19: a sub analysis dependant on level of respiratory intervention during hospitalisation. (Thesis). University of Hull. https://hull-repository.worktribe.com/output/4321390

• Thesis Type: Thesis
• Deposit Date: Jul 3, 2023
• Publicly Available Date: Jul 3, 2023
• Keywords: Sport science
• Public URL: https://hull-repository.worktribe.com/output/4321390
• Award Date: Nov 1, 2022