Telerehabilitation improves physical function and reduces dyspnoea in people with COVID-19 and post-COVID-19 conditions: a systematic review

Question: How effective and safe is telerehabilitation for people with COVID-19 and post-COVID-19 conditions? Design: Systematic review of randomised trials. Participants: People with COVID-19 and post-COVID-19 conditions. Intervention: Any type of telerehabilitation. Outcome measures: Satisfaction, quality of life, adverse events, adherence to telerehabilitation, dyspnoea, functional performance, read-missions, mortality, pulmonary function and level of independence. Results: Database searches retrieved 2,962 records, of which six trials with 323 participants were included in the review. Breathing exercises delivered via telerehabilitation improved 6-minute walk distance (MD 101 m, 95% CI 61 to 141; two studies), 30-second sit-to-stand test performance (MD 2.2 repetitions, 95% CI 1.5 to 2.8; two studies), Multidimen-sional Dyspnoea-12 questionnaire scores (MD -6, 95% CI -7 to -5; two studies) and perceived effort on the 0 -to-10 Borg scale (MD -2.8, 95% CI -3.3 to -2.3; two studies), with low certainty of evidence. Exercise delivered via telerehabilitation improved 6-minute walk distance (MD 62 m, 95% CI 42 to 82, four studies), 30-second sit-to-stand test performance (MD 2.0 repetitions, 95% CI 1.3 to 2.7; two studies) and Multidi-mensional Dyspnoea-12 scores (MD -1.8, 95% CI -2.5 to -1.1; one study), with low certainty of evidence. Adverse events were almost all mild or moderate and occurred with similar frequency in the tele-rehabilitation group (median 0 per participant, IQR 0 to 2.75) as in the control group (median 0 per participant, IQR 0 to 2); Hodges-Lehmann median difference 0 (95% CI 0 to 0), with low certainty of evidence. Conclusion: Telerehabilitation may improve functional capacity, dyspnoea, performance and physical components of quality of life and does not substantially increase adverse events. Registration: PROSPERO CRD42021271049. [Vieira AGS, Pinto ACPN, Garcia BMSP, Eid RAC, Mol CG, Nawa RK (2022) Tele-rehabilitation improves physical function and reduces dyspnoea in people with COVID-19 and post-COVID-19 conditions: a systematic review. Journal of Physiotherapy 68:90-98] (c) 2022 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Breathing exercises and exercise delivered via telerehabilitation have shown improvements in functional capacity, dyspnoea, and performance, with low certainty of evidence. Adverse events were mostly mild or moderate and occurred similarly in the telerehabilitation group and control group.