Dyspnea: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition.
Claudio Cordani, Stefano G Lazzarini, Elisabetta Zampogna and 4 others
PMID 36511169WHAT IT FOUND
Pulmonary rehabilitation and exercise training may improve dyspnea in chronic respiratory conditions, but evidence is low to moderate quality.
No direct evidence exists for post-COVID dyspnea. Clinicians must check for post-exertional symptom exacerbation before applying these protocols.
Key findings
01Pulmonary rehabilitation or exercise training alone can effectively treat dyspnea in patients with interstitial lung disease, idiopathic pulmonary fibrosis, COPD or cancer, based on low-quality to moderate-quality evidence.
02In COPD, upper limb training, multicomponent interventions, and non-invasive ventilation showed positive effects, while neuromuscular electrical stimulation, singing, and physical activity counselling did not.
03Adding active mind-body movement therapies, inspiratory muscle training, or non-invasive ventilation to pulmonary rehabilitation did not provide significant benefits compared to pulmonary rehabilitation alone in COPD patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review maps evidence from other conditions (COPD, cancer, etc.) rather than post-COVID-19 condition directly, so applicability to PCC is indirect. Most included Cochrane Reviews provided very low- and low-quality evidence. Five of the fifteen included reviews did not report GRADE judgments. Non-Cochrane systematic reviews were excluded, potentially missing relevant evidence.
Declared interests
None reported in the provided text.
The easy way to misread this
Do not assume these findings prove efficacy for post-COVID-19 dyspnea. The evidence is indirect, derived from chronic respiratory diseases, and mostly low to very low quality. Applying these interventions without checking for post-exertional symptom exacerbation may harm patients with PCC.