Effects of an inpatient rehabilitation programme on functional capacity, quality of life and psychological distress in patients with post covid-19 condition: an observational study.

This was not a randomised controlled trial; patients were assigned to respiratory muscle training based on their breathing muscle strength or physician judgment, so the groups were very different at the start. There was no control group that received no rehabilitation, so improvements could be due to natural recovery over time rather than the treatment itself. The rehabilitation programme included many different therapies (exercise, counselling, occupational therapy, etc.), so it is impossible to tell how much of the improvement was due to respiratory muscle training versus the other components. There was no follow-up measurement after discharge, so it is unknown if the improvements lasted. The 6-minute walk test was performed only once at each time point, meaning a learning effect from doing the test might have contributed to the improved scores. The study did not distinguish between different stages or severities of post-COVID-19 condition, so it is unclear if patients with milder or more severe disease responded differently.

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Do not conclude that respiratory muscle training alone caused the improvements. The RMT group had much weaker breathing muscles at the start and participated in a comprehensive programme including exercise, therapy, and counselling, so the specific contribution of the breathing training cannot be separated from the rest of the care.