Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients.
Jean-Marc Vallier, Charles Simon, Antoine Bronstein and 4 others
PMID 36700245WHAT IT FOUND
There was no clear difference between home and hospital pulmonary rehabilitation in six-minute walk distance improvement.
Both groups improved, based on 17 analyzed patients.
Key findings
01Six-minute walk distance increased by 95 m in the inpatient group and 72 m in the home group, and the change did not differ clearly between groups.
02Seventeen patients were analyzed after five withdrew before testing because they were not satisfied with the assigned group.
03Quality of life improved in both groups, but general fatigue decreased only in the inpatient group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 17 patients were analyzed, after 5 of 22 randomized patients withdrew before testing because they were unhappy with their assigned group. Analysis was completed only on participants who finished the study, not on all randomized patients. Outcome assessors were not blinded to group allocation because the same rehabilitation team delivered treatment and testing. The sample size was small, based on a pilot standard deviation of 40 m and a non-inferiority limit of 50 m, and the authors call the results preliminary. The results text and the provided pulmonary function table disagree about whether dyspnea, TLC and FVC improved. The average interval between COVID-19 onset and start of intervention was 140.9 days, and earlier or later recovery stages were not studied. Each program included walks, endurance sessions, strength work, sophrology and meetings with a dietician, psychologist and physician, and the contribution of any single component cannot be separated.
The easy way to misread this
Do not read this as proof that home pulmonary rehabilitation is equivalent for all post-COVID patients. Only 17 analyzed patients were included, outcome assessors were not blinded, and five patients who withdrew before testing were excluded.