Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study.
Kai Liu, Weitong Zhang, Yadong Yang and 3 others
PMID 32379637WHAT IT FOUND
Six weeks of respiratory rehabilitation improved lung function, walking distance, quality of life, and anxiety in older adults without COPD discharged after COVID-19.
It did not improve daily living independence or depression.
Key findings
01After 6 weeks, the respiratory rehabilitation group had greater improvement in primary lung function outcomes than the control group: FEV1 1.10 to 1.44 L, FVC 1.79 to 2.36 L, FEV1/FVC% 60.48 to 68.19, and TLCO% 60.3 to 78.1.
02Secondary outcomes improved more with intervention: 6-minute walk distance rose from 162.7 m to 212.3 m, SF-36 physical health rose from 52.4 to 71.6, and SAS anxiety score fell from 56.3 to 47.4.
03Daily living independence and depression did not show a clear improvement: FIM scores were 109.2 to 109.4 in the intervention group and 109.3 to 108.9 in controls, while SDS scores were 56.4 to 54.5 and 55.9 to 55.8.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trial was open label, and the authors say blinding of assessors and participants could not be guaranteed, so placebo or observer bias may affect subjective outcomes such as quality of life and anxiety. Only 72 patients completed the study, and the control group's care is not described, so the comparison may be incomplete. Participants were older adults without COPD, with FEV1 at least 70% and MMSE over 21, discharged after acute illness, so results may not apply to patients with severe lung disease, cognitive impairment, or ongoing hospital care. The program bundled respiratory muscle training, cough exercise, diaphragmatic training, stretching, and home exercise, so the study cannot identify which component mattered. Follow-up was 6 weeks, and the authors say larger samples and longer studies are needed.
The easy way to misread this
Do not conclude that respiratory muscle training alone caused the improvements. The program bundled respiratory muscle training, cough exercise, diaphragmatic training, stretching, and home exercise, and the paper does not describe the control group's care.