A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

<jats:sec><jats:title>Objectives</jats:title><jats:p>To investigate superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to exercise capacity, lower limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL) and dyspnoea.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Parallel-group randomised controlled trial with 1:1 block randomisation.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Three major hospitals from Jiangsu and Hubei provinces, China.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO.</jats:p></jats:sec><jats:sec><jats:title>Intervention</jats:title><jats:p>Unsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry.</jats:p></jats:sec><jats:sec><jats:title>Outcomes</jats:title><jats:p>Primary outcome was 6 min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Adjusted between-group difference in change in 6MWD was 65.45 m (95% CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12 s (95% CI 12.34 to 27.9; p<0.001) post-treatment and 22.23 s (95% CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p>ChiCTR2000031834.</jats:p></jats:sec>