Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Oct;103(10):2051-2062.
doi: 10.1016/j.apmr.2022.06.007. Epub 2022 Jul 29.

Effect of Pulmonary Rehabilitation Approaches on Dyspnea, Exercise Capacity, Fatigue, Lung Functions, and Quality of Life in Patients With COVID-19: A Systematic Review and Meta-analysis

Ishtiaq Ahmed  1 , Rustem Mustafaoglu  2 , Ipek Yeldan  2 , Zeynal Yasaci  3 , Belgin Erhan  4
Affiliations
Meta-Analysis

Effect of Pulmonary Rehabilitation Approaches on Dyspnea, Exercise Capacity, Fatigue, Lung Functions, and Quality of Life in Patients With COVID-19: A Systematic Review and Meta-analysis

Ishtiaq Ahmed et al. Arch Phys Med Rehabil. 2022 Oct.

Abstract

Objective: To qualitatively synthesize and quantitatively evaluate the effect of pulmonary rehabilitation (PR) on dyspnea, lung functions, fatigue, exercise capacity, and quality of life (QoL) in patients with COVID-19.

Data sources: PubMed, Web of Science, and Cochrane databases were searched from January 2020 to April 2022.

Data selection: Randomized controlled trials (RCTs) assessing the effect of PR on dyspnea, lung functions, fatigue, exercise capacity, and QoL in patients with COVID-19.

Data extraction: The mean difference (MD) and a 95% CI were estimated for all the outcome measures using random effect models. The following data were extracted by 2 independent reviewers: (1) first author; (2) publication year; (3) nationality; (4) number of patients included (5) comorbidities; (6) ventilatory support; (7) length of inpatient stay; (8) type of PR; (9) outcome measures; and (10) main findings. The risk of bias was evaluated using the cochrane risk of bias tool.

Data synthesis: A total of 8 RCTs involving 449 participants were included in the review. PR was found to be significantly effective in improving dyspnea (5 studies, SMD -2.11 [95% CI, -2.96 to -1.27; P<.001]) and exercise capacity (MD 65.85 m [95% CI, 42.86 to 88.83; P<.001]) in patients with both acute and chronic COVID-19 with mild to severe symptoms, whereas fatigue (MD -2.42 [95% CI, -2.72 to -2.11, P<.05]) and lung functions (MD 0.26 L [95% CI, 0.04 to 0.48, P<.05]) were significantly improved in acute COVID-19 patients with mild symptoms. The effect of PR on QoL was inconsistent across studies. PR was found to be safe and feasible for patients with COVID-19.

Conclusion: Evidence from studies indicates that PR program is superior to no intervention in improving dyspnea, exercise capacity, lung functions, and fatigue in patients with COVID-19. PR appears to be safe and beneficial for both acute and chronic COVID-19 patients.

Keywords: COVID-19; Dyspnea; Exercise capacity; Pulmonary rehabilitation; Rehabilitation; SARS-COV-2.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram demonstrating the search process and study selection through the review.
Fig 2
Fig 2
Mean difference of change in 6-MWT between 7 studies after intervention from baseline.
Fig 3
Fig 3
Standard mean difference of change in dyspnea between 5 studies after intervention from baseline.
Fig 4
Fig 4
Standard mean difference of change in lung functions between 3 studies after intervention from baseline.
Fig 5
Fig 5
Mean difference of change in fatigue between 4 studies after intervention from baseline.
Fig 6
Fig 6
Standard mean difference of change in the QoL between 3 studies after intervention from baseline.
See this image and copyright information in PMC

References

    1. (WHO) WHO. WHO Coronavirus (COVID-19) Dashboard 2022. Available at: https://covid19.who.int/. Accessed May 9 2022.
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–1242. - PubMed
    1. Ahmed I, Inam AB, Belli S, Ahmad J, Khalil W, Jafar MM. Effectiveness of aerobic exercise training program on cardio-respiratory fitness and quality of life in patients recovered from COVID-19. Eur J Phys. 2021:1–6.
    1. Guan W-j, Ni Z-y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. New Engl J Med. 2020;382:1708–1720. - PMC - PubMed
    1. Sanchez-Ramirez DC, Normand K, Zhaoyun Y, Torres-Castro R. Long-term impact of COVID-19: a systematic review of the literature and meta-analysis. Biomedicines. 2021;9:900. - PMC - PubMed