Effect of a 4-week pulmonary telerehabilitation program for people with respiratory post-acute sequelae of COVID-19: a randomised controlled trial

Purpose: To evaluate a 4-week pulmonary telerehabilitation (PTR) program compared to usual care for people with persistent respiratory post-acute sequelae of COVID-19 (PASC). Methods: A multi-centre randomised controlled trial with remote assessment and assessor blinding. Participants were randomised 1:1 to 4-weeks, twice-weekly PTR or usual care (Control Group (CG)). PTR exercise intensity was titrated based on fatigue and dyspnoea. After the control period, participants in CG could cross-over into PTR to form a combined group (PTR-X). Primary outcome: 1-minute sit-to-stand test (1-minSTST). Secondary outcomes: 5-repetition sit-to-stand test; Montreal Cognitive Assessment blind-version; COVID-19 Yorkshire Rehabilitation Scale; COPD Assessment Test; 36-Item Short-Form Health Survey; Hospital Anxiety and Depression Scale; Fatigue Severity Scale; Kessler Psychological Distress Scale, all assessed at baseline and following intervention or control periods. Data were analysed using a linear mixed effects model. Results: Of 50 participants recruited, 39 completed the study (PTR group n = 14, CG n = 25). There were no statistically significant between-group differences in any outcomes. For the PTR-X group (n = 27) there was a statistically significant within-group improvement in 1-minSTST (2.4 repetitions, 95%CI 0.6–4.2). Conclusions: A 4-week (8 session) PTR intervention for respiratory PASC showed no significant between-groups differences suggesting that longer PTR programs or alternative interventions should be evaluated.