Effectiveness of respiratory rehabilitation in patients with COVID‐19: A meta‐analysis

Abstract

AbstractAimExamine effectiveness of respiratory rehabilitation and moderating factors on lung function and exercise capacity in post‐COVID‐19 patients.DesignMeta‐analysis.MethodsR software 4.0.2 assessed the effectiveness of respiratory rehabilitation adopting the random‐effects model and presenting standardised mean differences (SMDs). Heterogeneity was determined by Cochran's Q and I2. The Cochrane Risk of Bias 2.0 and MINORS evaluated quality of the included studies.Data SourcesA comprehensive search was undertaken in Cochrane, Embase, Ovid‐MEDLINE, Scopus, NCBI SARS‐CoV‐2 Resources, ProQuest, Web of Science and CINAHL until March 2022.ResultsOf the 5703 identified studies, 12 articles with 596 post‐COVID‐19 patients were included. Eleven of our twelve studies had moderate to high quality and one study had high risk of bias assessed with MINORS and RoB 2 tool. Overall, respiratory rehabilitation was effective in improving forced expiratory volume in 1 s (1.14; 95%CI 0.39–1.18), forced vital capacity (0.98; 95%CI 0.39–1.56), total lung capacity (0.83; 95%CI 0.22–1.44), 6‐minute walk distance (1.56; 95%CI 1.10–2.02) and quality of life (0.99; 95%CI 0.38–1.60). However, no significant differences were observed for ratio of the forced expiratory volume in 1 s to the forced vital capacity of the lungs, anxiety and depression. Respiratory rehabilitation for post‐COVID‐19 patients was effective in those without comorbidities, performed four types of exercise programs, frequency ≥3 times/week and rehabilitation time 6 weeks.ConclusionsRespiratory rehabilitation improved lung function, exercise capacity and quality of life in post‐COVID‐19 patients. The findings suggest rehabilitation programs for post‐COVID‐19 patients should use multiple respiratory exercise programs with frequency of ≥3 times per week for longer than 6 weeks.ImpactThese findings will help improve the implementation of respiratory rehabilitation programs for post‐COVID‐19 patients.Implications for the professionOur findings can be used to develop patient‐centred respiratory rehabilitation interventions by nurses and clinicians for post‐COVID‐19 patients.Reporting MethodPRISMA guideline was followed.Patient or Public ContributionNo patient or public contribution.