Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), is a multisystem infectious disease which has led to a global pandemic. Tele-medicine is a tool to connect patients and health care professions while maintaining social distancing and restrictions. Tele-physiotherapy is a field of physiotherapy which has the advantage of providing therapy. Since some months ago, different organizations have started the tele-physiotherapy/tele-rehabilitation program to manage the patients' complications after COVID-19. This research team have developed a tele-rehabilitation guideline for physiotherapists to help them how to use tele-physiotherapy program for patients after COVID-19 hospitalization. The aim of this study is to evaluate the efficacy of tele-physiotherapy program in patients discharged after COVID-19.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), is a multisystem infectious disease which has led to a global pandemic. Due to multisystem nature of this disease, it can cause a variety of early and late complications. New studies have revealed some of the long-term sequelae of this disease, such as neurological injuries, arterial or venous thrombosis, cardiac, brain strokes, etc. which need to be taken into consideration during management of patients. Many COVID-19 survivors who require critical care may also develop psychological, physical and cognitive impairments. These patients may develop various impairments because of hospitalization owing to extended immobilization and many hours bed ridden; these include neuromuscular complications, severe muscle weakness and fatigue, joint stiffness, dysphagia, psychological problems, reduced mobility, low quality of life, frequent falls, and even quadriparesis. Given impacts of COVID-19 on global health care system, innovative approaches in managing patients are needed. This is the reason that tele-medicine is becoming a trendy title for researchers . Tele-medicine is a tool to connect patients and health care professions while maintaining social distancing and restrictions . Digital health interventions can help provide self-monitoring tools, field updates, exercise protocols, and psychological support. Depending on the funding and facilities provided by the health care system, tele-medicine can be designed and employed in each country uniquely. Physiotherapy interventions can be also delivered through modern digital communication tools. Tele-physiotherapy is a field of physiotherapy which has the advantage of providing therapy wherever is most convenient for the patient through the use of modern digital communication. Based on the evidences from other outbreak of viruses in the coronavirus strain epidemics, many of the discharged patients after COVID-19 pneumonia are likely to have residual impairment even some years after hospitalization. Not only discharged COVID-19 patients, but also other members of the society might need physiotherapy in this crisis. Despite this need, social distancing should be taken into account and human lives can't be put in danger. Tele-physiotherapy provides a great opportunity for therapists to communicate with their patients, assess and treat them. Since some months ago, different organizations have started the tele-physiotherapy/tele-rehabilitation program to manage the patients' complications after COVID-19. This research team have developed a tele-rehabilitation guideline for physiotherapists to help them how to use tele-physiotherapy program for patients after COVID-19 hospitalization. The aim of this study is to evaluate the efficacy of tele-physiotherapy program in patients discharged after COVID-19.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
72
Allocated participants to this group will receive 18 physiotherapy sessions (three sessions per week) during six weeks. in these sessions, physiotherapist will prescribe aerobic, resistive, breathing and functional exercises and airway clearance techniques (if needed) based on result of assessment of patients at the discharge phase. the physiotherapist will use some educational contents for the patient and call him/her to guide the patient about how exercises should be performed (determining frequency, time, intensity and type of exercise). the patient should do exercises until next session and provide a feedback. The patient will be assessed weekly using a pre-designed questionnaire remotely. the progression of interventions will be based on the results of weekly assessment.
Allocated participants to control group will receive one consultation session by the physiotherapist. At this session, patients will be educated about how to perform their daily activities, breathing exercises, walking, using oxygen cylinder and dietary.
Imam Khomeini Hospital Complex
Tehran, Iran
6-Minute Walk Test (6MWT)
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity. The distance which patient can walk during 6 minutes will be measured.
Time frame: Baseline
6-Minute Walk Test (6MWT)
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity. The distance which patient can walk during 6 minutes will be measured.
Time frame: After six weeks
6-Minute Walk Test (6MWT)
6-minute walk test is a sub-maximal test to evaluate the aerobic capacity. The distance which patient can walk during 6 minutes will be measured.
Time frame: After 10 weeks
Five Times Sit to Stand test (5TST)
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times. it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
Time frame: Baseline
Five Times Sit to Stand test (5TST)
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times. it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
Time frame: After six weeks
Five Times Sit to Stand test (5TST)
The five times sit to stand is a test which measures the time for sitting and standing from a chair for five times. it is commonly used to assess strength of lower extremity, transitional movements and falling risks in adults.
Time frame: After 10 weeks
Fatigue Severity Scale (FSS)
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals. the questionnaire asks the individuals to rate the level of their fatigue. FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
Time frame: Baseline
Fatigue Severity Scale (FSS)
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals. the questionnaire asks the individuals to rate the level of their fatigue. FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
Time frame: After six weeks
Fatigue Severity Scale (FSS)
Fatigue Severity Scale is a short nine statement questionnaire which is used to assess the impact of fatigue on individuals. the questionnaire asks the individuals to rate the level of their fatigue. FSS scores vary from 9 to 63 and higher scores present higher fatigue (worsened).
Time frame: After 10 weeks
International Physical Activity Questionnaire (IPAQ)
The IPAQ is a 27-item subjective measure of physical activity. This instrument is repetitively used instrument to assess the physical activity. This instrument was developed to assess physical activity in adults aged 18-65 years. The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
Time frame: Baseline
International Physical Activity Questionnaire (IPAQ)
The IPAQ is a 27-item subjective measure of physical activity. This instrument is repetitively used instrument to assess the physical activity. This instrument was developed to assess physical activity in adults aged 18-65 years. The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
Time frame: After six weeks
International Physical Activity Questionnaire (IPAQ)
The IPAQ is a 27-item subjective measure of physical activity. This instrument is repetitively used instrument to assess the physical activity. This instrument was developed to assess physical activity in adults aged 18-65 years. The Persian version of IPAQ was translated and cross-cultural adapted by Moghaddam et al. (2012).
Time frame: After 10 weeks
Level of dyspnea
Level of dyspnea is assessed by modified Borg scale. the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
Time frame: Baseline
Level of dyspnea
Level of dyspnea is assessed by modified Borg scale. the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
Time frame: After six weeks
Level of dyspnea
Level of dyspnea is assessed by modified Borg scale. the patient will report his or her level of dyspnea after 6-minute walk test in range of 0(without dyspnea) to 10(most severe dyspnea).
Time frame: After 10 weeks
Short From-36
Short Form-36 is a self report instrument which evaluate eight domains of health. it is commonly used as a person or population's quality of life.
Time frame: Baseline
Short From-36
Short Form-36 is a self report instrument which evaluate eight domains of health. it is commonly used as a person or population's quality of life.
Time frame: After six weeks
Short From-36
Short Form-36 is a self report instrument which evaluate eight domains of health. it is commonly used as a person or population's quality of life.
Time frame: After 10 weeks
Strength of shoulder abduction muscle group
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: Baseline
Strength of shoulder abduction muscle group
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After six weeks
Strength of shoulder abduction muscle group
Strength of shoulder abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After 10 weeks
Strength of hip abduction muscle group
Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: Baseline
Strength of hip abduction muscle group
Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After six weeks
Strength of hip abduction muscle group
Strength of hip abduction muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After 10 weeks
Strength of knee extension muscle group
Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: Baseline
Strength of knee extension muscle group
Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After six weeks
Strength of knee extension muscle group
Strength of knee extension muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After 10 weeks
Strength of elbow flexion muscle group
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: Baseline
Strength of elbow flexion muscle group
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After six weeks
Strength of elbow flexion muscle group
Strength of elbow flexion muscle group is assessed by hand held dynamometer and will be presented in kilogram.
Time frame: After 10 weeks
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