The Effect of Home-based Exercise on Functional Capacity of Covid-19 Survivor With Cardiovascular Comorbidity

National Cardiovascular Center Harapan Kita Hospital Indonesia46 enrolled

Overview

Objective propose: to investigate the effect of home based breathing exercise and chest mobilization on the cardiorespiratory functional capacity of Covid-19 survivors with cardiovascular comorbidity. Breathing exercise and chest mobilization are proven to increase lung functional capacity in Covid-19 survivors. It is hypothesized that breathing exercise and chest mobilization in Covid-19 survivors will give benefits to Covid-19 survivors with cardiovascular disease.

Lung restrictive disorder is one of the reasons that induce chronic fatigue in COVID-19 (Corona Virus Disease-19) survivors. It also gives a significant effect on cardiovascular patients who are in the second phase of cardiac rehabilitation. Breathing exercise and chest mobilization are proven to increase lung functional capacity in Covid-19 survivors. On the other hand, there is still no research that shows the effectiveness of Breathing exercises and chest mobilization in Covid-19 survivors who are suffering from cardiovascular problems. Patients in National Cardiac Center Hospital, Jakarta, with a history of Covid-19 and have cardiovascular disease are recruited. They will undergo pre and post-exercise examinations such as blood sampling, do 6 minutes walking test, Peak Cough Flow and Peak Flow Rate test, measuring the chest dimension, treadmill, and answer the European Quality of Life Five Dimension (EQ-5D) questions. With randomization, patients will be determined to treatment or control group. They will be prepared about what exercises should they do at home. Subjects will be supervised digitally and regularly through Zoom meetings. Exercises will be done for 3 months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Interventions

Breathing and chest mobilization exercisesBEHAVIORAL

Patients walk regularly 5 times per week and increase the distance day by day according to their improved ability. Patients also do breathing and chest mobilization exercise 3 times per week. It is a recorded moderated exercise for 30 minutes duration. Patients can access the video as a home-based activity through an online videos platform and will be supervised.

Second phase cardiac rehabilitationBEHAVIORAL

Independently, patients walk regularly 5 times per week and increase the distance day by day according to their improved ability without breathing and chest mobilization exercise.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who got infected by Covid-19 in 3 months before recruitment and suffering cardiovascular disease * Able to communicate and operate Youtube and Zoom. Exclusion Criteria: * Limitation to move any part of the body that causes the inability to do the instructed exercise. * Feel pain in extremities (visual analog scale \>3) * Chronic Obstructive Pulmonary Disease * Neuromuscular disorder (stroke, peripheral neuropathy with significant motoric control disturbance * Musculoskeletal disorder (fracture, post amputation, severe arthritis in support joints)

Outcomes

Primary Outcomes

Change of Peak Cough Flow (PC)

to define the functional capacity. Unit of measure : L/min.

Time frame: Change from Baseline Peak Cough Flow (PC) at 3 months

Change of Peak Flow Rate (PFR)

to define the functional capacity. Unit of measure : L/min.

Time frame: Change from Baseline Peak Flow Rate (PFR) at 3 months

Change of Cardiac Exercise Test

Patients walk on treadmill. Unit of measure : minutes, METs (Metabolic Equivalent of Task)

Time frame: Change from Baseline Cardiac Exercise Test at 3 months

Change of 6-minutes walking test

To define initial ability to walk in 30 minutes for second phase cardiac rehabilitation (aerobic exercise). Unit of measure : meter

Time frame: Change from Baseline 6-minutes walking test at 3 months

Secondary Outcomes

Change of Hemoglobin

Hemoglobin (g/dL)

Time frame: Change from Baseline Hemoglobin at 3 months

Change of Hematocrit

Hematocrit (%)

Time frame: Change from Baseline Hematocrit at 3 months

Change of Erythrocyte

Erythrocyte (million/µL)

Time frame: Change from Baseline Erythrocyte at 3 months

Change of Mean Corpuscular Volume

Mean Corpuscular Volume (fL)

Time frame: Change from Baseline Mean Corpuscular Volume at 3 months

Change of Mean Corpuscular Hemoglobin

Mean Corpuscular Hemoglobin (pg)

Time frame: Change from Baseline Mean Corpuscular Hemoglobin at 3 months

Change of Mean Corpuscular Hemoglobin Concentration

Mean Corpuscular Hemoglobin Concentration (%)

Time frame: Change from Baseline Mean Corpuscular Hemoglobin Concentration at 3 months

Change of Red Cell Distribution Width

Red Cell Distribution Width (%)

Time frame: Change from Baseline Red Cell Distribution Width at 3 months

Change of Leucocyte

Leucocyte (/µL)

Time frame: Change from Baseline Leucocyte at 3 months

Change of Platelet

Platelet (thousand/µL)

Time frame: Change from Baseline Platelet at 3 months

Change of European Quality of Life Five Dimension (EQ-5D)

1=have no problem, 2=have slight problem, 3=moderate problem, 4=severe problem, 5=unable to do. We will compare the points between pre and post exercise and looking the improvement.

Time frame: Change from Baseline EQ-5D at 3 months

Change of Basophil

Basophil (/µL)

Time frame: Change from Baseline Basophil at 3 months

Change of Eosinophil

Eosinophil (/µL)

Time frame: Change from Baseline Eosinophil at 3 months

Change of Neutrophil

Neutrophil (/µL)

Time frame: Change from Baseline Neutrophil at 3 months

Change of Lymphocyte

Lymphocyte (/µL)

Time frame: Change from Baseline Lymphocyte at 3 months

Change of Monocyte

Monocyte (/µL)

Time frame: Change from Baseline Monocyte at 3 months

Change of C-Reactive Protein

to determine infection markers. Unit of measure : mg/L

Time frame: Change from Baseline C-Reactive Protein at 3 months

Change of D-dimer

Unit of measure : ng/mL

Time frame: Change from Baseline D-dimer at 3 months