The effect of pulmonary rehabilitation training on pulmonary function, arterial oxygen, stress, depression and quality of life in post-coronavirus patients

Abstract

Background and Purpose: Covid-19 is an infectious disease with a very high contagion in the society that its management and control is still considered a challenge for the health systems. Severe respiratory infections with corona various (COVID 19) complications such as hypoxia, lymphopenia, shortness of breath and heart disorders are among the manifestations of this disease. Fatigue, reduced lung function, reduced cardio-respiratory capacity, psychological problems such as depression and stress, reduced quality of life, and movement disorder are some of the permanent post-acute problems of people who have recovered from the corona virus. Due to the novelty of the corona virus, there is not much consistent evidence that rehabilitation training are effective in improving the physical condition, pulmonary and mental function in post-coronavirus patients. Therefore, the purpose of this study was to investigate the efficacy of pulmonary rehabilitation training on pulmonary function, arterial oxygen, stress, depression and quality of life in post-covid patients. Materials and Methods: Forty two patients (22 men and 20 women) with moderate to severe consequences of the covid-19 disease in the age range of 45-70 years were admitted to comprehensive 8-week outpatient pulmonary rehabilitation programme and divided into two groups of training and control. The trining protocol included eight weeks of aerobic, mental and breathing exercises (three days a week, 80 minutes per session) under the supervision and monitoring of arterial oxygen EKG. Pulmonary function measurement (PFT), Corona Stress Standard Questionnaire (CSS-18), depression intensity (Beck Depression Questionnaire), and quality of life (SF-36 questionnaire) were assessed befor and after the pulmonary rehabilitation program. Independent t-test was used to compare the data between control and training groups. Results: The oxygen support in patients with pulmonary rehabilitation was significantly reduced (p<0.001). In addition, the level of oxygen saturation in arterial blood (SaO2%) was significantly improved in the pulmonary rehabilitation group compared to the control both at rest, during exercise and physical activity (p<0.001). The pulmonary function indices (FVC, FEV1), and quality of life significantly (p<0.001) improved in rehabilitation group, whereas the level of stress (p<0.05) and depression (p<0.01) showed significant decreases compared to the control group. Conclusion: Considering the multifaceted involvement of corona disease and its numerous complications, it seems that compehensive pulmonary rehabilitation training could be effective in post-covid patients through improving the performance, oxygenation of the pulmonary system, and quality of life, as well as reducing the stress and depression which total improve the functional and cognitive abilities.

Keywords

• covid-19
• rehabilitation training
• depression
• stress
• spirometry index