Empowering Long COVID Recovery: The Vital Role of Pulmonary Rehabilitation
"Empowering Long COVID Recovery: The Vital Role of Pulmonary Rehabilitation"
Introduction
In the evolving landscape of post-COVID recovery, the enduring impacts of the virus persist as a formidable challenge for many individuals in Australia and across the world. COVID-19 survivors face risk of long-term symptoms including; fatigue, breathlessness and continued functional limitations.
Although the exact prevalence of long COVID is unknown, more than a third of patients with COVID-19 develop symptoms that persist for more than 3 months after SARS-CoV-2 infection (Sally et al 2019). The NSW Agency for Clinical Innovation (ACI) defines Long COVID as: a condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually: (a) three months from the onset of COVID-19; AND (b) with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.
The most common symptoms reported by various studies are fatigue and shortness of breath lasting months after the acute onset of COVID-19. There is currently limited research on the possible pathophysiology and risk factors of long COVID.
However, what is promising is that studies are now emerging showing that a 6-8 week personalised pulmonary rehabilitation improves exercise capacity, functional status, shortness of breath, fatigue and overall quality of life.
Pulmonary Rehabilitation: An Optimal Pathway
Outpatient Settings as Rehabilitation Hubs
The outpatient pulmonary rehabilitation setting has been suggested as an appropriate site for the rehabilitation of people recovering from COVID-19, especially for those following a long hospital and ICU stay. Furthermore, the NSW ACI Long COVID organisational model of care strongly recommends pulmonary rehabilitation as a service that can address the respiratory symptomatology of long COVID to advise and enable appropriate investigations and interventions, and work towards improved outcomes for these individuals.
A compelling study by Nopp et al (2024) conducted a prospective observational cohort study involving 58 patients undergoing structured pulmonary rehabilitation. The study showcased an average improvement of 62.9 meters in the 6-minute walk test, along with reported enhancements in addressing shortness of breath, fatigue, and quality of life.
Another pivotal study by Vallier et al (2023) aimed to compare the effects of home-based pulmonary rehabilitation versus inpatient rehabilitation in treating post-COVID-19 patients. The randomized control trial unequivocally demonstrated significant improvements in the 6-minute walk test for both groups, indicating that home-based rehabilitation is equally efficient and effective as inpatient rehabilitation.
Respiratory Rehab Australia's Leading Role
At Respiratory Rehab Australia, we are a leading provider in this field, offering tailored programs staffed with seasoned healthcare professional’s adept at conducting comprehensive assessments. Our expertise extends to addressing multifaceted challenges during the recovery phase, utilising evidence-based approaches to facilitate recovery and enhance overall well-being.
Objectives and Tailored Strategies
Core Rehabilitation Objectives
At Respiratory Rehab Australia we prioritise your needs by tailoring a treatment program that suits your needs and goals. These may include improving your strength, alleviating fatigue, enhancing your balance and improving overall your quality of life. Our programs are guided by the recommendations published by the NSW ACI.
More specifically, we offer the following:
An individualised exercise assessment, prescription, supervised exercise training and advice on the gradual return to exercise and physical activity
Education and techniques to manage breathlessness, such as paced breathing and breathing control. Education may also include management of fatigue, including the importance of exercise and physical activity, symptom management and monitoring, inhaler medication education (where applicable), smoking cessation, nutrition, psychological support, and managing cough and sputum.
Adaptive Approaches in Rehabilitation
Innovative Modalities for Enhanced Reach
Respiratory Rehab Australia recognises the constraints posed by the pandemic on conventional face-to-face rehabilitation. As a response, we have embraced innovative modalities such as telehealth and home-based rehabilitation at a time that suits you. We are committed to your health and wellbeing.
Conclusion
In conclusion, at Respiratory Rehab Australia we aid individuals in their pursuit of reclaiming vitality and resilience amidst the lingering effects of COVID-19. For comprehensive guidance on the delivery of pulmonary rehabilitation via telehealth or home-based rehabilitation schedule a consultation with us today.
References
Gov and Au (2020). Respiratory Network Rehabilitation following COVID-19 in the pulmonary rehabilitation setting. [online] Available at: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0005/605525/ACI-Respiratory-Rehab-Following-COVID-19.pdf.
The ACI Respiratory and Rehabilitation networks Long COVID model of care ORGANISATIONAL MODEL OF CARE. (2023). Available at: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0009/823068/ACI-Long-COVID-Model-of-Care.pdf [Accessed 9 Jan. 2024].
Singh, S., Baldwin, M.M., Daynes, E., Evans, R.A., Greening, N., R Gisli Jenkins, Lone, N., McAuley, H., Mehta, P., Newman, J.V., P. Novotný, Smith, D., Stanel, S., Toshner, M. and Brightling, C. (2023). Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. The Lancet Respiratory Medicine. doi:https://doi.org/10.1016/s2213-2600(23)00159-5.
VALLIER, J.-M., SIMON, C., BRONSTEIN, A., DUMONT, M., JOBIC, A., PALEIRON, N. and MELY, L. (2023). Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients. European Journal of Physical and Rehabilitation Medicine, 59(1). doi:https://doi.org/10.23736/s1973-9087.22.07702-4.
Yong, S.J. (2021). Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infectious Diseases, [online] 53(10), pp.1–18. doi:https://doi.org/10.1080/23744235.2021.1924397.
