Early bedside pulmonary rehabilitation in COVID-19 pneumonia: A prospective, single-arm interventional study of safety, feasibility, and functional evaluation in isolation.

BACKGROUND

Patients with Coronavirus Disease 2019 (COVID-19) pneumonia often experienced reduced activities of daily living due to isolation-related inactivity and muscle deconditioning. This study aimed to assess the safety and feasibility of early pulmonary rehabilitation (PR) in isolated patients with COVID-19 pneumonia and to evaluate their functional status and health-related quality of life.

METHODS

A bedside PR program-prioritizing early mobilization and ambulation, supplemented with calisthenic and device-based resistance exercises, chest mobilization, and breathing exercises-was delivered in isolation rooms. Assessments included the 1-min sit-to-stand test (1MSTST), COPD Assessment Test (CAT), and Hospital Anxiety and Depression Scale (HADS) at baseline and discharge.

RESULTS

In this single-arm study, 23 hospitalized patients (mean age 61 ± 11 years, 78% male) completed the program with an adherence rate of 71%. No adverse events occurred. 1MSTST repetitions increased (median change 8.0 [3.0, 12.8]; p < 0.002), with increases in oxygen saturation nadir and peak heart rate (p = 0.012 and p < 0.001, respectively). Higher adherence was correlated with greater increase in 1MSTST (r = 0.626, p = 0.010), and lower baseline 1MSTST predicted larger gains (r = -0.662, p = 0.005). CAT total score and items related to cough, phlegm, and chest tightness decreased significantly, whereas HADS depression scores worsened at discharge.

CONCLUSIONS

Early bedside PR was safely and feasibly delivered to isolated patients with COVID-19 pneumonia. 1MSTST and CAT were useful tools for functional evaluation during the acute phase.

TRIAL REGISTRATION: UMIN Clinical Trials Registry, UMIN000057259. Retrospectively registered on March 11, 2025.