Frontiers in rehabilitation sciences · 2026
Effects of an outpatient pulmonary rehabilitation program on exercise capacity, muscle fatigue, dyspnea, and functional status in post-COVID-19 patients: non-randomized clinical trial.
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Oliveira Miriã C, Capodaglio Paolo, Paixão Heren N C, Fonseca Adriano L, Alves Larissa R, Ribeiro Júnior Jairo B S, Oliveira Rodrigo F, Fernandes Tiago V, Marconi Daniel G, Andraus Rodrigo A C, Oliveira Deise A A P, Oliveira Claudia S, Silva Carlos H M, Guedes Orlando A, Freitas Júnior Wilson R, Oliveira Luis V F
Аннотация
BACKGROUND: COVID-19 may lead to persistent sequelae that impair functional capacity, resulting in dyspnea, fatigue, and limitations in activities of daily living.
OBJECTIVE: To evaluate exercise capacity, fatigue, dyspnea, and functional status in patients following hospitalization for COVID-19 who underwent an outpatient pulmonary rehabilitation program (PRP).
METHODS: The study was approved by the Research Ethics Committee of UniEVANGÉLICA (approval number 4,296,707; September 24, 2020) and registered at ClinicalTrials.gov (Identifier: NCT04982042). This prospective single-arm non-randomized clinical trial included symptomatic individuals after COVID-19 infection. Exercise capacity was assessed using the Six-Minute Walk Test, muscle fatigue using the Fatigue Severity Scale (FSS), modified Medical Research Council (mMRC) Dyspnea Scale, and functional status using the Post-COVID-19 Functional Status Scale (PCFS). The PRP consisted of cardiorespiratory training and muscle strengthening exercises performed three times per week for six weeks.
RESULTS: A total of 54 patients were included (29 in the Ward Group and 25 in the ICU Group). After the PRP, 6MWT distance increased from 428.52 ± 104.5 m to 503.19 ± 98.04 m (p < 0.0001), mMRC dyspnea decreased from 3.50 ± 1.31 to 1.56 ± 0.60 (p < 0.0001), PCFS improved from 2.91 ± 0.59 to 0.63 ± 0.75 (p < 0.001), and FSS decreased from 4.68 ± 1.50 to 2.97 ± 1.55 (p < 0.001). The Ward Group showed greater unadjusted gains than the ICU Group; however, multivariable analysis identified lower baseline 6MWD as the only independent predictor of improvement (β = -0.547; p < 0.001), whereas ICU admission was not independently associated with the magnitude of gain (p = 0.246).
CONCLUSION: The outpatient PRP was associated with significant improvements in exercise capacity, fatigue, dyspnea, and functional status. Lower baseline exercise capacity predicted greater improvement, regardless of ICU admission.
OBJECTIVE: To evaluate exercise capacity, fatigue, dyspnea, and functional status in patients following hospitalization for COVID-19 who underwent an outpatient pulmonary rehabilitation program (PRP).
METHODS: The study was approved by the Research Ethics Committee of UniEVANGÉLICA (approval number 4,296,707; September 24, 2020) and registered at ClinicalTrials.gov (Identifier: NCT04982042). This prospective single-arm non-randomized clinical trial included symptomatic individuals after COVID-19 infection. Exercise capacity was assessed using the Six-Minute Walk Test, muscle fatigue using the Fatigue Severity Scale (FSS), modified Medical Research Council (mMRC) Dyspnea Scale, and functional status using the Post-COVID-19 Functional Status Scale (PCFS). The PRP consisted of cardiorespiratory training and muscle strengthening exercises performed three times per week for six weeks.
RESULTS: A total of 54 patients were included (29 in the Ward Group and 25 in the ICU Group). After the PRP, 6MWT distance increased from 428.52 ± 104.5 m to 503.19 ± 98.04 m (p < 0.0001), mMRC dyspnea decreased from 3.50 ± 1.31 to 1.56 ± 0.60 (p < 0.0001), PCFS improved from 2.91 ± 0.59 to 0.63 ± 0.75 (p < 0.001), and FSS decreased from 4.68 ± 1.50 to 2.97 ± 1.55 (p < 0.001). The Ward Group showed greater unadjusted gains than the ICU Group; however, multivariable analysis identified lower baseline 6MWD as the only independent predictor of improvement (β = -0.547; p < 0.001), whereas ICU admission was not independently associated with the magnitude of gain (p = 0.246).
CONCLUSION: The outpatient PRP was associated with significant improvements in exercise capacity, fatigue, dyspnea, and functional status. Lower baseline exercise capacity predicted greater improvement, regardless of ICU admission.