Effectiveness of pulmonary rehabilitation on improving quality of life in post–COVID-19 patients

Abstract

Background: Coronavirus disease 2019 (COVID-19) frequently results in persistent respiratory, physical and psychological sequelae after the acute infection resolves. Many survivors report reduced exercise capacity, dyspnea, fatigue and decreased health-related quality of life (HRQoL). Pulmonary rehabilitation (PR) — a structured programme of breathing retraining, aerobic and strengthening exercises, and education — has been proposed to mitigate these long-term consequences. This study aimed to evaluate the effectiveness of a 5-week pulmonary rehabilitation programme on exercise capacity and HRQoL in post–COVID-19 patients. Methods: A pre–post experimental design was used. Thirty participants who recovered from COVID-19 within the previous year (age 20–55 years) were recruited and allocated into two equal groups (n=15 per group): an experimental group receiving a combined PR programme (diaphragmatic breathing plus aerobic training, ROM and strengthening exercises) and a control group receiving diaphragmatic breathing alone. Interventions were delivered 5 days/week for 5 weeks; each session lasted 30 minutes for the experimental group and 10 minutes for the control group. Outcome measures were the Six-Minute Walk Test (6MWT) for exercise capacity and the SF-36 questionnaire for HRQoL, both administered pre and post-intervention. Data were analysed using paired t-tests for within-group comparisons and independent t-tests for between-group comparisons; significance was set at p<0.05. Results: Both groups demonstrated statistically significant improvements within groups for 6MWT distance, SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) after the intervention period. The experimental group showed a larger mean increase in 6MWT distance (mean change ≈38 m, p<0.001) compared with the control group (mean change ≈9 m, p<0.05). Post-intervention between-group comparisons revealed significantly greater gains in the experimental group for 6MWT distance (mean difference ≈41 m, p<0.05), PCS (mean difference ≈18 points, p<0.001), and MCS (mean difference ≈14 points, p<0.001). These findings indicate that a combined pulmonary rehabilitation programme produced clinically and statistically significant improvements in both exercise capacity and HRQoL in post–COVID-19 patients over a 5-week period. Conclusions: A short, structured pulmonary rehabilitation programme that couples diaphragmatic breathing with aerobic and strengthening exercises significantly improves exercise capacity and health-related quality of life in post–COVID-19 patients compared with diaphragmatic breathing alone. These results support the incorporation of multi-component PR into post-COVID care pathways to address persistent functional limitations and psychosocial sequelae. Further large-scale and longer-term studies are recommended to confirm durability of benefits and to optimize programme parameters. Background: Coronavirus disease 2019 (COVID-19) frequently results in persistent respiratory, physical and psychological sequelae after the acute infection resolves. Many survivors report reduced exercise capacity, dyspnea, fatigue and decreased health-related quality of life (HRQoL). Pulmonary rehabilitation (PR) — a structured programme of breathing retraining, aerobic and strengthening exercises, and education — has been proposed to mitigate these long-term consequences. This study aimed to evaluate the effectiveness of a 5-week pulmonary rehabilitation programme on exercise capacity and HRQoL in post–COVID-19 patients. Methods: A pre–post experimental design was used. Thirty participants who recovered from COVID-19 within the previous year (age 20–55 years) were recruited and allocated into two equal groups (n=15 per group): an experimental group receiving a combined PR programme (diaphragmatic breathing plus aerobic training, ROM and strengthening exercises) and a control group receiving diaphragmatic breathing alone. Interventions were delivered 5 days/week for 5 weeks; each session lasted 30 minutes for the experimental group and 10 minutes for the control group. Outcome measures were the Six-Minute Walk Test (6MWT) for exercise capacity and the SF-36 questionnaire for HRQoL, both administered pre and post-intervention. Data were analysed using paired t-tests for within-group comparisons and independent t-tests for between-group comparisons; significance was set at p<0.05. Results: Both groups demonstrated statistically significant improvements within groups for 6MWT distance, SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) after the intervention period. The experimental group showed a larger mean increase in 6MWT distance (mean change ≈38 m, p<0.001) compared with the control group (mean change ≈9 m, p<0.05). Post-intervention between-group comparisons revealed significantly greater gains in the experimental group for 6MWT distance (mean difference ≈41 m, p<0.05), PCS (mean difference ≈18 points, p<0.001), and MCS (mean difference ≈14 points, p<0.001). These findings indicate that a combined pulmonary rehabilitation programme produced clinically and statistically significant improvements in both exercise capacity and HRQoL in post–COVID-19 patients over a 5-week period. Conclusions: A short, structured pulmonary rehabilitation programme that couples diaphragmatic breathing with aerobic and strengthening exercises significantly improves exercise capacity and health-related quality of life in post–COVID-19 patients compared with diaphragmatic breathing alone. These results support the incorporation of multi-component PR into post-COVID care pathways to address persistent functional limitations and psychosocial sequelae. Further large-scale and longer-term studies are recommended to confirm durability of benefits and to optimize programme parameters.