Diaphragmatic strengthening exercises for patients with post COVID-19 condition after mild-to-moderate acute COVID-19 infection: a randomized controlled study

• Published in: Journal of rehabilitation medicine Vol. 56; p. jrm25491
• Main Authors: Abo Elyazed, Tamer I, Abd El-Hakim, Ahmed Abd El-Moneim, Saleh, Ola I, Sonbol, Marwa Mostafa Fadel, Eid, Hoda Assad, Moazen, Eman, Alhassoon, Mohammad Hamad, Elfeky, Seham Ezzat Fathy
• Format: Journal Article
• Language: English
• Published: Sweden Journal of Rehabilitation Medicine 11.06.2024; Medical Journals Sweden
• Subjects: Adult; Aged; Breathing Exercises; COVID-19; deep breathing; Diaphragm - physiopathology; Dyspnea; Dyspnea - etiology; Dyspnea - physiopathology; Female; Humans; incentive spirometry; Infections; Longitudinal Studies; Male; Medical research; Middle Aged; post COVID-19 condition; Post-Acute COVID-19 Syndrome; Regression analysis; Respiration; Respiratory therapy; SARS-CoV-2; Spirometry; Standard of care; Treatment Outcome
• ISSN: 1650-1977; 1651-2081; 1651-2081
• DOI: 10.2340/jrm.v56.25491

To assess the clinical effects of incentive spirometry (IS) and diaphragmatic breathing (DB) in patients with post COVID-19 condition and diaphragmatic dysfunction as compared with the standard care alone. The present longitudinal randomized study included 60 patients with post COVID-19 condition and diaphragmatic dysfunction. Patients were equally randomized to receive standard care plus IS (G1), standard care plus DB (G2) or standard care alone (G3) for 8 weeks. The primary outcome is clinical improvement as evaluated by the modified Medical Research Council (mMRC) dyspnoea scale. Comparison between the studied groups revealed significant improvement in G1 and G2 in all parameters at the end of follow-up. However, no significant improvement was found in G3. At the end of follow-up, 15 patients (75.0%) in G1, 11 patients (55.0%) in G2, and 3 patients (15.0%) in G3 showed improvement on the mMRC dyspnoea scale. Multivariate logistic regression analysis identified mild acute COVID-19 infection (p = 0.009), use of IS (p < 0.001), and use of DB (p = 0.023) as significant predictors of improvement on the mMRC dyspnoea scale. IS or DB training in addition to the standard care in post COVID-19 condition was associated with better clinical improvement as compared with the standard care alone.