Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials

Background: Pulmonary rehabilitation (PR) has demonstrated efficacy in managing long COVID-19, underscoring the need to refine and tailor PR strategies for optimal patient outcomes. Objectives: To evaluate the impact of PR on patients with long COVID-19 and to compare the efficacy of different types...

Full description

Saved in:
Bibliographic Details
Main Authors: Shige Li, Bing Dai, Yusheng Hou, Liang Zhang, Jie Liu, Haijia Hou, Dandan Song, Shengchen Wang, Xiangrui Li, Hongwen Zhao, Wei Wang, Jian Kang, Wei Tan
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Therapeutic Advances in Respiratory Disease
Online Access:https://doi.org/10.1177/17534666251323482
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850222148014047232
author Shige Li
Bing Dai
Yusheng Hou
Liang Zhang
Jie Liu
Haijia Hou
Dandan Song
Shengchen Wang
Xiangrui Li
Hongwen Zhao
Wei Wang
Jian Kang
Wei Tan
author_facet Shige Li
Bing Dai
Yusheng Hou
Liang Zhang
Jie Liu
Haijia Hou
Dandan Song
Shengchen Wang
Xiangrui Li
Hongwen Zhao
Wei Wang
Jian Kang
Wei Tan
author_sort Shige Li
collection DOAJ
description Background: Pulmonary rehabilitation (PR) has demonstrated efficacy in managing long COVID-19, underscoring the need to refine and tailor PR strategies for optimal patient outcomes. Objectives: To evaluate the impact of PR on patients with long COVID-19 and to compare the efficacy of different types and durations of PR interventions. Design: Systematic review and meta-analysis. Data sources and methods: We systematically searched randomized controlled trials (RCTs) of the effectiveness of PR in long COVID-19 patients published before April 2024. The primary outcomes were physical capacity assessed by the 6-minute walking test (6MWT), lung function measured by forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), health-related quality of life (HRQoL), and fatigue. Secondary outcomes were thirty-second sit-to-stand test (30STST), handgrip strength tests, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), dyspnea, depression, anxiety, perceived effort, and adverse events. Results: A total of 37 studies with 3363 patients were included. Compared to controls, PR improved physical capacity (6MWT, 30STST, handgrip), lung function (FEV1, FVC, MIP, MEP), HRQoL, fatigue, dyspnea, and anxiety but did not reach statistical significance for depression. Subgroup analyses of PR duration indicated that programs of ⩽4 weeks improved 6MWT; those between 4 and 8 weeks significantly improved 6MWT, lung function (FEV1, FVC), HRQoL, and reduced fatigue; and programs over 8 weeks improved HRQoL and reduced fatigue. Exercise type analysis revealed that breathing exercises improved 6MWT, lung function (FEV1, FVC), and HRQoL; multicomponent exercises enhanced 6MWT performance and reduced fatigue; the combination of both types improved 6MWT, FEV1 (L), FVC (%pred), HRQoL, and reduced fatigue. Conclusion: PR improves physical capacity, lung function, and quality of life and alleviates dyspnea, fatigue, and anxiety in long COVID-19 patients. A 4- to 8-week PR program and a combination of both breath exercises and multicomponent training is most effective for managing long-term COVID-19 syndromes. Trial registration: PROSPERO ID: CRD42024455008.
format Article
id doaj-art-2ee53a4bdfca478c8e400eb2324708c0
institution OA Journals
issn 1753-4666
language English
publishDate 2025-03-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Respiratory Disease
spelling doaj-art-2ee53a4bdfca478c8e400eb2324708c02025-08-20T02:06:27ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662025-03-011910.1177/17534666251323482Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trialsShige LiBing DaiYusheng HouLiang ZhangJie LiuHaijia HouDandan SongShengchen WangXiangrui LiHongwen ZhaoWei WangJian KangWei TanBackground: Pulmonary rehabilitation (PR) has demonstrated efficacy in managing long COVID-19, underscoring the need to refine and tailor PR strategies for optimal patient outcomes. Objectives: To evaluate the impact of PR on patients with long COVID-19 and to compare the efficacy of different types and durations of PR interventions. Design: Systematic review and meta-analysis. Data sources and methods: We systematically searched randomized controlled trials (RCTs) of the effectiveness of PR in long COVID-19 patients published before April 2024. The primary outcomes were physical capacity assessed by the 6-minute walking test (6MWT), lung function measured by forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), health-related quality of life (HRQoL), and fatigue. Secondary outcomes were thirty-second sit-to-stand test (30STST), handgrip strength tests, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), dyspnea, depression, anxiety, perceived effort, and adverse events. Results: A total of 37 studies with 3363 patients were included. Compared to controls, PR improved physical capacity (6MWT, 30STST, handgrip), lung function (FEV1, FVC, MIP, MEP), HRQoL, fatigue, dyspnea, and anxiety but did not reach statistical significance for depression. Subgroup analyses of PR duration indicated that programs of ⩽4 weeks improved 6MWT; those between 4 and 8 weeks significantly improved 6MWT, lung function (FEV1, FVC), HRQoL, and reduced fatigue; and programs over 8 weeks improved HRQoL and reduced fatigue. Exercise type analysis revealed that breathing exercises improved 6MWT, lung function (FEV1, FVC), and HRQoL; multicomponent exercises enhanced 6MWT performance and reduced fatigue; the combination of both types improved 6MWT, FEV1 (L), FVC (%pred), HRQoL, and reduced fatigue. Conclusion: PR improves physical capacity, lung function, and quality of life and alleviates dyspnea, fatigue, and anxiety in long COVID-19 patients. A 4- to 8-week PR program and a combination of both breath exercises and multicomponent training is most effective for managing long-term COVID-19 syndromes. Trial registration: PROSPERO ID: CRD42024455008.https://doi.org/10.1177/17534666251323482
spellingShingle Shige Li
Bing Dai
Yusheng Hou
Liang Zhang
Jie Liu
Haijia Hou
Dandan Song
Shengchen Wang
Xiangrui Li
Hongwen Zhao
Wei Wang
Jian Kang
Wei Tan
Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
Therapeutic Advances in Respiratory Disease
title Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
title_full Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
title_short Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials
title_sort effect of pulmonary rehabilitation for patients with long covid 19 a systematic review and meta analysis of randomized controlled trials
url https://doi.org/10.1177/17534666251323482
work_keys_str_mv AT shigeli effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT bingdai effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT yushenghou effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT liangzhang effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT jieliu effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT haijiahou effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT dandansong effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT shengchenwang effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT xiangruili effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT hongwenzhao effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT weiwang effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT jiankang effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT weitan effectofpulmonaryrehabilitationforpatientswithlongcovid19asystematicreviewandmetaanalysisofrandomizedcontrolledtrials