Early motor and respiratory re-education in patients hospitalized for COVID-19

Introduction
Patients with SARS-CoV-2 infection often experience physical, functional, and psychological impairments, necessitating a tailored Individual Rehabilitation Project (IRP). Early motor and respiratory re-education can prevent hypomobility-related damage, restore lost functions, and ease the transition home post-hospitalization. The purpose of this study was to assess the effects of an early IRP on strength, dyspnea, and patients' dependence in ADLs during the acute phase of COVID-19.

Material and methods
A retrospective observational study was conducted on patients hospitalized for COVID-19 from March 2020 to July 2022. Patients underwent an initial PRM assessment (T0), a re-educational intervention (I), and a PRM reevaluation (T1) at discharge. The interventions included motor and respiratory re-education. MBI, MRC and BDI scales, alongside SpO2 values, were used as outcome measures. Wilcoxon Signed-Rank tests were performed to compare variables at T0 and T1; Mann-Whitney independent-samples U test was conducted for subgroups analysis.

Results
Data of 52 patients (24 males; mean age 74.9±12.4 years) were included. Thirty-two patients (62%) received both motor and respiratory re-education. MRC (p < 0.001, r = 0.57), MBI (p < 0.001, r = 0.76), and BDI (p < 0.001, r = 0.70) showed statistically significant improvements. SpO₂ didn't reach statistical significance (p = 0.065, r = 0.26). No statistically significant difference was found at subgroup analysis.

Conclusions
An early, individualized rehabilitation approach combining motor and respiratory re-education significantly enhanced muscle strength, reduced dyspnea, and promoted independence in ADLs in acutely hospitalized COVID-19 patients. These findings underscore the value of early rehabilitation for mitigating the functional decline associated with COVID-19.