Physiotherapy alleviates dyspnoea in long COVID

In individuals experiencing dyspnoea after sustaining a SARS-CoV-2 infection, physiotherapy, particularly pulmonary rehabilitation, may be beneficial in mitigating respiratory symptoms, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for trials including adults with persistent breathlessness following COVID-19, regardless of the initial severity, for whom physiotherapy was implemented as a treatment for dyspnoea. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the PEDro Scale was used to assess study quality.

A total of 19 studies that included 1,292 adults met the eligibility criteria and were included in the meta-analysis. Of the studies, 15 were randomized controlled trials and four were nonrandomized controlled trials. In terms of the rehabilitation modalities, six studies used respiratory muscle training, six used low-to-moderate intensity rehabilitation, six used high-intensity rehabilitation, and one used passive rehabilitation. The substantial methodological variability observed between and within groups contributed to high heterogeneity of results.

Pooled data demonstrated a statistically significant benefit of physiotherapy in reducing dyspnoea (standardized mean difference, –0.63, 95 percent confidence interval [CI], –1.03 to –0.24; p<0.001, I2=88 percent).

In subgroup analysis, the effect on dyspnoea was significant only in the high-intensity rehabilitation group, with no significant heterogeneity.

Additional studies are required to evaluate more consistent rehabilitation methods in order to establish the effects of rehabilitation and avoid the confusion caused by using too many rehabilitation modalities.