Many structures and organs are adversely affected after COVID-19. The most obvious andcommon problem is lung involvement. In the pathology report of the patients, it has beenshown that there are changes such as diffuse alveolar damage, bronchiolitis andinterstitial fibrosis. The most prominent effect of COVID-19 in patients with reducedlung functions is reduced diffusion capacity. While the disease severity worsens,pulmonary fibrosis becomes more pronounced in cases. The complaints of dyspnea andfatigue of patients after discharged continue. Inspiratory and expiratory respiratorymuscle weakness are observed in more than 50% of patients with COVID-19, measured in thefirst month after the discharged. This respiratory muscle weakness is associated withmyopathy due to hypoxemia, oxygen support, prolonged bed rest and corticosteroid use,regardless of disease severity.It is seen that these patients with COVID-19 need exercise training because of lunginvolvement, decreased exercise capacity and persistence of some symptom complaints afterthe discharged.
Patients with COVID-19 have not only reduced respiratory capacity, but also diminished
muscle strength, exercise capacity, weakness cardiac system. In parallel with
aforementioned, physical activity level and quality of life get worse in this patients.
Therefore, the patients with COVID-19 need exercise training after the discharged. In the
literature, the achievement of exercise training in many aspects such as exercise
capacity, lung health, respiratory muscle strength, dyspnea has been proven in many
diseases such as chronic obstructive pulmonary disease and heart failure.
Effects of high-intensity interval aerobic exercise training on oxygen consumption,
muscle oxygenation, physical activity level, pulmonary function, functional exercise
capacity, respiratory and peripheral strength, inspiratory muscle endurance, functional
status, dyspnea, fatigue perception and quality of life have not been investigated in
literature in patients with COVID-19. According to inclusion and exclusion criteria, 15
patients for training group and 15 patients for control group will be included. All
assessments will be completed in two days before and after eight weeks training.
Primary outcome measurement will be oxygen consumption (cardiopulmonary exercise test).
Secondary outcome will be muscle oxygenation (Moxy device), physical activity level
(multi sensor activity device), pulmonary function (spirometer), functional exercise
capacity (six-minute walk test), respiratory (mouth pressure device) and peripheral
muscle (hand-held dynamometer) strength, inspiratory muscle endurance (incremental
threshold loading test), functional status (Post-COVID-19 Functional Status Scale),
dyspnea (London Chest Daily Living Activity Scale), fatigue (Fatigue Severity Scale) and
quality of life (Saint George Respiratory Questionnaire).
Other: High-intensity interval aerobic exercise training
High-intensity interval aerobic exercise training will be given to training group on
treadmill 3 days in a week and 15-45 minutes in a day for 8 weeks with the assistance of
a physiotherapist.
The training workload of the active phase of high-intensity interval aerobic exercise
training will be applied at 80-100% of peak oxygen consumption or 85-95% of peak heart
rate or according to Borg scale dyspnea/fatigue 15-18 points.
The training workload of the active recovery phase of high-intensity interval aerobic
exercise training will be applied at 50-60% of peak oxygen consumption or 60-75% of peak
heart rate or according to Borg scale dyspnea/fatigue 11-13 points.
Other: Control Group
Breathing exercises will be given to the control group 120 times in a day and 7 days in a
week for 8 weeks as a home program. The control group will be followed-up by telephone
once a week.
Inclusion Criteria:
- aged between 18-75 years
- diagnosed with COVID-19 before
- patients whose COVID-19 Polymerase Chain Reaction test turned negative or be
negative already
- patients who are willing to participate in this study
Exclusion Criteria:
Patients with
- body mass index >35 kg/m2
- cancer, renal or hepatic diseases
- aortic stenosis, complex arrhythmia, aortic aneurysm
- serious neurological, neuromuscular, orthopedic, other systemic diseases or other
diseases affecting physical functions
- uncontrolled hypertension and/or diabetes mellitus, heart failure and cardiovascular
disease
- acute pulmonary exacerbation, acute upper or lower respiratory tract infection
- cognitive impairment that causes difficulty in understanding and following exercise
test instructions
- bulla formation in the lung
- participated in a planned exercise program in the last three months
- contraindication for exercise testing and/or exercise training according to the
American College of Sports Medicine
Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Clinic
Ankara, Turkey
Investigator: Meral Boşnak GÜÇLÜ, Prof. Dr
Contact: +903122162647
meralbosnak@gazi.edu.tr
Meral Boşnak GÜÇLÜ, Prof. Dr
+903122162647
meralbosnak@gazi.edu.tr
Ece BAYTOK, MsC
+903122162647
ecebaytok@gazi.edu.tr