The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in catastrophic infectionsand fatalities across the nation. Many older Veterans with comorbidities are especiallyvulnerable to complications and poor recovery. This award will investigate the effect ofa novel, home-based, supervised, group exercise tele-rehabilitation in Veterans recoveredfrom COVID-19 on cardiopulmonary and physical function.
There is an urgent need to understand the lasting impact of COVID-19 on the
cardiopulmonary system to improve physical function and prevent long-lasting disability.
Pertinent knowledge gaps regarding the post-recovery physiology driving any impairments
need to be addressed to improve the quality of life in Veterans with prior SARS-CoV-2
infection. Further, it is important to devise successful rehabilitation strategies that
can be safely conducted in a Veteran's home. Hence, the investigators propose to utilize
VA Video Connect to deliver a home based, supervised group exercise program to Veteran
COVID-19 survivors. The objective of this exercise trial is to determine the influence of
COVID-19 on cardiorespiratory fitness, pulmonary and physical function and to investigate
the effect of a home-based exercise tele-rehabilitation on these outcomes. The study
design includes rural and urban sites and investigators with a history of VA
rehabilitation collaboration. Moreover, the investigators will explore healthcare
disparities related to COVID-19 which are associated with functional decline and may
affect sustainability of exercise rehabilitation strategies deployed, if necessary, under
social distancing restrictions.
Other: Tele-exercise
Exercise training 2x/week at home. Sessions include circuit exercises of aerobic and
resistive training stations which are led remotely.
Inclusion Criteria:
- Veteran
- documented COVID-19 > 90 days ago
- diagnosis of 2 of following conditions: hypertension, diabetes, cardiovascular
disease, chronic kidney disease, chronic obstructive pulmonary disease OR 1
condition and BMI > 30 kg/m2
Exclusion Criteria:
- myocardial infarction (within 3 months)
- exertional or unstable angina (chest pain that limits activity)
- severe congestive heart failure (EF < 20% in last year or NYHA Classification III or
IV)
- uncontrolled hypertension (SBP >180 &/or DBP > 110 mm Hg at screening)
- screening EKG with ischemia, complex arrhythmia, or high-grade block (per Minnesota
Code)
- poorly controlled diabetes mellitus (FBS>200 mg/dl, RBS > 299 mg/dl, or HbA1C > 10)
- treatment for cancer except skin cancer (within 3 months)
- peripheral vascular disease with claudication
- severe arthritis limiting ambulation
- neurologic disease limiting ambulation (weakness requiring assist device; severe
neuropathy)
- end stage liver disease (decompensated liver disease)
- End stage renal failure (dialysis)
- severe pulmonary disease (home O2, admission for dyspnea or pneumonia within 1
month)
- high fall risk (history of falls, bone fracture)
- dementia (based on Evaluation to Consent)
- signs or symptoms of any medical comorbidity that would preclude exercise testing or
training
- exercises on routine basis (structured aerobic exercise > 3 time per week)
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
Baltimore, Maryland, United States
Investigator: Kristina Marcus, MS
Contact: 410-605-7000
kristina.marcus@va.gov
Investigator: Alice S. Ryan, PhD
Alice S Ryan, PhD
(410) 605-7851
Alice.Ryan@va.gov
Alice S. Ryan, PhD, Principal Investigator
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD