Low-intensity Aerobic Training Associated With Global Muscle Strengthening in Post-COVID-19
Condition: COVID-19
MeSH terms: COVID-19
Study type: Interventional

Summary: 
      The study called "Effect of low-intensity aerobic training associated with global muscle
      strengthening in post-COVID-19 individuals" wants to check if doing easy workouts and
      strengthening muscles can make breathing problems better for adults who had COVID-19.

      The participant has been apprised that potential benefits may be derived from the research,
      including the reception of treatment for pertinent complaints meeting the study's inclusion
      criteria. Conversely, they have also been briefed on possible discomforts and risks
      associated with the study, such as the exposure of their image to the therapist administering
      the treatment.

      The participant acknowledges that their privacy will be upheld, ensuring the confidentiality
      of personal information, including their name or any other identifying data. It has been
      communicated that the participant reserves the right to decline participation in the study or
      withdraw consent at any point without the obligation to provide justification. Moreover, they
      are assured that opting out of the study will not result in any adverse consequences.
    

Detailed description: 
      Patients of both genders aged 18 to 59 years were included in the study. They had been
      diagnosed with COVID-19 in the past year, experienced mild or moderate symptoms, had
      shortness of breath, were either sedentary or engaged in physical exercise at least twice a
      week, and agreed to sign the Informed Consent Form. Excluded from the study were individuals
      hospitalized due to COVID-19, those diagnosed with chronic lung diseases, smokers, those who
      had undergone prior physiotherapeutic treatment for post-COVID-19 syndrome, individuals with
      a history of lower limb surgeries or fractures (within the last six months), BMI over 30
      kg/m², and those with neurological, cognitive, or cardiac impairments.

      The sample, selected for convenience, was divided into two distinct groups: the global muscle
      strengthening group (GF) and the low-intensity aerobic training associated with global muscle
      strengthening group (GAF). The GF comprised eight volunteers, while the GAF had nine,
      totaling eight sessions with a frequency of two interventions per week, lasting 30 minutes
      each for the GF and 60 minutes each for the GAF. Two assessments were conducted: one at
      admission and another at the end of the treatment.

      Participants were recruited at the Dr. Cícero Brandon School Clinic of Faculty President
      Antônio Carlos in Ubá city, state of Minas Gerais, with authorization for data collection and
      infrastructure use signed by the study researchers and supervisor. Volunteers were assessed
      during the first session to ensure compliance with inclusion and exclusion criteria outlined
      in the medical history form. They were informed about the entire procedure and study
      objectives and subsequently guided to sign the Informed Consent Form, following Resolution
      466/2012 of the National Health Council.

      Body Mass Index (BMI) calculation was done using a Multilaser digital scale and a two-meter
      measuring tape. Quality of life was assessed using the abbreviated version of the WHOQOL-100,
      the WHOQOL-bref, consisting of 26 questions related to general quality of life, satisfaction
      with one's health, and domains of physical, psychological, social relationships, and the
      environment.

      Aerobic capacity was evaluated through the Six-Minute Walk Test (6MWT), performed on a flat,
      obstacle-free 30-meter track. The objective was to analyze the farthest distance a patient
      could walk in six minutes without running, with the option to stop at any time without
      interrupting the timing. Standardized encouragement phrases were used every minute during the
      test.

      The Medical Research Council (MRC) Dyspnea Scale was used to categorize the degree of
      dyspnea, with patients choosing an item corresponding to the proportion of limitation caused
      by dyspnea in their daily activities. Muscle strength measurement was conducted for each
      volunteer using a validated digital scale in the quadriceps (90° knee flexion), hamstrings
      (90° knee flexion), biceps brachii (90° elbow flexion), triceps brachii (anatomical
      position), and deltoid (midportion, 30° shoulder abduction).

      Blood pressure, heart rate, and oxygen saturation were measured at the beginning and end of
      each session using a premium brand sphygmomanometer and stethoscope, a G-tech pulse oximeter,
      and assessed throughout the session. Difficulty levels in performing proposed activities,
      considering peripheral musculature, were queried using the Borg Scale.

      The GF group focused on exercises for strengthening hip adductor muscles associated with
      bridge exercises using a small exercise ball, hamstring strengthening with ankle weights in
      prone position, bilateral hip flexor strengthening in supine position with ankle weights,
      bilateral shoulder flexor strengthening with dumbbells, bilateral shoulder extensor
      strengthening with dumbbells, bilateral shoulder abductor strengthening with dumbbells, and
      bilateral serratus anterior muscle strengthening with dumbbells (all exercises except the
      first in three sets of 10 repetitions). Progression was based on each patient's development.

      The GAF protocol initially involved a five-minute warm-up, consisting of two minutes of
      stationary marching and three minutes of jumping jacks. Patients were then instructed to
      climb up and down ramps, ascend and descend stairs, walk on a flat surface, and use a cycle
      ergometer (each task performed for five minutes). For the recovery phase, bilateral
      stretching of hamstrings, rectus femoris, triceps brachii, pectoralis major,
      sternocleidomastoid, and scalene muscles was performed, each lasting 30 seconds. This
      protocol was associated with the anaerobic training described in the GF.

      Volunteers were allocated to two groups using a simple random sampling method with two
      blocks. Results were placed in sealed envelopes, concealing the patient allocation sequence
      from the researcher.
    

Intervention name(s): muscle strengthening
Intervention type(s): Procedure
Intervention description(s): The study involved adults aged 18 to 59 diagnosed with COVID-19 in the past year, experiencing mild or moderate symptoms, dyspnea, and either sedentary or engaging in physical exercise at least twice a week. Excluded were those with certain medical conditions. The participants were divided into two groups: one focused on global muscle strengthening (GF), and the other on low-intensity aerobic training with global muscle strengthening (GAF). The study assessed various parameters, including BMI, quality of life, aerobic capacity, dyspnea, and muscle strength. The sessions varied in duration and intensity. Volunteers were recruited from a clinic in Ubá-MG and randomly assigned to groups. The study aimed to evaluate the impact of the interventions on post-COVID-19 recovery.
Other intervention name(s): aerobic exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Rehabilitation; Physiotherapy; Endurance training; Medical Research Council; Quality of Life