The Effects of Pulmonary Physiotherapy Treatments on Patients With COVID-19
Condition: Covid-19; Pneumonia; SARS Pneumonia
MeSH terms: COVID-19; Pneumonia
Study type: Interventional

Summary: 
      The aim of this study is to evaluate the efficacy of pulmonary physiotherapy on respiratory
      functions in hospitalized patients with Novel Coronavirus 2019 pneumonia. Patients will be
      randomized into 1) intervention group: receiving pulmonary physiotherapy technique to improve
      pulmonary function and walking training or 2) control group: Usual medical care. Patients in
      both groups will receive therapeutic incentive spirometer. Various outcome measurements of
      pulmonary functions will be evaluated before and after of interventions. Mortality rate,
      hospitalization duration and re-admission will be followed until one month after end of
      intervention. Also, patient's quality of life will be measured after one month.
    

Detailed description: 
      In late December 2019, the new coronavirus (COVID-19) emerged in Wuhan, China and it has been
      confirmed as the cause of pneumonia in a large number of Chinese patients. The virus, also
      known as SARS-CoV-2, has since then spread to more than 200 countries worldwide.

      The most common symptoms of COVID-19 are fever, dry cough, shortness of breath and tiredness.
      In severe cases, the infection could cause pneumonia, acute respiratory distress syndrome
      (ARDS) and sometimes leads to death. Pulmonary physiotherapy is a comprehensive, effective
      and safe treatment method which is aimed at improving patient's respiratory symptoms, train
      effective coughing, clear the airway secretion, eliminate exacerbation and so on. It seems
      that pulmonary physiotherapy interventions can effectively decrease hospitalization, reduce
      the risk of complications and improve the patient's medical condition.

      The aim of this study is to evaluate the effectiveness of the hold breathing technique, chest
      expansion exercise, postural drainage procedure and Cough techniques carried out during
      pulmonary physiotherapy sessions.

      The researchers will invite 40 hospitalized patients in Imam Khomeini Hospital Complex,
      Tehran, Iran. All patients will be enrolled after taking informed consent. All of the
      procedure will be performed with the coordination of the patient's physicians. Patients will
      be randomized to the intervention or control group. Primary outcome measurements will be
      evaluated immediately before and after the interventions (with three days period). Also,
      patient's condition (including process of disease progression, mortality, hospital stay
      duration and re-admission) will be followed until one month using medical records review and
      interviewing with the patient or his/her family. Patient's health related quality of life
      will be measured using short form-36 quality of life assessment tool one month after the end
      of interventions. Intention-to-treat analysis will be performed in the patients that dropped
      out of the study.
    

Intervention name(s): Pulmonary Physiotherapy Techniques
Intervention type(s): Other
Intervention description(s): Participants will receive pulmonary physiotherapy techniques in six session during three days (twice daily). Four distinguished interventions will be provided for the patients: 1) Chest expansion exercises (for prevention and treatment of potential atelectasis); 2) Techniques to Mobilize or loosen the pulmonary secretions (Active cycle breathing, Coughing techniques, Vibration and Postural drainage); 3) Hold breathing exercise (3 sets, 10 repetition) and; 4) Walking training (based on patient's tolerance until 6 minute).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: All the enrolled participants will be allocated to the intervention of control groups using blocked-balanced randomization method.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Pulmonary Physiotherapy; 2019 novel coronavirus disease; COVID-19; Rehabilitation