Effects of Telerehabilitation After Discharge in COVID-19 Survivors
Condition: Covid19
MeSH terms: COVID-19
Study type: Interventional

Summary: 
      Effects of telerehabilitation after discharge on quality of Life, psychosocial status,
      physical activity, daily activities of living, and sleep quality in patients treated as
      inpatients with the diagnosis of COVID-19 will be investigated. Post-discharge physical
      activity level, psychosocial status, sleep quality, quality of life, daily activities of
      living, and quality of life will be determined. The effects of exercise interventions in
      online-based physiotherapist monitoring will be provided. Monthly comparisons of physical
      activity, quality of life, depression, and sleep quality responses using telerehabilitation
      for three months following COVID-19 will be investigated.
    

Detailed description: 
      The new type of Coronavirus (SARS-CoV-2) has progressed rapidly in our country and around the
      world and has caused a global health emergency, requiring the implementation of restrictive
      measures. While the origin of SARS-CoV-2 is still under investigation, the available
      information points to wild animals sold illegally in the Wuhan Seafood Wholesale Market.
      Common symptoms of infection are fever, cough, and dyspnea. In more severe cases, pneumonia,
      severe acute respiratory tract infection, renal failure, and even death may occur. Up-to-date
      information about physiotherapy and rehabilitation applications on COVID-19 disease is
      limited to positioning and mobilization in the acute phase of the disease. Current guidelines
      and protocols state that airway clearance techniques, respiratory exercises and practices
      using assistive devices, exercise training and respiratory muscle training should not be
      applied in the acute period. Tele-medicine is a clinical practice that connects the patient
      to healthcare professionals through electronic platforms, potentially improving the
      self-management of patients and allowing the care of patients with limited access to health
      services. In these days when staying at home is recommended to minimize exposure and
      contamination risk, telerehabilitation can be considered as an advantage, using information
      and communication technologies to provide remote rehabilitation services to individuals at
      home. It has been reported that with telerehabilitation, improvements have been achieved in
      health outcomes and quality of life, such as reducing hospitalization rates and
      re-admissions, ensuring early discharge, facilitating access to rehabilitation services,
      decreasing costs, and ensuring early return to work. Regular physical activity and exercise
      provide many health benefits, such as increasing cardiorespiratory fitness and reducing
      symptoms of anxiety and depression. Increasing cardiorespiratory fitness may play a
      preventive and facilitating role against respiratory infections. This may prevent or help
      treat pneumonia and acute respiratory distress syndrome, which develops with COVID-19 and
      causes respiratory failure. It has been stated that there is a significant decrease in the
      level of physical activity globally in the period of social isolation, which is accepted
      worldwide during COVID-19 pandemic. Decrease in the level of physical activity and increase
      in sedentary behavior due to isolation limitations may cause rapid deterioration and
      premature death in cardiovascular health in a population with high cardiovascular risk.
      Considering that short-term (1-4 weeks) inactivity is associated with adverse effects on
      cardiovascular function and structure, and increased cardiovascular risk factors, it appears
      to be a clinically relevant intervention to promote the health benefits of home-based
      physical activity programs. In this study, a brochure created by physiotherapists for
      post-COVID-19 patients will be sent electronically. The number of repetitions and/or sets of
      the exercises in the brochure will be increased weekly by the physiotherapists according to
      the tolerance of the patients. Physical activity levels will be questioned at the beginning
      and at the end of each month to be maintained for three months in total. The need for
      isolation due to the COVID-19 pandemic creates an unprecedented, stressful situation for many
      people for an unknown period of time. In addition to increasing the level of anxiety and
      depression, this may have negative effects on sleep quality. Since sleep plays a main role in
      emotion regulation, sleep disturbances may have direct consequences on emotional functioning.
      Therefore, it was planned to evaluate depression and sleep in individuals who survived
      COVID-19 at the beginning and at the end of each month, for a total of three months. It will
      be possible to determine whether there is a relationship between depression and sleep
      efficiency with exercise recommendations that will be given in a controlled manner by a
      physiotherapist via telerehabilitation and increase according to the patient's tolerance. It
      has been reported that patients hospitalized with acute respiratory distress syndrome have
      post-traumatic stress disorder at a rate of 22% -24%, depression at a rate of 26% -33%, and
      general anxiety at a rate of 38% -44% even after 2 years. It has been reported that these are
      concerns that may accompany a serious decrease in quality of life and function after
      COVID-19. Therefore, it is planned to assess quality of life at the beginning and at the end
      of each month for a total of three months in individuals who survived COVID-19.

      Post-discharge physical activity level, psychosocial status, sleep quality, quality of life,
      daily activities of living, and quality of life will be determined. The effect of exercise
      interventions in online-based physiotherapist monitoring will be provided. Monthly
      comparisons of physical activity, quality of life, depression, and sleep quality responses
      using telerehabilitation for three months following COVID-19 will be investigated.
    

Intervention name(s): Telerehabilitation
Intervention type(s): Other
Intervention description(s): Telerehabilitation will consists of physiotherapist-guided exercises. Exercises will be designed by physiotherapists for COVID-19 survivors using the current guidelines. Exercise brochure will be prepared and will be sent to participants. Repetitions and sets of exercises will be modified according to the patients.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: telerehabilitation; physical activity; sleep quality; post COVID-19; quality of life