Efficacy of Synchronous and Asynchronous Telerehabilitation in COVID-19 Discharges

Study Overview
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Brief Summary
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Investigators aimed to evaluate the effectiveness of exercise programs given by synchronous and asynchronous telerehabilitation methods in patients after discharge from COVID-19.

Detailed Description
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Fifty seven participants will be enrolled. Participants will be randomly divided into 3 groups. For this purpose, patients will be recruited at the time of discharge from the hospital and two experimental groups with the same physical therapy and educational program will be carried out. participants in the control group will only educational program. Participants in experimental groups will be followed using videoconference interviews from synchronous telerehabilitation methods and mobile application from asynchronous telerehabilitation methods at home. These participants will be given an 8-week exercise program. The exercise program will consist of physical exercises (aerobic and strength exercises) along with breathing exercises and the patients will be evaluated before and after the treatment. After treatment programs, the functional capacity, performance, and hemodynamic parameters of the participants will be evaluated. Quality of life, physical activity level, anxiety-depression, and fatigue severity will also be evaluated with questionnaires.

Official Title
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Efficacy of Synchronous and Asynchronous Telerehabilitation in COVID-19 Discharges

Conditions
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COVID-19, Telerehabilitation

Intervention / Treatment
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* Other: Synchronous telerehabilitation programme
* Other: Asynchronous telerehabilitation programme


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: COVID-19 patients in the subacute period discharged Be 18 years or older Having received oxygen therapy or mechanical ventilation support in the hospital Access to online interviews and web-based exercises with a secure internet connection Having sufficient speaking and hearing skills for telerehabilitation Volunteer to participate in research Exclusion Criteria: Unstable clinical condition Having had cerebrovascular disease, intra-articular drug injection or surgery of the lower extremities in the last 6 months Inability to walk independently, even with an assistive device Having serious neuromuscular problems Not being cooperative enough to answer and understand questionnaires and scales

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Controlled Study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Synchronous telerehabilitation program (Video conference)<br>Participants will exercise program at home for an average of 30 minutes a day, 3 days a week, under the supervision of a physiotherapist via synchronized video conference. The program will continue for 8 weeks. The exercise program will consist of physical exercises (aerobic and strength exercises) along with breathing exercises and an educational program. Physical exercises will be adjusted in 3 different difficulty levels: sitting, standing with or without support. | Other: Synchronous telerehabilitation programme<br>* Exercise program and educational program<br>* Other names: Video conference;|
| Experimental: Asynchronous telerehabilitation programme (Mobil app.)<br>The same exercises as in the synchronous telerehabilitation program will be done at the same frequency. Participants will watch the videos sent by the investigator via the mobile application and then do the exercises at home. The participants will meet with the investigator once a week to an update exercise program. | Other: Asynchronous telerehabilitation programme<br>* Exercise program educational program<br>* Other names: Mobil application;|
| No Intervention: Control<br>Participants in this group will only receive an educational program | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incremental Shuttle Walk Test (ISWT) | The participant will be asked to walk around two 9-meter cones and complete them within the given time. Oxygen saturation and heart rate will be measured before and immediately after the test. They will be asked to self-report dyspnea and fatigue according to the modified Borg scale (0-10). | Change from baseline walking distance (meters) of the patients at the end of the 8th week and, postintervation sixth months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30-Second Chair Stand Test (30 CST) | The patient will be asked to sit and stand as much as possible within 30 seconds, with his hands crossed over his chest. The number of sitting and staying for 30 seconds will be noted. | Change from baseline number of sitting and staying of the patients at the end of the 8th week and, postintervation sixth months | 
| Brief Physical Performance Battery (BPPB) | It is a test used to evaluate the lower extremity function of patients. This battery represents the sum of 3 functional tests such as standing stance tests, 4 meters walking test and 5 times chair sit and stand (5STS). Each test is scored between 0 (not completing the test) and 4 (highest performance level) | Change from baseline score of the patients at the end of the 8th week and, postintervation sixth months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19, Telerehabilitation, Exercise program, Breathing exercises