Effect of Respiratory Versus Aerobic Training on Respiratory and Immunity Efficiency in Recovered COVID- 19 Patients

Study Overview
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Brief Summary
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This study will be conducted on eighty patients of both sexes with age ranging from 35 to 45years. The will be recovered from COVID-19 infection with chest symptoms. They will be selected from Nasr city police authority hospital. They will be randomly assigned into 3 equal groups.

Detailed Description
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This study will be conducted on eighty patients of both sexes with age ranging from 35 to 45years. The will be recovered from COVID-19 infection with chest symptoms. They will be selected from Nasr city police authority hospital. They will be randomly assigned into 3 equal groups. Participants will be assigned into 3 groups equal in number (group A, group B, group C) Group A (Respiratory Training Group) : It will include 30 patients of both sexes, recovered from COVID-19 infection. In addition to medical drugs, they will receive respiratory training for 6 weeks. Group B : (Aerobic Training Group) : It will include 30 patients of both sexes, recovered from COVID-19 infection. In addition to medical drugs, they will receive aerobic training for 6 weeks Group C : (control group) :It will include 20 patients of both sexes, recovered from COVID-19 infection on medical drugs only will receive no exercise as control group.

Official Title
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Effect of Respiratory Versus Aerobic Training on Respiratory and Immunity Efficiency in Recovered COVID- 19 Patients

Conditions
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Covid 19 Infection

Intervention / Treatment
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* Other: Respiratory Training
* Other: Aerobic training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients recovered from COVID -19 infection. Patients with body mass index 25 - 35 kg/m2 Patients previously diagnosed with chest symptoms of COVID- 19 infection. Patients' body temperature less than 37.5 Blood oxygen saturation ≥95% Exclusion Criteria: Smokers Patients with Myocardial infarction Patients with diabetes. Patients with autoimmune disease. Patients with positive COVID -19 infection. Patients with previous chest diseases a heart rate of >100 bpm a blood pressure of <90/60 mmHg or >140/90 mmHg a blood oxygen saturation of ≤95% other diseases that are not suitable for exercise (osteoarthritis knee - stroke patients, etc)

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 45 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group A (Respiratory Training Group)<br>It will include 30 patients of both sexes, recovered from COVID-19 infection. In addition to medical drugs, they will receive respiratory training for 6 weeks. | Other: Respiratory Training<br>* Respiratory training in form of : Diaphragmatic breathing,Segmental breathing, Incentive spirometer:<br>|
| Active Comparator: Group B : (Aerobic Training Group)<br>It will include 30 patients of both sexes, recovered from COVID-19 infection. In addition to medical drugs, they will receive aerobic training for 6 weeks | Other: Aerobic training<br>* aerobic exercises are customized according to the patient's underlying disease and residual dysfunction. These exercises will include walking on treadmill. After an initial, 5-minute warm-up phase performed on the treadmill at a low load, each endurance training session lasted 30 minutes and ended with 5-minute recovery and relaxation phase. A total of 3-5 sessions are carried out per week. Patients who are prone to fatigue should perform intermittent exercises<br>|
| No Intervention: Group C : (control group)<br>It will include 20 patients of both sexes, recovered from COVID-19 infection on medical drugs only will receive no exercise as control group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete blood picture | A venous blood sample will be taken to be analyzed in the laboratory | change from baseline at 6 weeks | 
| Arterial blood gases | arterial blood sample will be assessed | change from baseline at 6 weeks | 
| 6-minute walk Distance | patient will be instructed to walk as fast as long as possible, in a 30 meters obstacle- free corridor, limited by turnaround cones. Standardized verbal encouragement will be given every minute. After 6 min, patient will be instructed to stop, and the total distance will be measured, rounding to the nearest meter. | change from baseline at 6 weeks | 
| Breath-hold test | A rough index of cardiopulmonary reserve measured by the length of time that a person can voluntarily stop breathing; normal duration is 30 seconds or longer; diminished cardiac or pulmonary reserve is indicated by a duration of 20 seconds or less. | change from baseline at 6 weeks | 
| Oxygen saturation | Percentage of haemoglobin saturated with oxygen measured by pulse oximeter | change from baseline at 6 weeks | 
| Borg Dyspnea Scale score | It is a 0 to 10 rated numerical score used to measure dyspnea as reported by the patient during six minute walk test | change from baseline at 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximum oxygen consumption | Maximum oxygen consumption(VO2 max): Results of (6MWT) was used to calculate Vo2 max by using Cahalin equation as follows; Vo2 max = 0.03x distance in meters +3.98, in which distance is obtained from (6MWT) | change from baseline at 6 weeks |