Pulmonary Tele-rehabilitation and Progressive Muscle Relaxation on Discharged Covid-19 Patients

Study Overview
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Brief Summary
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The aim of this study is to investigate efficacy of internet based pulmonary rehabilitation and progressive muscle relaxation program on functional capacity, depression and anxiety, dyspnea, fatigue, sleep quality and quality of life in covid19 patients after hospital discharge

Detailed Description
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Novel coronavirus disease 2019 (covid19) could cause respiratory and physical dysfunction, anxiety and depression, fatigue and affect sleep quality and quality of life in infected patient after hospital discharge. there is expect that pulmonary rehabilitation can improve these symptoms and prevent complications in these cases. It seems that Progressive muscle relaxation exercise could improve pulmonary rehabilitation effect. Due to social isolation of Covid 19 patients after hospital discharge, internet base rehabilitation will be used in this study. participants will be randomized in two pulmonary tele-rehabilitation groups after hospital discharge. One group will be received pulmonary rehabilitation include education, breathing exercises, aerobic and upper and lower limbs muscle strengthening exercises. Another group will be perform progressive muscle relaxation in addition of these exercise. Treatment duration is 6 week with 5 days/week frequency. Two exercise sessions per week will be supervised with expert physiotherapist via videoconferencing. Outcomes will be measured at baseline, within two week and at the end of six week exercises program.

Official Title
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Effect of Pulmonary Tele-rehabilitation With and Without Progressive Muscle Relaxation Program in Covid-19 Patients After Hospital Discharge: Randomized Clinical Trial

Conditions
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Covid19

Intervention / Treatment
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* Other: Pulmonary telerehabilitation
* Other: progressive muscle relaxation training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Covid 19 patient that confirmed with polymerase chain reaction test (PCR) Hospitalized Corvid 19 patients after discharge Accessibility to internet and using video call Exclusion Criteria: Mental and physical disability Uncontrolled cardiac dysfunction such as arrhythmia Sever neurological condition such as guillain-barre and stroke Uncontrolled diabetes or blood pressure Pregnant women Re-hospitalization during treatment program Chronic pulmonary and kidney condition

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: pulmonary telerehabilitation plus progressive muscle relaxation training<br>This group will perform six week pulmonary rehabilitation program and progressive muscle relaxation exercise at theirs home, with two supervised sessions by physiotherapist per week via videoconferencing. | Other: Pulmonary telerehabilitation<br>* pulmonary telerehabilitation program include breathing exercise,aerobics exercise and upper and lower limbs muscle strengthening exercise<br>Other: progressive muscle relaxation training<br>* summarized Jacobson progressive muscle relaxation training method<br>|
| Active Comparator: pulmonary telerehabilitation<br>This group will perform six week pulmonary rehabilitation program at theirs home, with two supervised sessions by physiotherapist per week via videoconferencing. | Other: Pulmonary telerehabilitation<br>* pulmonary telerehabilitation program include breathing exercise,aerobics exercise and upper and lower limbs muscle strengthening exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional capacity | six minute walk test (6MWT) | change from baseline in 6MWT at 2 and 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| dyspnea | Borg scale, The borg scale is a self-rating tool to measure the degree of breathlessness on a scale from 0 to 10, higher score mean worse dyspnea | change from baseline in Borg scale at 2 and 6 weeks | 
| Sleep quality | petersburg sleep quality index (PSQI), PSQI is a eighteen item scale.The total scores range is 0-21. A higher score indicates a worse sleep quality. | change from baseline in PSQI at 6 week | 
| anxiety and depression | hospital anxiety and depression scale (HADS), HADS is a fourteen item scale. Seven of the items relate to anxiety and seven relate to depression.The total scores range is 0-21 for both depression and anxiety scores. A higher score indicates a worse depression and anxiety. | change from baseline in HADS at 6 week |