Effects of combined training on functionality and quality of life of adults recovered from COVID-19
DOI:
https://doi.org/10.11606/issn.2317-0190.v32i2a236956Keywords:
Cardiac Rehabilitation , Muscle Strength, Post-acute COVID-19 Syndrome, Quality of Life, Walk TestAbstract
Objective: To evaluate the effects of combined training on the functionality and quality of life of patients recovered from COVID-19. Method: A clinical trial was conducted in which the training group (TG) underwent combined training (aerobic + strength) for 8 weeks and was compared to the control group (CG). Functional capacity (6-minute walk test - 6MWT); lower limb muscle strength (30-second sit-to-stand test - TLS30s); upper limb strength (handgrip strength - HGS); perception of dyspnea and fatigue (modified Borg Scale); and quality of life (SF-36) were evaluated before and after the protocol. Results: Both the 6MWT (p= 0.001), TLS30s (p= 0.007), perceived fatigue (p= 0.001) and the Vitality (p= 0.016) and Emotional Aspects (p= 0.001) domains of the SF-36 showed differences in the TG before and after training. The Physical Aspects domain showed a significant difference in relation to the CG (p= 0.019; Cohen's d= 0.35) at the end of the protocol. Conclusion: The combined training program was effective in improving the functionality of trained patients and the physical perception of quality of life among the groups. (Study approved by the Ethics Committee of the Universidade do Vale do Rio dos Sinos and registered in RBR-10gb3p94)
Downloads
References
Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv [Preprint]. 2021:2021.01.27.21250617. Doi: https://doi.org/10.1101/2021.01.27.21250617
Santana AV, Fontana AD, Pitta F. Pulmonary rehabilitation after COVID-19. J Bras Pneumol. 2021;47(1):e20210034. Doi: https://doi.org/10.36416/1806-3756/e20210034
Wright J, Astill SL, Sivan M. The Relationship between Physical Activity and Long COVID: A Cross-Sectional Study. Int J Environ Res Public Health. 2022;19(9):5093. Doi: https://doi.org/10.3390/ijerph19095093
Soares MN, Eggelbusch M, Naddaf E, Gerrits KHL, van der Schaaf M, van den Borst B, et al. Skeletal muscle alterations in patients with acute COVID-19 and post-acute sequelae of COVID-19. J Cachexia Sarcopenia Muscle. 2022;13(1):11-22. Doi: https://doi.org/10.1002/jcsm.12896
Yong SJ. Persistent Brainstem Dysfunction in Long-COVID: A Hypothesis. ACS Chem Neurosci. 2021;12(4):573-580. Doi: https://doi.org/10.1021/acschemneuro.0c00793
Pleguezuelos E, Del Carmen A, Llorensi G, Carcole J, Casarramona P, Moreno E, et al. Severe loss of mechanical efficiency in COVID-19 patients. J Cachexia Sarcopenia Muscle. 2021;12(4):1056-1063. Doi: https://doi.org/10.1002/jcsm.12739
Zhou J, Liu B, Liang C, Li Y, Song YH. Cytokine Signaling in Skeletal Muscle Wasting. Trends Endocrinol Metab. 2016;27(5):335-347. Doi: https://doi.org/10.1016/j.tem.2016.03.002
Barbara C, Clavario P, De Marzo V, Lotti R, Guglielmi G, Porcile A, et al. Effects of exercise rehabilitation in patients with long coronavirus disease 2019. Eur J Prev Cardiol. 2022;29(7):e258-e260. Doi: https://doi.org/10.1093/eurjpc/zwac019
Bailly M, Pélissier L, Coudeyre E, Evrard B, Bingula R, Rochette C, et al. Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches. Int J Environ Res Public Health. 2022;19(15):9025. Doi: https://doi.org/10.3390/ijerph19159025
Ahmadi Hekmatikar AH, Ferreira Júnior JB, Shahrbanian S, Suzuki K. Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review. Int J Environ Res Public Health. 2022;19(4):2290. Doi: https://doi.org/10.3390/ijerph19042290
Mohamed AA, Alawna M. The effect of aerobic exercise on immune biomarkers and symptoms severity and progression in patients with COVID-19: A randomized control trial. J Bodyw Mov Ther. 2021;28:425-432. Doi: https://doi.org/10.1016/j.jbmt.2021.07.012
Fugazzaro S, Contri A, Esseroukh O, Kaleci S, Croci S, Massari M, et al. Rehabilitation Interventions for Post-Acute COVID-19 Syndrome: A Systematic Review. Int J Environ Res Public Health. 2022;19(9):5185. Doi: https://doi.org/10.3390/ijerph19095185
Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2012;10(1):28-55. Doi: https://doi.org/10.1016/j.ijsu.2011.10.001
Jimeno-Almazán A, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz BJ, Courel-Ibáñez J, et al. Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial. J Appl Physiol (1985). 2023;134(1):95-104. Doi: https://doi.org/10.1152/japplphysiol.00489.2022
Carvalho T, Milani M, Ferraz AS, Silveira ADD, Herdy AH, Hossri CAC, et al. Brazilian Cardiovascular Rehabilitation Guideline - 2020. Arq Bras Cardiol. 2020;114(5):943-987. Doi: https://doi.org/10.36660/abc.20200407
Brasil. Lei n. 14.019, de 2 de julho de 2020. Dispoe sobre a obrigatoriedade do uso de máscaras de proteção individual para circulação em espaços públicos e privados acessíveis ao público, em vias públicas e em transportes públicos, sobre a adoção de medidas de assepsia de locais de acesso público, inclusive transportes públicos, e sobre a disponibilização de produtos saneantes aos usuários durante a vigência das medidas para enfrentamento da emergência de saúde pública de importância internacional decorrente da pandemia da COVID-19. Diário Oficial da Republica Federativa do Brasil, Brasília (DF); 2020 jul 3: Seção 1:2.
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7. Doi: https://doi.org/10.1164/ajrccm.166.1.at1102
Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2):113-9. Doi: https://doi.org/10.1080/02701367.1999.10608028
Pasqualoto AS, Fontoura FF, Sbruzzi G, Albuquerque IM, Calegari L, Stedile NR, et al. Recomendações para reabilitação funcional de pacientes pós-COVID-19. ASSOBRAFIR/CREFITO-5; 2022.
Campolina AG, Bortoluzzo AB, Ferraz MB, Ciconelli RM. Validação da versão brasileira do questionário genérico de qualidade de vida short-form 6 dimensions (SF-6D Brasil). Cien Saude Colet. 2011;16(7):3103-10. Doi: https://doi.org/10.1590/s1413-81232011000800010
World Physiotherapy. Documento Informativo 9 sobre respostas do COVID-19 da World Physiotherapy. Abordagens de reabilitação seguras para pessoas vivendo com a COVID Longa: atividade física e exercício. Londres: World Physiotherapy; 2021.
Haukoos JS, Lewis RJ. Advanced statistics: bootstrapping confidence intervals for statistics with "difficult" distributions. Acad Emerg Med. 2005;12(4):360-5. Doi: https://doi.org/10.1197/j.aem.2004.11.018
Melo MB, Daldegan-Bueno D, Menezes Oliveira MG, Souza AL. Beyond ANOVA and MANOVA for repeated measures: Advantages of generalized estimated equations and generalized linear mixed models and its use in neuroscience research. Eur J Neurosci. 2022;56(12):6089-6098. Doi: https://doi.org/10.1111/ejn.15858
Hasenoehrl T, Palma S, Huber DF, Kastl S, Steiner M, Jordakieva G, et al. Post-COVID: effects of physical exercise on functional status and work ability in health care personnel. Disabil Rehabil. 2023;45(18):2872-2878. Doi: https://doi.org/10.1080/09638288.2022.2111467
Bohannon RW, Crouch R. Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract. 2017;23(2):377-381. Doi: https://doi.org/10.1111/jep.12629
Hockele LF, Sachet Affonso JV, Rossi D, Eibel B. Pulmonary and Functional Rehabilitation Improves Functional Capacity, Pulmonary Function and Respiratory Muscle Strength in Post COVID-19 Patients: Pilot Clinical Trial. Int J Environ Res Public Health. 2022;19(22):14899. Doi: https://doi.org/10.3390/ijerph192214899
Seeßle J, Waterboer T, Hippchen T, Simon J, Kirchner M, Lim A, et al. Persistent Symptoms in Adult Patients 1 Year After Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study. Clin Infect Dis. 2022;74(7):1191-1198. Doi: https://doi.org/10.1093/cid/ciab611
Ramírez-Vélez R, Legarra-Gorgoñon G, Oscoz-Ochandorena S, García-Alonso Y, García-Alonso N, Oteiza J, et al. Reduced muscle strength in patients with long-COVID-19 syndrome is mediated by limb muscle mass. J Appl Physiol (1985). 2023;134(1):50-58. Doi: https://doi.org/10.1152/japplphysiol.00599.2022
Morrow A, Gray SR, Bayes HK, Sykes R, McGarry E, Anderson D, et al. Prevention and early treatment of the long-term physical effects of COVID-19 in adults: design of a randomised controlled trial of resistance exercise-CISCO-21. Trials. 2022;23(1):660. Doi: https://doi.org/10.1186/s13063-022-06632-y
Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023;21(3):133-146. Doi: https://doi.org/10.1038/s41579-022-00846-2
Tabacof L, Tosto-Mancuso J, Wood J, Cortes M, Kontorovich A, McCarthy D, et al. Post-acute COVID-19 Syndrome Negatively Impacts Physical Function, Cognitive Function, Health-Related Quality of Life, and Participation. Am J Phys Med Rehabil. 2022;101(1):48-52. Doi: https://doi.org/10.1097/PHM.0000000000001910
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Acta Fisiátrica

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
O conteúdo do periódico está licenciado sob uma Licença Creative Commons BY-NC-SA. Esta licença permite que outros remixem, adaptem e criem a partir do seu trabalho para fins não comerciais, desde que atribuam ao autor o devido crédito e que licenciem as novas criações sob termos idênticos.








