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The planned research will enable the assessment of rehabilitation's effects using two pulmonary rehabilitation models: conventional and supplemented with an education program for patients hospitalized due to pneumonia with confirmed COVID-19.
The planned group size is 60 patients diagnosed with pneumonia and confirmed COVID-19. The given population was calculated based on the sampling calculator, considering the following parameters: fraction size, confidence level, and maximum error. Eligible patients will be randomly divided into two groups: a study group (30 patients) undergoing pulmonary rehabilitation supplemented with an education program, and a control group (30 patients) undergoing conventional pulmonary rehabilitation. Patients of both groups will be included in a 14-day rehabilitation program (Monday to Saturday). Treatments and therapies will be continued for a maximum of three hours daily. The program will be applied individually to each patient and include in-bed assisted exercises, airway clearance techniques, effective cough exercises, pursed-lips breathing, exercises to strengthen the diaphragm and intercostal muscles and cardiopulmonary exercises. Patients from the study group will additionally undergo daily education using an original brochure containing information about self management during the treatment process, the benefits of appropriately adapted physical activity, practical tips on airway clearance techniques or physical exercise. The test will be performed two times: before the start of rehabilitation and after completing the rehabilitation program. The patients' condition and the rehabilitation effects will be assessed using the following measures:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Education program and Pulmonary rehabilitation | Experimental | Conventional pulmonary rehabilitation coupled with original education program. |
|
| Pulmonary rehabilitation | Other | Conventional pulmonary rehabilitation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Education program | Other | Patients in a study group will participate in daily education program using an original brochure containing information about self-management during the treatment process, the benefits of appropriately adapted physical activity, practical tips on airway clearance techniques or physical exercise. |
| Measure | Description | Time Frame |
|---|---|---|
| Vital capacity (Voldyne 5000) | Measurements will be performed with certified motivational spirometer, Voldyne 5000. Patient, in a sitting position, will inhale as much air as possible starting from residual volume (RV) level and approach to vital capacity (VC) level. The result will be read from the scale placed on the wall of the device. | First examination- before the start of the 14-day rehabilitation program |
| Vital capacity (Voldyne 5000) | Measurements will be performed with certified motivational spirometer, Voldyne 5000. Patient, in a sitting position, will inhale as much air as possible starting from residual volume (RV) level and approach to vital capacity (VC) level. The result will be read from the scale placed on the wall of the device. | Second examination- at the end of the 14-day rehabilitation program |
| Oxygen saturation | Measurements will be performed with pulse oximeter and the parameter analyzed will be SpO2 (oxygen saturation by pulse oximetry; percentage of oxygen in patients' blood). | First examination- before the start of the 14-day rehabilitation program |
| Oxygen saturation | Measurements will be performed with pulse oximeter and the parameter analyzed will be SpO2 (oxygen saturation by pulse oximetry; percentage of oxygen in patients' blood). | Second examination- at the end of the 14-day rehabilitation program |
| Acid-base balance | The gasometry results will be taken from patients' medical documentation. The parameters analyzed will be oxygen pressure (pO2) and carbon dioxide pressure (pCO2). | First examination- before the start of the 14-day rehabilitation program |
| Measure | Description | Time Frame |
|---|---|---|
| Physical performance assessment by Sit-to-Stand Test (STS) | The test will be performed starting in sitting position in the chair with straight back, feet flat on the floor, and arms crossed over the chest or placed on the thighs. The patient will be instructed to stand up fully from the seated position and then sit back down as quickly and safely as possible during 30 seconds (number of standings in 30 seconds). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Renata Borys, MSc | University of Rzeszow | Principal Investigator |
| Agnieszka Guzik, A/Prof | University of Rzeszow | Study Director |
| Magdalena Kołodziej, PhD | University of Rzeszow | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Rzeszów | Rzeszów | 35-959 | Poland |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D011014 | Pneumonia |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
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| ID | Term |
|---|---|
| D018479 | Early Intervention, Educational |
| ID | Term |
|---|---|
| D002662 | Child Health Services |
| D003153 | Community Health Services |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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random selection to two groups (study group and control group)
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|
| Pulmonary rehabilitation | Other | The patients will participate in a 14-day rehabilitation program (Monday to Saturday). Treatments and therapies will be continued for a maximum of three hours daily. The program will be applied individually to each patient and include in-bed assisted exercises, airway clearance techniques, effective cough exercises, pursed-lips breathing, exercises to strengthen the diaphragm and intercostal muscles and cardiopulmonary exercises. |
|
| Acid-base balance |
The gasometry results will be taken from patients' medical documentation. The parameters analyzed will be oxygen pressure (pO2) and carbon dioxide pressure (pCO2). |
| Second examination- at the end of the 14-day rehabilitation program |
| First examination- before the start of the 14-day rehabilitation program |
| Physical performance assessment by Sit-to-Stand Test (STS) | The test will be performed starting in sitting position in the chair with straight back, feet flat on the floor, and arms crossed over the chest or placed on the thighs. The patient will be instructed to stand up fully from the seated position and then sit back down as quickly and safely as possible during 30 seconds (number of standings in 30 seconds). | Second examination- at the end of the 14-day rehabilitation program |
| Fatigue assessment using modified Borg scale | Fatigue will be examined during physical activity and the level of fatigue will be marked on a scale from 1 (no fatigue) to 10 (very very hard fatigue). | First examination- before the start of the 14-day rehabilitation program |
| Fatigue assessment using modified Borg scale | Fatigue will be examined during physical activity and the level of fatigue will be marked on a scale from 1 (no fatigue) to 10 (very very hard fatigue). | Second examination- at the end of the 14-day rehabilitation program |
| Dyspnea assessment with Medical Research Council dyspnea scale | Perceived breathlessness degree will be marked on a scale 0 (no breathlessness) to 4 (breathlessness at rest). | First examination- before the start of the 14-day rehabilitation program |
| Dyspnea assessment with Medical Research Council dyspnea scale | Perceived breathlessness degree will be marked on a scale 0 (no breathlessness) to 4 (breathlessness at rest). | Second examination- at the end of the 14-day rehabilitation program |
| Anxiety and depression assessment using HADS scale | The scale consists of 16 statements to which the respondent refers on a four-point scale. Eight statements are used to measure anxiety and depression, each of which is rated on a scale of 0 to 3 points. The cut-off threshold is 7 points for depression and 7 points for anxiety. The intensity of depressed mood and anxiety will be analyzed. | First examination- before the start of the 14-day rehabilitation program |
| Anxiety and depression assessment using HADS scale | The scale consists of 16 statements to which the respondent refers on a four-point scale. Eight statements are used to measure anxiety and depression, each of which is rated on a scale of 0 to 3 points. The cut-off threshold is 7 points for depression and 7 points for anxiety. The intensity of depressed mood and anxiety will be analyzed. | Second examination- at the end of the 14-day rehabilitation program |
| Activities of daily living assesment using Barthel scale | The Barthel Scale will be used to measure patient's ability to perform activities of daily living (ADLs) independently, with scores ranging from 0 (completely dependent) to 100 (completely independent). | First examination- before the start of the 14-day rehabilitation program |
| Activities of daily living assesment using Barthel scale | The Barthel Scale will be used to measure patient's ability to perform activities of daily living (ADLs) independently, with scores ranging from 0 (completely dependent) to 100 (completely independent). | Second examination- at the end of the 14-day rehabilitation program |
| D018352 |
| Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D011314 | Preventive Health Services |