Addressing post-COVID-19 musculoskeletal symptoms through pulmonary rehabilitation with an evidence-based eHealth education tool: Preliminary results from a pilot randomized controlled clinical trial

Abstract

Background: The coronavirus disease (COVID-19) pandemic has led to a global health crisis with significant long-term consequences, including musculoskeletal symptoms such as fatigue, myalgia, and chronic pain. These issues, often linked to altered nociceptive processing, impair quality of life and are exacerbated in severe cases by intensive care unit-acquired weakness from immobilization and mechanical ventilation. Early rehabilitation, particularly pulmonary rehabilitation (PR), is crucial for mitigating these effects. Telerehabilitation, leveraging telemedicine, offers an innovative, accessible alternative, providing personalized programs that improve adherence and recovery. Recent studies highlight telerehabilitation's benefits alongside traditional methods, underscoring its potential for managing post-COVID-19 musculoskeletal sequelae. This study aimed to evaluate the effects of PR and an eHealth education tool (ET) on pain, functionality, quality of life, and psychological factors in post-COVID-19 patients with musculoskeletal symptoms and to compare telerehabilitation versus face-to-face approaches regarding treatment adherence.

Methods: This pilot randomized controlled trial included 12 patients with musculoskeletal symptoms of COVID-19. The participants were randomly assigned to a PR program with or without an evidence-based eHealth ET. Primary outcomes included pain reduction and improvements in functional capacity, quality of life, and psychological factors measured over a 45-week period. The secondary outcome was adherence to rehabilitation.

Results: A significant reduction in kinesiophobia was found in the eHealth ET group (P = .048), although no significant differences were observed in pain, Barthel index, or 6-minute walk test results between the groups. Clinically relevant improvements were observed in the telemedicine group.

Conclusions: An evidence-based eHealth ET was effective in reducing kinesiophobia, highlighting its potential to address psychological aspects of post-COVID-19 recovery. However, further studies are needed to assess its long-term effects on physical recovery.

Trial registration: ClinicalTrials.gov NCT05516836.