Publication: Efectos del entrenamiento de la musculatura respiratoria en la calidad de vida, función física, pulmonar y estado psicológico en personas con Covid Persistente. Estudio piloto.
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2022-09-30
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Abstract
Antecedentes: Parte de los supervivientes de la COVID-19 presentan síntomas persistentes en la función física, pulmonar, psicológica, deteriorando así su calidad de vida. Los beneficios el entrenamiento de la musculatura respiratoria (EMR) detectados en otras enfermedades sugieren que puede ser una estrategia útil para rehabilitar a estas personas.
Objetivo: Evaluar los efectos del EMR domiciliario de alta intensidad sobre la calidad de vida, función física, pulmonar y psicológica en personas con COVID persistente.
Metodología: Ensayo clínico controlado aleatorizado piloto, con doble ciego. Se reclutaron 28 participantes, que fueron distribuidos en 4 grupos: (1) Entrenamiento de la musculatura inspiratoria (EMI), (2) Entrenamiento de la musculatura inspiratoria y espiratoria combinado (EC), (3) EMI placebo, (4) EC placebo. Todos los grupos realizaron 8 semanas de entrenamiento de alta intensidad, 6 días por semana, 2 veces al día, desde casa bajo la supervisión telemática de un fisioterapeuta. Las variables evaluadas fueron la calidad de vida, sintomatología, fuerza de la musculatura respiratoria y periférica, resistencia cardiorrespiratoria, función pulmonar, niveles de ansiedad, depresión estrés postraumático y cognición.
Resultados: Los grupos experimentales mejoraron más que los grupos placebo en calidad de vida, sintomatología, fuerza respiratoria, capacidad cardiorrespiratoria, en niveles de ansiedad, depresión, estrés postraumático y función cognitiva. No se apreciaron diferencias ni las variables espirométricas ni en la fuerza periférica. El grupo EC mostró cierta superioridad.
Conclusiones: El EMR domiciliario puede ser una herramienta eficaz para mejorar la calidad de vida, síntomas y la función física, psicológica y cognitiva en el COVID persistente.
Background: A high proportion of COVID-19 survivors have reported persistent symptoms, such as extreme fatigue, breathlessness, limited exercise capacity, impaired pulmonary function, and cognitive and psychological consequences. Respiratory muscle training (RMT) might be beneficial for these patients due to decreased fatigue and breathlessness and increases exercise capacity. Objective: To investigate the effect of a high-intensity home-based RMT programme on quality of life, physical and pulmonary function, psychological and cognitive state in patients with post-acute COVID-19 syndrome. Methods: Double-blind randomized controlled trial. 28 participants were allocated into 4 groups: (1) Inspiratory muscle training (IMT) (n=7); (2) Inspiratory and Expiratory muscle training (IEMT) (n=7); (3) Sham-IMT (n=7); (4) Sham-IEMT (n=7). All groups performed a home-based training for 8 weeks (6 days/week, twice a day) supervised by a physiotherapist. Quality of life, symptoms, respiratory and peripheral muscle strength, cardiorespiratory endurance, pulmonary function, anxiety and depression levels, post-traumatic stress disorder and cognitive function were evaluated. All outcomes were recorded at baseline, at 4 weeks and after 8 weeks. Results: The experimental groups improved quality of life, symptoms such as fatigue and breathlessness, respiratory muscle strength, cardiorespiratory endurance, anxiety and depression levels, post-traumatic stress disorder and cognition function. There were no differences on pulmonary function and peripheral muscle strength. The combined intervention group showed a slight superiority. Conclusions: A home-based RMT programme can improve quality of life, symptoms, physical function, cognitive and psychological function in the short-term in patients with post-acute COVID-19 syndrome.
Background: A high proportion of COVID-19 survivors have reported persistent symptoms, such as extreme fatigue, breathlessness, limited exercise capacity, impaired pulmonary function, and cognitive and psychological consequences. Respiratory muscle training (RMT) might be beneficial for these patients due to decreased fatigue and breathlessness and increases exercise capacity. Objective: To investigate the effect of a high-intensity home-based RMT programme on quality of life, physical and pulmonary function, psychological and cognitive state in patients with post-acute COVID-19 syndrome. Methods: Double-blind randomized controlled trial. 28 participants were allocated into 4 groups: (1) Inspiratory muscle training (IMT) (n=7); (2) Inspiratory and Expiratory muscle training (IEMT) (n=7); (3) Sham-IMT (n=7); (4) Sham-IEMT (n=7). All groups performed a home-based training for 8 weeks (6 days/week, twice a day) supervised by a physiotherapist. Quality of life, symptoms, respiratory and peripheral muscle strength, cardiorespiratory endurance, pulmonary function, anxiety and depression levels, post-traumatic stress disorder and cognitive function were evaluated. All outcomes were recorded at baseline, at 4 weeks and after 8 weeks. Results: The experimental groups improved quality of life, symptoms such as fatigue and breathlessness, respiratory muscle strength, cardiorespiratory endurance, anxiety and depression levels, post-traumatic stress disorder and cognition function. There were no differences on pulmonary function and peripheral muscle strength. The combined intervention group showed a slight superiority. Conclusions: A home-based RMT programme can improve quality of life, symptoms, physical function, cognitive and psychological function in the short-term in patients with post-acute COVID-19 syndrome.
Description
Un agradecimiento especial a mi tutor el Dr. Ibai López de Uralde Villanueva y a la Dra. Tamara del Corral Núñez-Flores por todo el apoyo que me habéis brindado a lo largo de estos atareados meses. Me gustaría dar gracias por toda la confianza que habéis depositado en mí, que verdaderamente me ha hecho sentir como un miembro más del equipo. Como sueles decir Ibai, ojalá seguir a rueda mucho más tiempo porque, de veras, todavía tengo muchas cosas que seguir aprendiendo de vosotros dos, y de vuestra manera de trabajar.
Agradecer hoy y siempre a mi familia: mi padre Javier, a mi madre Loli y a mi hermano Javi. Por su presencia a altas horas de la noche ayudándome con los asuntos más tediosos de la investigación y, sobre todo, por cuidarme como lo habéis hecho desde siempre. No hubiera imaginado algo así si no fuera por vuestro apoyo incondicional. Este trabajo de verdad es casi más vuestro que mío.
A mis amigos de Cercedilla, por todas y cada una de esas quedadas a comer de los jueves en Ciudad Universitaria. Que ni la lluvia ni el frío las pare durante mucho tiempo más. Cada rato con vosotros era sin duda un respiro que me ayudaba a ponerme a trabajar después con más fuerza. Muchas gracias en especial a todos los que me han seguido durante todo este tiempo y se interesaron frecuentemente por mí.
Por último, agradecer a los colectivos “Covid Persistente España” y “Long Covid ACTS” el interés depositado en este proyecto y por contribuir a la difusión del mismo. No me quiero olvidar de todas las personas que tomaron parte de este ensayo. Todos ellos presentaron un comportamiento ejemplar y además han conseguido darle un gran colorido a una cosa tan monótona como fueron las videollamadas. Gracias a todos y a cada uno de vosotros he aprendido muchas cosas, que de seguro me han hecho crecer como persona.
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