The aim of this study is to evaluate the efficacy of pulmonary physiotherapy on respiratory functions in hospitalized patients with Novel Coronavirus 2019 pneumonia. Patients will be randomized into 1) intervention group: receiving pulmonary physiotherapy technique to improve pulmonary function and walking training or 2) control group: Usual medical care. Patients in both groups will receive therapeutic incentive spirometer. Various outcome measurements of pulmonary functions will be evaluated before and after of interventions. Mortality rate, hospitalization duration and re-admission will be followed until one month after end of intervention. Also, patient's quality of life will be measured after one month.
In late December 2019, the new coronavirus (COVID-19) emerged in Wuhan, China and it has been
confirmed as the cause of pneumonia in a large number of Chinese patients. The virus, also
known as SARS-CoV-2, has since then spread to more than 200 countries worldwide.
The most common symptoms of COVID-19 are fever, dry cough, shortness of breath and tiredness.
In severe cases, the infection could cause pneumonia, acute respiratory distress syndrome
(ARDS) and sometimes leads to death. Pulmonary physiotherapy is a comprehensive, effective
and safe treatment method which is aimed at improving patient's respiratory symptoms, train
effective coughing, clear the airway secretion, eliminate exacerbation and so on. It seems
that pulmonary physiotherapy interventions can effectively decrease hospitalization, reduce
the risk of complications and improve the patient's medical condition.
The aim of this study is to evaluate the effectiveness of the hold breathing technique, chest
expansion exercise, postural drainage procedure and Cough techniques carried out during
pulmonary physiotherapy sessions.
The researchers will invite 40 hospitalized patients in Imam Khomeini Hospital Complex,
Tehran, Iran. All patients will be enrolled after taking informed consent. All of the
procedure will be performed with the coordination of the patient's physicians. Patients will
be randomized to the intervention or control group. Primary outcome measurements will be
evaluated immediately before and after the interventions (with three days period). Also,
patient's condition (including process of disease progression, mortality, hospital stay
duration and re-admission) will be followed until one month using medical records review and
interviewing with the patient or his/her family. Patient's health related quality of life
will be measured using short form-36 quality of life assessment tool one month after the end
of interventions. Intention-to-treat analysis will be performed in the patients that dropped
out of the study.
Other: Pulmonary Physiotherapy Techniques
Participants will receive pulmonary physiotherapy techniques in six session during three days (twice daily). Four distinguished interventions will be provided for the patients: 1) Chest expansion exercises (for prevention and treatment of potential atelectasis); 2) Techniques to Mobilize or loosen the pulmonary secretions (Active cycle breathing, Coughing techniques, Vibration and Postural drainage); 3) Hold breathing exercise (3 sets, 10 repetition) and; 4) Walking training (based on patient's tolerance until 6 minute).
Inclusion Criteria:
1. Patients with COVID-19 pneumonia confirmed by RT-PCR test and diagnostic radiology.
2. Non-intubated patients
3. Patients with full consciousness
4. Be able to walking and performing exercises.
5. O2 Saturation < 88% when free air breathing.
6. be able to write and read in Farsi
Exclusion Criteria:
1. Any type of musculoskeletal disorder disabling patient to participate to study.
2. Intubation during the period of intervention
3. Patients' dissatisfaction to continue the study for any reason.
Imam Khomeini Hospital Complex
Tehran, Iran, Islamic Republic of
Mohammad Javaherian, Ph.D. cand., Principal Investigator
Tehran University of Medical Sciences