This study aims to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the benefits of pulmonary rehabilitation (PR) in patients with COVID-19. 120 patients will be randomized into an interventional group (PR plus IMT) and a control group (sham IMT plus PR). Improvement in quality of life, peak VO2 and VE/VCO2 slope will be defined as a primary outcome. Maximal inspiratory pressure, inspiratory muscle endurance, pulmonary function testing, severity of fatigue, cost-effectiveness and six minute walk test will be defined as the secondary outcomes.
Device: inspiratory muscle traiing
The patients are encouraged to inhale against a load to increase the inspiratory muscle strength and endurance
Other Name: tapered flow resistive loading
Inclusion Criteria:
To be eligible, participants must be:
- over 18 years of age
- confirmed COVID-19 diagnosis
- Individuals that required hospitalization and either i) non-invasive respiratory
support (CPAP, high-flow oxygen catheter, non-breathing oxygen mask, or ii) invasive
mechanical ventilation within three months of study recruitment.
Exclusion Criteria:
- Pregnancy
- Dependence on others to perform activities of daily living during the month prior to
the current ICU admission (gait aids are acceptable)
- documented cognitive impairment
- Proven or suspected spinal cord injury, or other neuromuscular diseases that will
result in a permanent or prolonged weakness (not including ICU acquired weakness)
- Severe neurological disease
- Death is deemed inevitable as a result of the current illness and either the patient
or treating clinical or substitute decision-maker are not committed to full active
treatment.
Secretaria de Saúde do Distrito Federal
Brasilia, DF, Brazil