With the COVID-19 pandemic, the number of patients to be treated in rehabilitation increased . Hospitalization for severe infection can induce muscular atrophy and muscular dysfunction that persists for several months and rehabilitation capacities may be exceeded. Exercises in eccentric mode could be performed, inducing greater muscular hypertrophy, muscle strength, power and speed than concentric exercises. The goal of this study was to compare functional recovery at 2 months after a training program in eccentric and concentric mode after severe COVID-19. An effective rehabilitation could help reduce costs and duration of care.
This is a prospective, open, controlled randomized study (2 x 60 individuals) performed in 5
centers. Participants will perform 24 exercise sessions on cycloergometer (3 sessions/week, 8
weeks). The experimental group (eccentric) will perform 5 habituation sessions: the initial
power of the exercise will be set to 10 Watts and then increased by 10% each session,
depending on the muscle tolerance. The training power must correspond to 3 times that of the
control group to obtain a similar metabolic stimulation. The control group (concentric) will
perform exercise training at an intensity of 60% of the reserve heart rate determined during
an initial cardiorespiratory test. The primary outcome will be the change in distance covered
during the 6-min walk test between the initial assessment and month 2. Secondary outcomes
will include study of sarcopenia, muscle strength, general and muscular fatigue, quality of
life, blood metabolomic data, ex vitro data for mitochondrial and histo-biochemical
functionality from muscle biopsies of the Vastus Lateralis.
Other: Rehabilitation by Eccentric exercises
Participants will perform 24 exercises sessions (30 minutes) with cycloergometer in eccentric mode (while resisting against self-paced pedaling), inducing a greater muscular hypertrophy as compared with concentric mode, the mechanical stimulation being 3 to 4 times greater at the same level metabolic stimulation.
Other: Rehabilitation by Concentric exercises
The control group (concentric) will perform exercise training at an intensity of 60% of the reserve heart rate determined during an initial cardiorespiratory test. The power will be adjusted weekly to stay within the target heart rate range.
Inclusion Criteria:
- Male or female, 18 to 80 years old
- Diagnosed for SARS-CoV-2 infection (COVID-19) requiring a rehabilitation program at
least 1 month after the hospitalization
- Autonomy in daily life activities 1 month after diagnosis
- Able to walk for 6 min (discontinuous walking possible)
- Giving informed written consent to participate in the study
- Health insurance coverage
Exclusion Criteria:
- Cardiovascular or respiratory contraindication to the rehabilitation program
- Difficulty to perform an eccentric exercise on a seated ergometer
- Pregnant or breastfeeding
- Under guardianship, curatorship or deprived of liberty
- Taking antivitamin K anticoagulation (muscle biopsy)
- Refusal to participate
CHU de Clermont-Ferrand
Clermont-Ferrand, France
CHU de Dijon
Dijon, France
CHU de Saint-Etienne
Saint-Étienne, France
Lise Laclautre, PharmD
04 73 754 963 - 33
promo_interne_drci@chu-clermontferrand.fr