The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome 2024 Michalas et al

Abstract

Background: Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome.

Methods: The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups.

Results: No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02).

Conclusions: Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.

Open access, https://www.mdpi.com/2075-4426/14/5/515

 

When the lack of statistically significant differences between the exercise group and control group is so glaring that all you can put under Conclusions is 'Similar studies have reported...'

 

Well if the problem was specifically about doing those specific exercises and how much people can lift, which it isn't, it still wouldn't amount to much as the differences are trivial and basically have nothing to do with the problem. Might as well have people train with yo-yos and report that they do better at playing with yo-yos for all that this matters. Or, oh, I'm sorry, report that other studies may have shown that training with yo-yos may be good for yo-yoing skills.

The only slightly relevant is dyspnea score, but the control group saw a similar decrease (2.5 -> 1.55 vs 2.25 -> 1.8), and only people able to engage with interval and strength training will be excluded so this has limited validity. Having slightly less dyspnea to begin with probably explains the lesser decrease.

Yet another example of when a measure becomes a target, it ceases to be a useful measure. "How much can you lift, bro?" is not what Long Covid is about.

But boy do they go on talking about how it emphasizes how thoroughly important physical therapy is, specifically of structured exercise programs, as people employed making people go through exercise programs.

 

Er no, these results are enough to say that there is no point in this approach.
The result is negative.
If it was of any important the p values would be much lower.

 

In the Discussion they say "The main limitation is the small sample size. Beyond the participants’ willingness, difficult transportation to the hospital and a pessimistic view of the benefits of rehabilitation played a significant role in participants’ decision to take part or not. It has long been acknowledged that these variables play a major role in participants’ refusal of pulmonary rehabilitation." You'd think it might prompt some reflection about whether that "pessimistic view" might in fact be correct, if they can't even get a positive result with a hand-picked group of highly motivated subjects.

 

The reported improvements are tiny.

Unrelated to pt's main symptoms and difficulties. Misses the point.

Result / outcome: Let's crank out more of the same in more people to replicate this trivia and make it look like something useful is being done....

Perhaps some humility and honesty needed.

Reflect on the patients "pessimistic view" by actually listening to their responses.....