{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:30:06Z","timestamp":1793237406017,"version":"4.5.0"},"reference-count":59,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2023,5,26]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The potential additive benefits of rehabilitation beyond spontaneous recovery post-COVID-19 currently remain unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this prospective, interventional, non-randomised parallel assignment two-arm study, we investigated the effects of an 8-week rehabilitation programme (Rehab, n=25) added to usual care (UC) versus UC (n=27) on respiratory symptoms, fatigue, functional capacity, mental health and health-related quality of life in patients with COVID-19 pneumonia, 6\u20138 weeks post-hospital discharge. The rehabilitation programme included exercise, education, dietary and psychological support. Patients with chronic obstructive pulmonary disease, respiratory and heart failure were excluded from the study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At baseline, groups were not different in mean age (56 years), gender (53% female), intensive care unit admission (61%), intubation (39%), days of hospitalisation (25), number of symptoms (9) and number of comorbidities (1.4). Baseline evaluation was conducted at median (IQR) 76 (27) days after symptoms onset. Groups were not different regarding baseline evaluation outcomes. At 8\u2009weeks, Rehab showed significantly greater improvement in COPD Assessment Test by a mean\u00b1SEM (95%\u2009CI) 7.07\u00b11.36 (4.29\u20139.84), p &lt;0.001 <jats:underline>and<\/jats:underline> all three fatigue questionnaires: Chalder-Likert: 5.65\u00b11.27 (3.04\u20138.25), p &lt;0.001; bimodal: 3.04\u00b10.86 (1.28\u20134.79), p=0.001; Functional Assessment of Chronic Illness Therapy: 6.37\u00b12.09 (2.08\u201310.65), p=0.005\u2009and Fatigue Severity Scale: 1.36\u00b10.433 (0.47\u20132.25), p=0.004. At 8 weeks rehab also showed significantly greater improvment in Short Physical Performance Battery: 1.13\u00b10.33 (0.46\u20131.79), p=0.002; Hospital Anxiety and Depression Scale (HADS) <jats:underline>A<\/jats:underline>nxiety: 2.93\u00b11.01 (0.67\u20135.18), p=0.013; Beck Depression Inventory: 7.81\u00b13.07 (1.52\u201314.09), p=0.017; Montreal Cognitive Assessment: 2.83\u00b10.63 (1.5\u20134.14), p &lt;0.001; EuroQol (EQ-5D-5L) Utility Index: 0.21\u00b10.05 (0.1\u20130.32), p=0.001\u2009and Visual Analogue Scale: 6.57\u00b13.21 (0.2\u201313.16), p=0.043. Both groups significantly improved 6-min walking distance by approximately 60 m and pulmonary function measures, whereas post-traumatic stress disorder measurement IES-R (Impact of Event Scale, Revised) and HADS-Depression score were not different between groups at 8\u2009weeks. A 16% attrition rate was observed in the rehabilitation group exhibiting a threefold increase in training workload. There were no adverse effects reported during exercise training.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These findings highlight the added value of rehabilitation post-COVID-19 to amplify the natural course of physical and mental recovery that otherwise would remain incomplete with UC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2022-001377","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T14:05:31Z","timestamp":1688047531000},"page":"e001377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Additive benefit of rehabilitation on physical status, symptoms and mental health after hospitalisation for severe COVID-19 pneumonia"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0425-6543","authenticated-orcid":false,"given":"Andreas","family":"Asimakos","sequence":"first","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavroula","family":"Spetsioti","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"},{"name":"Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspasia","family":"Mavronasou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"},{"name":"Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece"},{"name":"Clinical Exercise Physiology and Rehabilitation Laboratory, Physiotherapy Department, University of Thessaly, Lamia, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Gounopoulos","sequence":"additional","affiliation":[{"name":"2nd Cardiology Department, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Siousioura","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Effrosyni","family":"Dima","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Gianniou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Sigala","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Zakynthinos","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Kotanidou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"},{"name":"Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Vogiatzis","sequence":"additional","affiliation":[{"name":"Sport, Exercise & Rehabilitation, University of Northumbria at Newcastle, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Katsaounou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care and Pulmonary Services, Evaggelismos Hospital, Athens, Greece"},{"name":"Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"2025083110094784000_10.1.e001377.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m3026","article-title":"Management of post-acute COVID-19 in primary care","volume":"370","author":"Greenhalgh","year":"2020","journal-title":"BMJ"},{"key":"2025083110094784000_10.1.e001377.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32656-8"},{"key":"2025083110094784000_10.1.e001377.3","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(21)00383-0"},{"key":"2025083110094784000_10.1.e001377.4","doi-asserted-by":"crossref","unstructured":"Evans RA , Leavy OC , Richardson M . 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