{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:43Z","timestamp":1789538683564,"version":"build-2803163510"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID-19 may lead to persistent sequelae that impair functional capacity, resulting in dyspnea, fatigue, and limitations in activities of daily living.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate exercise capacity, fatigue, dyspnea, and functional status in patients following hospitalization for COVID-19 who underwent an outpatient pulmonary rehabilitation program (PRP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was approved by the Research Ethics Committee of UniEVANG\u00c9LICA (approval number 4,296,707; September 24, 2020) and registered at ClinicalTrials.gov (Identifier: NCT04982042). This prospective single-arm non-randomized clinical trial included symptomatic individuals after COVID-19 infection. Exercise capacity was assessed using the Six-Minute Walk Test, muscle fatigue using the Fatigue Severity Scale (FSS), modified Medical Research Council (mMRC) Dyspnea Scale, and functional status using the Post-COVID-19 Functional Status Scale (PCFS). The PRP consisted of cardiorespiratory training and muscle strengthening exercises performed three times per week for six weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 54 patients were included (29 in the Ward Group and 25 in the ICU Group). After the PRP, 6MWT distance increased from 428.52\u2009\u00b1\u2009104.5\u2005m to 503.19\u2009\u00b1\u200998.04\u2005m (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001), mMRC dyspnea decreased from 3.50\u2009\u00b1\u20091.31 to 1.56\u2009\u00b1\u20090.60 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001), PCFS improved from 2.91\u2009\u00b1\u20090.59 to 0.63\u2009\u00b1\u20090.75 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and FSS decreased from 4.68\u2009\u00b1\u20091.50 to 2.97\u2009\u00b1\u20091.55 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The Ward Group showed greater unadjusted gains than the ICU Group; however, multivariable analysis identified lower baseline 6MWD as the only independent predictor of improvement (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.547;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), whereas ICU admission was not independently associated with the magnitude of gain (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.246).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The outpatient PRP was associated with significant improvements in exercise capacity, fatigue, dyspnea, and functional status. Lower baseline exercise capacity predicted greater improvement, regardless of ICU admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2026.1921478","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:31:28Z","timestamp":1789536688000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of an outpatient pulmonary rehabilitation program on exercise capacity, muscle fatigue, dyspnea, and functional status in post-COVID-19 patients: non-randomized clinical trial"],"prefix":"10.3389","volume":"7","author":[{"given":"Miri\u00e3 C.","family":"Oliveira","sequence":"first","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Capodaglio","sequence":"additional","affiliation":[{"name":"Research Laboratory for Biomechanics, Orthopaedic Rehabilitation Unit, Rehabilitation and Ergonomics, Ospedale San Giuseppe","place":["Milan, Italy"]},{"name":"Physical and Rehabilitation Medicine Sector, Department of Biomedical, Surgical and Dental Sciences, University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heren N. C.","family":"Paix\u00e3o","sequence":"additional","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano L.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa R.","family":"Alves","sequence":"additional","affiliation":[{"name":"Health Sciences Graduate Program (PPGCS), Faculty of Medical Sciences (FCMSCSP), Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo B. 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C.","family":"Andraus","sequence":"additional","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deise A. A. P.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia S.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Human Movement and Rehabilitation Graduate Programn (PPGMHR), Evangelical University of Goi\u00e1s (UNIEVANGELICA)","place":["An\u00e1polis, Brazil"]},{"name":"Health Sciences Graduate Program (PPGCS), Faculty of Medical Sciences (FCMSCSP), Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]},{"name":"Department Rehabilitation, Barretos Cancer Hospital","place":["Barretos, S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H. 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