Ensayo clínico aleatorizado en pacientes COVID- 19 sobre el efecto de la fisioterapia precoz en su acondicionamiento físico

INTRODUCTION: The WHO recommends early rehabilitation and mobilization interventions in patients hospitalized for COVID-19. The benefits of early physiotherapy, during the hospital stay, have not been proven in clinical trials. OBJECTIVE: To evaluate the effects of early physiotherapy and health education in hospitalized COVID-19 patients, in relation to the symptoms described in previous studies, analyzing differences between groups regarding their physical conditioning, need for oxygen therapy and hospital stay. METHODOLOGY: Randomized clinical trial with two arms, developed in hospitalization and intermediate respiratory care units, with COVID-19 patients. Sixty-four patients included in the experimental group (implementation of an early physiotherapy program after 48–72 h of admission) and 62 patients in the control group (usual treatment of the center). Sociodemographic and clinical variables: mMRC, oxygen therapy, MRC-SS, 30 s-STST, FPM, Tinetti, FRAIL-España and PCFS. They were evaluated on admission, discharge and two months after discharge. RESULTS: The experimental patients had fewer days of admission and conventional oxygen therapy. At discharge, they present a lower risk of falling (72.9% vs. 95.8%) and less weakness in MRC-SS (2.1% vs. 14.6%). At two months they had less frailty (5.0% vs. 14.5%), greater hand grip strength, less dyspnea, better results in 30s-STST and fewer post-COVID limitations (86.5% vs. 96.4%). CONCLUSIÓN: The intervention of early physiotherapy in COVID-19 patients and the health education received, prevents muscle weakness during admission, improves physical conditioning at discharge and two months later, and reduces the days of hospital stay. ClinicalTrials.gov (NCT05032885).