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Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition

INTRODUCTION: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct “evidence on” rehabilitation interventions for people with post-COVID-19 condition (PCC), we can search and syn...

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Autores principales: ARIENTI, Chiara, CORDANI, Claudio, LAZZARINI, Stefano G., DEL FURIA, Matteo J., NEGRINI, Stefano, KIEKENS, Carlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Edizioni Minerva Medica 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077961/
https://www.ncbi.nlm.nih.gov/pubmed/36472558
http://dx.doi.org/10.23736/S1973-9087.22.07802-9
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author ARIENTI, Chiara
CORDANI, Claudio
LAZZARINI, Stefano G.
DEL FURIA, Matteo J.
NEGRINI, Stefano
KIEKENS, Carlotte
author_facet ARIENTI, Chiara
CORDANI, Claudio
LAZZARINI, Stefano G.
DEL FURIA, Matteo J.
NEGRINI, Stefano
KIEKENS, Carlotte
author_sort ARIENTI, Chiara
collection PubMed
description INTRODUCTION: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct “evidence on” rehabilitation interventions for people with post-COVID-19 condition (PCC), we can search and synthesize the indirect “evidence relevant to” coming from interventions effective for the symptoms of PCC in other health conditions. The World Health Organization (WHO) required this information to inform expert teams and provide specific recommendations in their Guidelines. With this overview of reviews with mapping, we aimed to synthesize in a map the Cochrane evidence relevant to rehabilitation for fatigue, post-exertional malaise and orthostatic intolerance due to PCC. EVIDENCE ACQUISITION: We searched the last five years’ Cochrane Systematic Review (CSRs) using the terms “fatigue,” “orthostatic intolerance,” “rehabilitation” and their synonyms in the Cochrane Library. We extracted and summarized the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence. EVIDENCE SYNTHESIS: Out of 1397 CSRs published between 2016 and 2021, we included 32 for fatigue and 4 for exercise intolerance. They provided data from 13 health conditions, with cancer (11 studies), chronic obstructive pulmonary disease (7 studies), fibromyalgia (4 studies), and cystic fibrosis (3 studies) being the most studied. Effective interventions for fatigue included exercise training and physical activities, telerehabilitation and multicomponent and educational interventions. Effective interventions for exercise intolerance included combined aerobic/anaerobic training and integrated disease rehabilitation management. The overall quality of evidence was low to very low and moderate in very few cases. We did not identify CSRs that specifically addressed post-exertional malaise or orthostatic intolerance. CONCLUSIONS: These results are the first step of indirect evidence able to generate helpful hypotheses for clinical practice and future research. They served as the basis for the three recommendations on treatments for these PCC symptoms published in the current WHO Guidelines for clinical practice.
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spelling pubmed-100779612023-04-07 Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition ARIENTI, Chiara CORDANI, Claudio LAZZARINI, Stefano G. DEL FURIA, Matteo J. NEGRINI, Stefano KIEKENS, Carlotte Eur J Phys Rehabil Med Article INTRODUCTION: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct “evidence on” rehabilitation interventions for people with post-COVID-19 condition (PCC), we can search and synthesize the indirect “evidence relevant to” coming from interventions effective for the symptoms of PCC in other health conditions. The World Health Organization (WHO) required this information to inform expert teams and provide specific recommendations in their Guidelines. With this overview of reviews with mapping, we aimed to synthesize in a map the Cochrane evidence relevant to rehabilitation for fatigue, post-exertional malaise and orthostatic intolerance due to PCC. EVIDENCE ACQUISITION: We searched the last five years’ Cochrane Systematic Review (CSRs) using the terms “fatigue,” “orthostatic intolerance,” “rehabilitation” and their synonyms in the Cochrane Library. We extracted and summarized the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence. EVIDENCE SYNTHESIS: Out of 1397 CSRs published between 2016 and 2021, we included 32 for fatigue and 4 for exercise intolerance. They provided data from 13 health conditions, with cancer (11 studies), chronic obstructive pulmonary disease (7 studies), fibromyalgia (4 studies), and cystic fibrosis (3 studies) being the most studied. Effective interventions for fatigue included exercise training and physical activities, telerehabilitation and multicomponent and educational interventions. Effective interventions for exercise intolerance included combined aerobic/anaerobic training and integrated disease rehabilitation management. The overall quality of evidence was low to very low and moderate in very few cases. We did not identify CSRs that specifically addressed post-exertional malaise or orthostatic intolerance. CONCLUSIONS: These results are the first step of indirect evidence able to generate helpful hypotheses for clinical practice and future research. They served as the basis for the three recommendations on treatments for these PCC symptoms published in the current WHO Guidelines for clinical practice. Edizioni Minerva Medica 2022-12-06 /pmc/articles/PMC10077961/ /pubmed/36472558 http://dx.doi.org/10.23736/S1973-9087.22.07802-9 Text en 2022 THE AUTHORS https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License.
spellingShingle Article
ARIENTI, Chiara
CORDANI, Claudio
LAZZARINI, Stefano G.
DEL FURIA, Matteo J.
NEGRINI, Stefano
KIEKENS, Carlotte
Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title_full Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title_fullStr Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title_full_unstemmed Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title_short Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition
title_sort fatigue, post-exertional malaise and orthostatic intolerance: a map of cochrane evidence relevant to rehabilitation for people with post covid-19 condition
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077961/
https://www.ncbi.nlm.nih.gov/pubmed/36472558
http://dx.doi.org/10.23736/S1973-9087.22.07802-9
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