JMIR Publications

ABSTRACT

Background:

Between 30-76% of COVID-19 patients have persistent physical, cognitive and/or mental symptoms, sometimes up to 9 months after acute COVID-19 infection. The expected rush of patients needing rehabilitation put pressure on primary care practices and resources, particularly physiotherapy. A novel approach such as multimodal VR rehabilitation at home might help these patients and physiotherapists, in contrast to attempts scaling up traditional care.

Objective:

To investigate the feasibility and preliminary effectiveness of self-administered multimodal Virtual Reality (VR) at home as an adjunct to physical rehabilitation after COVID-19.

Methods:

This is a single-arm feasibility and effectiveness trial in an outpatient care setting. Patients, who needed physiotherapy because of functional loss after COVID-19, were included as determined by the referring physician and treating physiotherapist. Participants received post-COVID-19 outpatient rehabilitation extended with self-administered multimodal (physical, mental, and cognitive) VR exercises for a period of 6 weeks. Main outcomes were related to feasibility, i.e. duration and frequency of VR use, adverse events, patient satisfaction, and reasons to withdraw. Secondary outcomes were physical performance, daily activities, cognitive functioning, anxiety and depression, quality of life and Positive Health.

Results:

Forty-eight patients were included. One patient did not start VR and 7 patients (15%) withdrew because of adverse events, mostly dizziness. Global satisfaction score was 67%. Average VR use was 30 minutes, 3-4 times a week for 3-6 weeks. Significant improvements (n=40) were found on the physical performance metrics and physical complaints (Patients-Specific Complaints scale; 71.3 before, 43.9 after, P<.001). SF-12 physical score improved with 1.5 points (P =.049) and SF-12 mental score with 3.5 point (P =0.01). Positive Health improved with 10.4 points (297.5 before, 307.9 after, p=0.036). No significant changes were found for other secondary outcomes.

Conclusions:

Self-administered multimodal VR exercises at home, as an adjunct to usual physiotherapy, is well tolerated and accepted in most post-COVID-19 patients with improvements in physical and mental functioning and health. Clinical Trial: ClinicalTrials.gov NCT04505761.