Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome
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Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome. / Metcalfe, Richard S.; Swinton, Paul A.; Mackintosh, Kelly A.; Berg, Ronan M.G.; Shelley, James; Saynor, Zoe L.; Hudson, Joanne; Duckers, Jamie; Lewis, Keir; Davies, Gwyneth A.; McNarry, Melitta A.
I: Medicine and Science in Sports and Exercise, Bind 55, Nr. 10, 2023, s. 1761-1769.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome
AU - Metcalfe, Richard S.
AU - Swinton, Paul A.
AU - Mackintosh, Kelly A.
AU - Berg, Ronan M.G.
AU - Shelley, James
AU - Saynor, Zoe L.
AU - Hudson, Joanne
AU - Duckers, Jamie
AU - Lewis, Keir
AU - Davies, Gwyneth A.
AU - McNarry, Melitta A.
N1 - Publisher Copyright: © Lippincott Williams & Wilkins.
PY - 2023
Y1 - 2023
N2 - Purpose The objective of this study is to investigate whether heterogeneous treatment effects occur for changes in inspiratory muscle strength, perceived dyspnea, and health-related quality of life after 8 wk of unsupervised home-based inspiratory muscle training (IMT) in adults with postacute coronavirus disease 2019 (COVID-19) syndrome. Methods In total, 147 adults with self-reported prior COVID-19 either completed an 8-wk home-based IMT intervention (n = 111, 92 females, 48 ± 11 yr, 9.3 ± 3.6 months postacute COVID-19 infection) or acted as "usual care"wait list controls (n = 36, 34 females, 49 ± 12 yr, 9.4 ± 3.2 months postacute COVID-19 infection). Results Applying a Bayesian framework, we found clear evidence of heterogeneity of treatment response for inspiratory muscle strength: the estimated difference between standard deviations (SD) of the IMT and control groups was 22.8 cm H2O (75% credible interval (CrI), 4.7-37.7) for changes in maximal inspiratory pressure (MIP) and 86.8 pressure time units (75% CrI, 55.7-116.7) for sustained MIP (SMIP). Conversely, there were minimal differences in the SD between the IMT and the control group for changes in perceived dyspnea and health-related quality of life, providing no evidence of heterogeneous treatment effects. Higher cumulative power during the IMT intervention was related to changes in MIP (β = 10.9 cm H2O (95% CrI, 5.3-16.8) per 1 SD) and SMIP (β = 63.7 (32.2-95.3) pressure time units per 1 SD), clearly indicating an IMT dose response for changes in inspiratory muscle strength. Older age (>50 yr), a longer time postacute COVID-19 (>3 months), and greater severity of dyspnea at baseline were also associated with smaller improvements in inspiratory muscle strength. Conclusions Heterogeneous individual responses occurred after an 8-wk home-based IMT program in people with postacute COVID-19 syndrome. Consistent with standard exercise theory, larger improvements in inspiratory muscle strength are strongly related to a greater cumulative dose of IMT.
AB - Purpose The objective of this study is to investigate whether heterogeneous treatment effects occur for changes in inspiratory muscle strength, perceived dyspnea, and health-related quality of life after 8 wk of unsupervised home-based inspiratory muscle training (IMT) in adults with postacute coronavirus disease 2019 (COVID-19) syndrome. Methods In total, 147 adults with self-reported prior COVID-19 either completed an 8-wk home-based IMT intervention (n = 111, 92 females, 48 ± 11 yr, 9.3 ± 3.6 months postacute COVID-19 infection) or acted as "usual care"wait list controls (n = 36, 34 females, 49 ± 12 yr, 9.4 ± 3.2 months postacute COVID-19 infection). Results Applying a Bayesian framework, we found clear evidence of heterogeneity of treatment response for inspiratory muscle strength: the estimated difference between standard deviations (SD) of the IMT and control groups was 22.8 cm H2O (75% credible interval (CrI), 4.7-37.7) for changes in maximal inspiratory pressure (MIP) and 86.8 pressure time units (75% CrI, 55.7-116.7) for sustained MIP (SMIP). Conversely, there were minimal differences in the SD between the IMT and the control group for changes in perceived dyspnea and health-related quality of life, providing no evidence of heterogeneous treatment effects. Higher cumulative power during the IMT intervention was related to changes in MIP (β = 10.9 cm H2O (95% CrI, 5.3-16.8) per 1 SD) and SMIP (β = 63.7 (32.2-95.3) pressure time units per 1 SD), clearly indicating an IMT dose response for changes in inspiratory muscle strength. Older age (>50 yr), a longer time postacute COVID-19 (>3 months), and greater severity of dyspnea at baseline were also associated with smaller improvements in inspiratory muscle strength. Conclusions Heterogeneous individual responses occurred after an 8-wk home-based IMT program in people with postacute COVID-19 syndrome. Consistent with standard exercise theory, larger improvements in inspiratory muscle strength are strongly related to a greater cumulative dose of IMT.
KW - BREATHING
KW - BREATHLESSNESS
KW - LONG COVID
KW - POSTACUTE COVID-19 SYNDROME
KW - REHABILITATION
KW - TREATMENT
UR - http://www.scopus.com/inward/record.url?scp=85171392951&partnerID=8YFLogxK
U2 - 10.1249/MSS.0000000000003207
DO - 10.1249/MSS.0000000000003207
M3 - Journal article
C2 - 37170947
AN - SCOPUS:85171392951
VL - 55
SP - 1761
EP - 1769
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
SN - 0195-9131
IS - 10
ER -
ID: 370487901