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Journal of Integrative Medicine


Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review

Masoud Rahmati a, Mahdieh Molanouri Shamsi b, Wongi Woo c, Ai Koyanagi d,e, Seung Won Lee f, Dong Keon Yon g,h, Jae Il Shin i, Lee Smith j   

  1. a Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, 6816785468, Khoramabad, Iran
    b Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, 1411713116, Tehran, Iran
    c Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Gangnam-gu, Seoul 06273, Republic of Korea
    d Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830, Barcelona, Spain
    e Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, 08010, Spain
    f Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
    g Medical Science Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea
    h Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul 02447, Republic of Korea
    i Department of Pediatrics, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
    j Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
  • Received:2022-04-18 Accepted:2022-09-25 Online:2023-01-20 Published:2023-01-20
  • Contact: Masoud Rahmati; E-mail address: Jae Il Shin; E-mail address: Mahdieh Molanouri Shamsi; E-mail address:

Background: Hospitalized patients recovering from coronavirus disease 2019 (COVID-19) may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge. However, to date, no attempt has been made to collate and synthesize literature in this area.

Objective: This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.

Search strategy: A systematic search of MEDLINE/PubMed, CINAHL, Scopus and medRxiv was conducted to identify articles published up to March 2022.

Inclusion criteria: This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity, exercise, or breathing training to enhance or restore functional capacity, pulmonary function, quality of life, and mental health or function.

Data extraction and analysis: Selection of included articles, data extraction, and methodological quality assessments were conducted by two review authors respectively, and consensus was reached through discussion and consultation with a third reviewer. Finally, we review the outcomes of studies based on four categories including: (1) functional capacity, (2) pulmonary function, (3) quality of life, and (4) mental health status.

Results: A total of 7534 titles and abstracts were screened; 10 cohort studies, 4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review. Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity, pulmonary function, quality of life and mental health status.

Conclusion: Physical rehabilitation interventions may be safe, feasible and effective in COVID-19 patients discharged from the hospital, and can improve a variety of clinically relevant outcomes. Further studies are warranted to determine the underlying mechanisms.

Key words: COVID-19, Physical activity, Exercise, Rehabilitation, Systematic review

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