EFFECTIVENESS OF HOME-BASED REHABILITATION IN POST-COVID FUNCTIONAL RECOVERY: LONGITUDINAL STUDY

Abstract

Background:
A considerable proportion of individuals recovering from coronavirus disease 2019 continue to experience persistent functional limitations, fatigue, and reduced exercise tolerance after the acute phase. Access to conventional facility-based rehabilitation remains limited in many low- and middle-income settings, highlighting the need for alternative, accessible rehabilitation models.

Objective:
To evaluate the effectiveness of a structured home-based rehabilitation program supported by tele-physiotherapy on functional recovery among post-COVID individuals in Karachi, Pakistan.

Methods:
A longitudinal study was conducted over six months in selected urban healthcare settings in Karachi. A total of 108 post-COVID participants were enrolled, with 96 completing follow-up assessments. Participants received an individualized home-based rehabilitation program delivered through tele-physiotherapy. Outcomes were assessed at baseline, three months, and six months using the Functional Independence Measure, six-minute walk test, Fatigue Severity Scale, and Short Form-36 questionnaire. Data were normally distributed and analyzed using repeated measures analysis of variance with post hoc comparisons.

Results:
Significant improvements were observed across all outcome measures over time. Mean Functional Independence Measure scores increased from 96.3 ± 14.8 at baseline to 118.7 ± 12.1 at six months (p < 0.001). Six-minute walk test distance improved from 382.4 ± 76.5 meters to 481.6 ± 68.4 meters (p < 0.001). Fatigue Severity Scale scores decreased from 4.9 ± 1.1 to 2.8 ± 0.9, while both physical and mental components of quality of life demonstrated statistically significant improvement (p < 0.001).

Conclusion:
Home-based rehabilitation supported by tele-physiotherapy was associated with meaningful and sustained functional recovery in post-COVID individuals. This approach represents a feasible and effective rehabilitation model for resource-limited healthcare settings.

Keywords:
COVID-19, Exercise Tolerance, Fatigue, Functional Recovery, Rehabilitation, Telemedicine, Quality of Life