Respiratory Investigation · Mar 18, 2026

Early bedside pulmonary rehabilitation in COVID-19 pneumonia: A prospective, single-arm interventional study of safety, feasibility, and functional evaluation in isolation

By Nakazawa A, Sasaki T, Arayama Y et al.

BACKGROUND: Patients with Coronavirus Disease 2019 (COVID-19) pneumonia often experienced reduced activities of daily living due to isolation-related inactivity and muscle deconditioning. This study aimed to assess the safety and feasibility of early pulmonary rehabilitation (PR) in isolated patients with COVID-19 pneumonia and to evaluate their functional status and health-related quality of life. METHODS: A bedside PR program-prioritizing early mobilization and ambulation, supplemented with calisthenic and device-based resistance exercises, chest mobilization, and breathing exercises-was delivered in isolation rooms. Assessments included the 1-min sit-to-stand test (1MSTST), COPD Assessment Test (CAT), and Hospital Anxiety and Depression Scale (HADS) at baseline and discharge. RESULTS: In this single-arm study, 23 hospitalized patients (mean age 61 ± 11 years, 78% male) completed the program with an adherence rate of 71%. No adverse events occurred. 1MSTST repetitions increased (median change 8.0 [3.0, 12.8]; p < 0.002), with increases in oxygen saturation nadir and peak heart rate (p = 0.012 and p < 0.001, respectively). Higher adherence was correlated with greater increase in 1MSTST (r = 0.626, p = 0.010), and lower baseline 1MSTST predicted larger gains (r = -0.662, p = 0.005). CAT total score and items related to cough, phlegm, and chest tightness decreased significantly, whereas HADS depression scores worsened at discharge. CONCLUSIONS: Early bedside PR was safely and feasibly delivered to isolated patients with COVID-19 pneumonia. 1MSTST and CAT were useful tools for functional evaluation during the acute phase. TRIAL REGISTRATION: UMIN Clinical Trials Registry, UMIN000057259. Retrospectively registered on March 11, 2025.

doi.org/10.1016/j.resinv.2026.101406 Open access PubMed 41855996 Interventions