Effects of incentive spirometer added to standard rehabilitation in previously hospitalized adults with post-COVID-19 condition: a randomized controlled trial

Authors

  • Marina Kloni Physiotherapy Department, Rehabilitation Centre EDEN, Larnaca, Cyprus; Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
  • Alexandros Heraclides Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
  • Theognosia Panteli Physiotherapy Department, Rehabilitation Centre EDEN, Larnaca, Cyprus; Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
  • Alexios Klonis Department of Anaesthesiology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
  • Panagiotis Rentzias Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
  • Christos Karagiannis Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus

DOI:

https://doi.org/10.2340/jrm.v58.44926

Keywords:

Incentive spirometer, Post-Covid-19 syndrome, dyspnoea, peak expiratory flow, quality of life, functional outcomes

Abstract

Objective: Post-COVID-19 condition is associated with persistent respiratory symptoms and impaired functional capacity. This study evaluated the effects of adding an incentive spirometer to standard rehabilitation in adults with post-COVID-19 condition, with peak expiratory flow, dyspnoea, and quality of life as the prespecified primary outcomes.

Design: Randomized controlled trial.

Subjects/Patients: Eighty-two previously hospitalized adults diagnosed with post-COVID-19 condition, were randomly assigned to an experimental group (rehabilitation plus incentive spirometer, n = 41) or a control group (rehabilitation alone, n = 41).

Methods: Eight outcomes were assessed at baseline and 1 month, including peak expiratory flow, Medical Research Council dyspnoea scale, EQ-5D-5L, and functional performance tests.

Results: Both groups improve at 1-month follow-up. The experimental group showed greater improvements in peak expiratory flow (between-group difference = 65.85 L/min; 95% CI: 4.35 to 127.35; p = 0.007), and dyspnoea (MRC difference = −1.08; 95% CI: −1.54 to −0.62; p < 0.001) compared with the control group. No significant between-group differences were observed for quality of life or functional performance measures.

Conclusion: Adding incentive spirometry to standard rehabilitation improved peak expiratory flow and reduced dyspnoea in adults with post-COVID-19 condition, supporting its use as a low-cost adjunct for respiratory symptom management.

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References

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Published

2026-05-05

How to Cite

Kloni, M., Heraclides, A., Panteli, T., Klonis, A., Rentzias, P., & Karagiannis, C. (2026). Effects of incentive spirometer added to standard rehabilitation in previously hospitalized adults with post-COVID-19 condition: a randomized controlled trial. Journal of Rehabilitation Medicine, 58, jrm44926. https://doi.org/10.2340/jrm.v58.44926

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