A Telerehabilitation Programme Significantly Enhances Recovery in Post-Discharge COVID-19 Patients: TERECO Randomised Controlled Trial Published in Thorax
In August this year, Professor Li Jian’an, a pioneer in rehabilitation medicine in China, and his team compiled the findings of their study on “The Impact of Exercise Under Remote Monitoring on the Rehabilitation of Patients Discharged After COVID-19.” They authored the academic article titled “A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial,” which was published in August 2021 in THORAX, a journal with an impact factor as high as 10.139 (a higher impact factor indicates greater influence). By sharing these results globally, they helped achieve consensus within the medical community. Historically, very few rehabilitation-related articles have been published in THORAX, and professional papers focusing on exercise rehabilitation for patients discharged after COVID-19 are even rarer.
Report by Changjiang Daily
In 2020, when the COVID-19 epidemic in China was at its peak and no globally effective control measures had yet been identified, a clinical research project titled “The Impact of Exercise Under Remote Monitoring on the Rehabilitation of Discharged COVID-19 Patients” was jointly launched. Led by Professor Li Jian’an, the initiative involved Shangyi Information Technology and Changfeng Pharmaceutical, in collaboration with Jiangsu Province People’s Hospital, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, and Huangshi Hospital of Traditional Chinese Medicine. The digital therapeutic solution “Shukang” was prioritized as the rehabilitation software for clinical recovery from COVID-19. Given that the Shukang app facilitates remote home-based rehabilitation with ease, it effectively enabled healthcare professionals to manage and guide cardiopulmonary rehabilitation for discharged patients during this exceptional period in 2020, while allowing patients to adhere to prescribed exercise regimens in terms of timing and dosage through the app.
The study, conducted over several months, yielded clinical results for “The Impact of Exercise Under Remote Monitoring on the Rehabilitation of Patients Discharged After COVID-19” that far exceeded expectations, helping COVID-19 patients recover more quickly and effectively and return to normal life. The project’s closing meeting in August also attracted significant attention from the industry, with extensive coverage by major domestic media outlets.
SARS-CoV-2 infection primarily leads to pulmonary fibrosis and impaired lung function, resulting in a significant decline in cardiopulmonary endurance. Therefore, discharged COVID-19 patients particularly require targeted rehabilitation training focused on cardiopulmonary function. The Shukang App, a digital therapeutic solution, enables remote intelligent assessment and formulates personalized exercise prescriptions for patients. Through remote guidance, intelligent monitoring, dynamic optimization, and smart follow-up, it intervenes in patients’ lifestyles to facilitate remote home-based exercise rehabilitation, thereby improving cardiopulmonary endurance and achieving rehabilitation goals.
Upon completion of this 6-week clinical study, patients who exercised using the Shukang App achieved an average distance of 588.4 meters in the 6-minute walk test, representing a 15% improvement and approaching the level of healthy individuals of the same age (624 meters), with particularly significant enhancements.
Pulmonary Function Test – FEV1/FVC (%) Results: The APP trial group showed an average increase of 5.79%, while the general exercise group exhibited an average decrease of 0.09%.
The APP trial group showed a mean 90% improvement in lower-limb muscular endurance, demonstrating significant efficacy; the conventional exercise group showed a mean 22.2% improvement. Enhanced lower-limb muscular endurance contributes to improved cardiorespiratory fitness and better daily functional performance.
"Clinical Study Results on the Impact of Remotely Monitored Exercise on the Rehabilitation of Patients Discharged After COVID-19"
(6-minute walk test: the distance a patient can walk at their fastest tolerable pace within 6 minutes; it is an exercise test used to assess functional status in patients with moderate to severe cardiopulmonary diseases. Pulmonary function test - FEV1/FVC (%): one of the essential examinations for respiratory diseases.)
In 2019, Shukang entered the U.S. market and signed cooperation agreements with Baylor, the largest cardiac rehabilitation center in the United States, and HCA, the largest healthcare group, to initiate clinical trials at heart failure and heart transplant centers. Within three months, the 30-day readmission rate for heart failure patients was reduced from 17.8% to 2.1%. In 2020, amid the outbreak of the COVID-19 pandemic, physicians urgently deployed Shukang for patients with mild to moderate COVID-19. Within just two months, a six-member rehabilitation team in Dallas expanded its patient caseload from 200 to 3,000, and the conditions of treated patients were rapidly brought under control.
Following the outbreak of the epidemic in the United States, the number of infections rose rapidly, with patients commonly experiencing cardiopulmonary impairment. Physicians already using Shukang attempted to apply it to patients with mild to moderate COVID-19 and observed rehabilitative benefits that accelerated physical recovery. Subsequently, an increasing number of doctors began employing Shukang for the rehabilitation treatment of COVID-19 patients.
Shukang’s efficacy in cardiac rehabilitation for patients with heart failure and those recovering from COVID-19 quickly drew the attention of U.S. industry experts, prompting hospitals and insurance providers to extend partnership offers. Currently, Shukang has partnered with Blue Cross, one of the largest insurance carriers in the United States, under which the insurer covers the costs while Shukang delivers rehabilitation services to patients.
In May 2021, the National Health Commission launched the “China-Africa Twinning Hospital Cooperation Mechanism Project.” Led by experts from various fields in China, this initiative establishes one-on-one partnership agreements with African hospitals. Jiangsu Province People’s Hospital, where Professor Li Jian’an is based, signed a cooperation agreement on clinical rehabilitation research with Ain Shams University Hospital in Egypt. Changfeng Pharmaceutical and Chengdu Shangyi Information Technology participated jointly in this effort. As the sole rehabilitation software involved, “Shukang” will once again be utilized for the post-discharge rehabilitation of COVID-19 patients in Egypt, helping them improve their cardiopulmonary endurance and return to normal life as soon as possible. The project was launched in September and has a duration of one year.
With the global advancement of mobile internet and 5G, the integration of technology with the healthcare industry has gradually become a trend. In the future, digital therapeutics may create even more miracles.