Table 2. Principal recommendations for discharged patients.
| Consideration | Description |
| Exclusion criteria | (1) Heart rate >100 beats/min; (2) blood pressure <90/60 mmHg or >140/90 mmHg; (3) blood oxygen saturation ≤95%; (4) other diseases in which exercise is unsuitable. |
| Exercise termination criteria | (1) Fluctuations in body temperature >37.2 °C; (2) respiratory symptoms and fatigue worsen and are not relieved after rest; (3) stop activities immediately and consult a doctor if the following symptoms occur: chest tightness, chest pain, breathing difficulties, severe cough, dizziness, headache, blurred vision, palpitations, sweating, trouble standing. |
| Rehabilitation evaluation | Clinical evaluation: physical examination, imaging,
laboratory tests, lung function tests. Evaluation of exercise and respiratory function: (1) Respiratory muscle strength: maximum inspiratory pressure/maximum expiratory pressure. (2) Muscle strength (Medical Research Council), isokinetic muscle testing. (3) Joint range-of-motion measurement. (4) Balance function evaluation: Berg Balance Scale. (5) Aerobic exercise capacity: 6MWT. (6) Physical activity assessment: international physical activity level tables (International Physical Activity Questionnaire), physical activity scale for the elderly. Assessment of daily living ability: assessment of activities of daily living (ADL) (Barthel index). |
| Respiratory rehabilitation interventions |
Patient education: (1) manuals or video materials to
explain the importance of respiratory rehabilitation; (2) healthy lifestyle
education; (3) encourage patients to participate in family and social activities.
Recommendations for respiratory rehabilitation: (1) Aerobic exercises for patients such as walking, brisk walking, jogging, and swimming, starting from low intensity, gradually increasing the intensity and duration: 3–5 times per week for 20–30 min each time. Intermittent exercise can be used in patients who are prone to fatigue. (2) Strength training: progressive resistance training is recommended for strength training with a frequency of 2–3 times per week, with a training period of 6 weeks and a weekly increase of 5%–10%. (3) Balance training: patients with balance dysfunction should undergo balance training, including hands-free training and balance training using a device, under the guidance of a physiotherapist. (4) Breathing training: if patients have shortness of breath, wheezing, and difficulty with sputum discharge, they must begin breathing and sputum training and breathing mode training including body management, adjusting breathing rhythm, thoracic activity training, and mobilizing breathing muscle group participation. Sputum training: first, patients can use breathing techniques to help reduce sputum and energy consumption in coughing; second, patients may need to be assisted with positive expiratory pressure (PEP)/oscillatory PEP and other equipment. ADL guidance: (1) Basic ADL: assess ability to perform daily activities such as training transfer, grooming, toileting, and bathing, and provide rehabilitation guidance for daily life obstacles. (2) Instrumental ADL: assess the ability of instrumental daily activities, identify obstacles in task participation, and conduct targeted intervention under the guidance of an occupational therapist. |