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. 2026 Mar 17;13:1772741. doi: 10.3389/fmed.2026.1772741

Table 1.

Characteristics of included studies.

Author, year, country Population Severity Comorbidities Sample size (IG/CG) Intervention setting/mode Exercise protocol Duration (weeks) Control Outcomes Results PEDRro score
Alsharidah et al., 2023 (13), Saudi Arabia Young female aged 18–30 years Mild to moderate (OPD cases) Not reported, most of the patients were young 48 (24/24) Telerehabilitation pulmonary exercise program

  • Breathing exercises and chest expansion exercises for 15 min

  • AE for 20–30 min, 60–80% MHR

  • RT for 30 min, 10RM

  • Three sessions/week

  • Total time 60–80 min/session

 6 Suggest performing regular everyday routines, prescribed educational presentations 6MWD, FEV1, FVC, HRQoL (SF-36) 6MWD and HRQoL were significantly improved in the intervention group compared with the control group (p = 0.001) 10
da Silva et al., 2025 (24), Brazil After hospital discharge, hemodynamically stable; no tracheostomy; not bedridden; no decompensated chronic diseases or neuromuscular and orthopedic diseases n/a (mostly severe to very severe because admitted in ICU) Mostly CVD (65%), DM, pulmonary disease, and obesity (60%) 57 (28/29) Telerehabilitation supervised by a physical therapist
(videoconference)

  • Warm-up with breathing and thoracic mobility exercises

  • AE for 30 min, RPE scale at 3–4 of 10, and 70–80% MHR

  • RT at 50–100% of 10RM for upper limbs, and 100–200% of the 30CST for lower limbs

  • ST

  • Relaxation and breathing exercises

  • Three sessions/week

  • Total duration 30–50 min/session

 8 General care and self-monitoring of vital signs (videoconference) 6MST, 2MSWT, 30CST, SF-36 (physical functioning domain) 6MST (p < 0.05), 2MSWT (p = 0.001), and HRQoL—physical functioning (p < 0.001) were significantly improved in the intervention group compared with the control group 6
Elyazed et al., 2024 (14), Egypt Aged 40–70 years, after hospital discharge or home treatment, no ICU admission n/a (no severe) All patients had obesity but no chronic disease 60 (30/30) Home exercises with telemonitoring and face-to-face supervision

  • Regular walking for 30–60 min, 5 days a week, normal pace

  • RMT for 10–15 min, two times per day, minimal load of 1–2 kg placed on the abdomen

  • RT with low weight 1–3 kg, three sets with 10 reps, two times a day, 5–7 days a week, low weight of 1–3 kg

 12 No exercise program with usual medical care 6MWD, PFI, CFS, mMRC, SF-36 CFS, 6MWD, PFI, SF-36, and mMRC were significantly improved in the intervention group compared with the control group (p < 0.001) 7
Fares et al., 2023 (25), Egypt Aged 50–70 years Post-severe DM, HT, and obesity 100 (50/50) Pulmonary rehabilitation program (outpatient clinic combined with home-based training)

  • Breathing exercises (pursed-lip breathing, diaphragmatic breathing, and incentive spirometry)

  • Circuit exercise program (stretching and body-weight exercises)

  • Walking exercise, 1–30 min/time, 1–5 sessions/day (gradually progress using time/session of each day)

  • Six sessions/week (three outpatient clinic sessions and three home sessions)

 6 Usual medical care mMRC, FVC, 6MWD mMRC, FVC, and 6MWD were significantly improved in the intervention group compared with the control group (p < 0.001) 7
Jimeno-Almazán et al., 2023 (26), Spain Non-hospitalized patients with post-COVID-19 condition, aged >18 years, with a chronic symptomatic phase lasting >12 week from symptom onset n/a (no severe) Mood disorders (n = 34), but many chronic diseases were excluded 43 (23/20)
Note; Total n = 80 from four groups, n = 23 received concurrent exercise and respiratory exercise		 A tailored multicomponent exercise program adapted from the ACSM guideline with inspiratory muscle training (center-based)

  • Concurrent training with RMT for 3 days/week (2 days of RT, 50%1RM, and 1 day of light intensity continuous training, 30–60 min), moderate-intensity variable training (MIVT): 4–6×3–5 min at 70–80% of HRR

  • Light intensity continuous training (LICT: 30–60 min, 65–70% HRR)

  • 11–16 of Borg score

  • IMT (1 set of 30 repetitions, two times/day, 62.5 ± 4.6% of maximal inspiratory pressure (MIP), 12–15 of Borg scale)

 8 Following the WHO guidelines for post-COVID-19-related illness rehabilitation VO2max, muscle strength, SF-12, GAD-7, PHQ-9, mMRC, FSS, CFS SF-12, mMRC, FSS, CFS, PHQ9, and GAD7 were significantly improved in the intervention group compared with baseline. However, no significant differences were found in any other variable between groups 9
Kaddoussi et al. (27), 2024, Tunisia Aged > 18 years, mMRC≥2 for more than 3 months Various severities ranging from mild to very severe (post-ICU) DM, HT, dyslipidemia, and thyroid disorders 30 (20/10) Exercise training (outpatient department)

  • 5-min warm-up

  • AE (walking) for 10–35 min, light intensity (increase time by 5 min/week), HR target = HREnd ± 5 bpm (from 6MWT)

  • RT for 15–20 min, 10 reps, three sets/time (body weight and dumbbell)

  • Respiratory exercise for 15 min

  • Three sessions/week, 60–90 min in each session

 6 Usual level of sedentary physical activities mMRC, FEV1, FVC, FEV1/FVC, 6MWD, SpO2, heart rate mMRC (p = 0.001) and 6MWD (p = 0.023) were significantly improved in the intervention group compared with the control group 9
Li et al., 2022 (28), China Aged 18–75 years, post-discharge COVID-19 patients with an mMRC score of 2–3 Both severe and non-severe cases 61% had at least one comorbidity (e.g., HD, HT, DM, obesity, TB, others) 119 (59/60) Home exercise program via a smartphone application (RehabApp)

  • Breathing control and thoracic expansion exercises, 2–3 sets, 12 reps, 10–15 min

  • AE at 30–60%HRR, RPE 11–14, 20–30 min

  • RT (body weight), 12 reps, 2–3 sets, 9–15 min

  • Three to four sessions/week

 6 Received short educational instructions 6MWD, lower limb muscle strength, FEV1, FVC, FEV1/FVC, PEF, MVV, SF-12, mMRC 6MWD, muscle strength, MVV, SF-12, and mMRC were significantly improved in the intervention group compared with the control group (p < 0.01) 8
Liu et al., 2020 (29), China Older adults aged > 65 years, 6 months after infection n/a (tended to be severe because all were post-hospital discharge with a variety of comorbidities) HT, DM, and osteoporosis 72 (36/36) Respiratory rehabilitation training (home-based)

  • RMT (ThresholdPEP), 10 breaths/set, three sets, 60% of maximum expiratory pressure

  • Cough exercise, 10 times, three sets

  • Diaphragmatic training, 30 times, add weight 1–3 kg

  • ST

  • Home exercise: pursed-lip breathing and coughing (30 sets/day)

  • Two sessions/week

 6 Not reported FEV1, FVC, FEV1/FVC, DLCO, 6MWD, SF-36, FIM, SAS, SDS FEV1, FVC, FEV1/FVC, DLCO, 6MWD, SF-36, and SDS were significantly improved in the intervention group compared with the control group (p < 0.05) 6
Longobardi et al., 2023 (30), Brazil Aged > 45 years, discharged from the ICU 3–6 months before study; half of the patients required MV Severe/critical HT, dyslipidemia, rheumatic disease, DM, CVD, psychological disorders, pulmonary disease, hypothyroidism, others; all patients had obesity (100%) 41 (21/20) Semi-supervised, individualized, home-based exercise training

  • AE (walking/jogging 10 min to ≥50 min/day) using Borg 9–17

  • RT, 8–15 reps, 3–5 sets, intensity progressed every 2 weeks using Borg 9–17

  • ST for the major muscle groups

  • Three sessions/week (~60–80 min/session)

 16 Standard of care SF-36, FEV1, FVC, FEV1/FVC, cardiorespiratory fitness, handgrip strength, 30CST, TUGT, FSS, BAI, BDI Only the 30CST showed no significant difference between the intervention and control groups (p = 0.48) 7
Teixeira et al., 2022 (31), Brazil Aged ≥18 years, after hospital discharge Both severe and non-severe HT, DM, CVD, hypothyroidism, respiratory disease, obesity, others 32 (12/20) Tele-supervised home-based exercise training

  • 5-min warm-up

  • RT (3 days/week on alternate days) one set of 10–15 reps (week 1), two sets of 10–15 reps (weeks 2–3), three sets of 10–15 reps (weeks 4–6), and three sets of 15–20 reps (weeks 7–12), intensity 14–17 of RPE

  • AE (5 days/week) 10–15 min (week 1), 20 min (weeks 3–4), and 30 min (weeks 5–12), intensity 11–13 of RPE

  • 5-min cool-down

 12 Not reported FEV1, FVC, FEV1/FVC, MIP, MEP, handgrip strength, FTSST, TUGT, 6MWD FEV1, FVC, and handgrip strength improved significantly (p < 0.001). Only the intervention group showed improvements in MIP and MEP compared with baseline. However, no significant differences were found in any other variable between groups 6

ACSM, American College of Sports Medicine; AE, aerobic exercise; BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; CFS, Chalder Fatigue Scale; CG, control group; CVD, cardiovascular disease; DLCO, diffusing capacity of the lung for carbon monoxide; DM, diabetes mellitus; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; FIM, Functional Independence Measure; FSS, Fatigue Severity Scale; FTSST, five-times sit-to-stand test; GAD-7, General Anxiety Disorder-7; HRQoL, health-related quality of life; HRR, heart rate reserve; HT, hypertension; ICU, intensive care unit; IG, intervention group; MEP, maximal expiratory pressure; MHR, maximum heart rate; MIP, maximal inspiratory pressure; mMRC, Modified Medical Research Council Dyspnea Scale; MVV, maximum voluntary ventilation; MV, mechanical ventilation; n/a, not applicable; PFI, Physical Fitness Index; PHQ-9, Patient Health Questionnaire-9; PEF, peak expiratory flow; reps, repetitions; RM, repetition maximum; RMT, respiratory muscle training; RPE, rating of perceived exertion; RT, resistance exercise; SAS, Self-Rating Depression Scale; SDS, Self-Rating Anxiety Scale; 6MWD, 6-min walk distance; 6MST, 6-min step test; SF-36, Short Form Health Survey-36; ST, stretching exercise; 30CST, 30-s chair stand test; TB, tuberculosis; TUGT, timed up and go test; 2MSWT, 2-min stationary walk test.