CHEST Guidelines-How-to-Safely-Reopen-Cardiopulmonary-Rehabilitatio

How-to-Safely-Reopen-Cardiopulmonary-Rehabilitatio

Pdf Summary

The article outlines strategies for safely reopening cardiopulmonary rehabilitation facilities, which are vital for patients with chronic cardiac or respiratory disorders, by highlighting the improvements they offer in quality of life, reducing hospital admissions, and alleviating mental health issues. The COVID-19 pandemic resulted in the suspension of many such facilities due to concerns over virus transmission through aerosols.<br /><br />Initial guidance for reopening was provided by the American Thoracic Society, advising measures like mask-wearing and maintaining physical distance. However, questions about aerosol generation during exercises in these settings remained. A study by Helgeson et al. examined aerosol particle concentrations generated during exercise by healthy volunteers and found significant increases primarily during intense activity. This prompted further investigation.<br /><br />Helgeson et al. subsequently conducted a study with 24 patients in a rehabilitation center, where all participants wore masks. They observed increased aerosol particle concentrations, especially of larger particles, during exercise. This suggests that cardiopulmonary rehabilitation could be aerosol-generating, potentially impacting viral transmission risk depending on room size, ventilation rates, and exercise intensity.<br /><br />The study underscores the need for measures like adequate room ventilation, physical barriers, and possibly the use of more effective personal protective equipment like N95 masks, especially if ventilation modifications aren't feasible. The findings also stress the importance of further research into safe participant numbers in rehabilitation settings and the viral load of aerosols to better understand transmission risks. Continuous improvement of facility ventilation and air purification systems is recommended to minimize any potential risk.

Keywords

cardiopulmonary rehabilitation

COVID-19

aerosol transmission

American Thoracic Society

exercise safety

ventilation

N95 masks

aerosol particles

viral transmission

facility reopening