# Impact of an asynchronous telerehabilitation program on the self-efficacy and motivation for physical activity in discharged COVID-19 patients: a secondary analysis of a randomized controlled trial

## TL;DR

An asynchronous telerehabilitation program improved self-efficacy and motivation in recovering COVID-19 patients, but these benefits faded over time.

## Contribution

This study evaluates the impact of asynchronous telerehabilitation on self-efficacy and motivation in post-discharge COVID-19 patients.

## Key findings

- The telerehabilitation group showed better self-efficacy and extrinsic motivation at 3- and 6-month follow-ups.
- Self-efficacy correlated with physical performance metrics like the six-minute walk test and 30-second chair stand test.
- Improvements in motivation and self-efficacy were moderate to large but not sustained long-term.

## Abstract

Telerehabilitation has become an important tool for the recovery of coronavirus disease (COVID-19) patients, allowing treatment to be continued remotely for this and other pathologies. Self-efficacy plays a key role in motivating and ensuring adherence to these programs. The aim of this study was to evaluate the effects on self-efficacy (GSES) and sport motivation (BRSQ-36) and analyze the correlation between self-efficacy and physical condition after a program composed of therapeutic exercises and education.

This pilot randomized controlled trial included 35 post-discharge COVID-19, with two groups: an asynchronous telerehabilitation and a booklet-based rehabilitation groups who undertook a 12-week intervention of therapeutic exercise and education..

The telerehabilitation group showed better results in all variables analyzed, with moderate and large clinical changes in overall motivation d = 0.8, but no significant changes. At the 3- and 6-month follow-up, statistically significant differences in self-efficacy were found in favor of the telerehabilitation group (3-m, p = 0.025, d = 0.76); 6-m, p = 0.007, d = 0.79). The telerehabilitation group showed better results in ‘Extrinsic Motivation’ (3-m, p = 0.037, d = 0.75; 6-m, p = 0.010, d = 0.94) and ‘Identified Regulation’ (3-m, p < 0.001, d = 1.09; 6-m, p = 0.005, d = 0.49) after 3- and 6-month follow-up. . In all patients, a direct correlation was found between self-efficacy and meters walked in the six minutes’ walk test (6 MWT) (p = 0.022; R2 = 0.149), ‘30 STST and 30’ ACT (p = 0.002; R2 = 0.261; p = 0.017; R2 = 0.160), respectively; an inverse correlation was found after three months with the fatigue variable (p < 0.001; R2 = 0.2858) and after six months (p < 0.001; R2 = 0.2889).

The findings highlight the potential of asynchronous telerehabilitation to improve self-efficacy and extrinsic motivation in a short period of time, which could facilitate better adherence to rehabilitation programs and improve physical condition. However, the results seem to be limited in the long term.