Breathing and relaxation exercises help improving fear of COVID-19, anxiety, and sleep quality: A randomized controlled trial

Objective: To investigate the effects of breathing and relaxation exercises performed via telerehabilitation on fear, anxiety, sleep quality, and quality of life of individuals without coronavirus disease 2019 (COVID-19) during the ongoing pandemic. Design: A prospective, randomized, controlled single-blind study. Methods: Fifty participants who had not been exposed to the COVID-19 virus earlier were randomly divided into experimental (n = 25) and control groups (n = 25). Both groups received an information session about COVID-19 once at the start of the study via a mobile phone video application. The experimental group also performed a breathing and relaxation exercise program twice daily (morning and evening), 7 days per week, for 4 weeks; one session of the program was conducted under the remote supervision of a physiotherapist as telerehabilitation, and the remaining sessions were performed as a home program. The Fear of COVID-19 Scale (FCV-19S), which was the primary outcome measure, The Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and EQ-5D-3L were administered to both groups. Results: The FCV-19S, HAMA, and PSQI were statistically significantly improved to compare the controls, with a large effect size (ηp2 = 0.135, 0.313, and 0.200, respectively). The EQ-5D-3L index and EQ-5D-3L visual analog scale were not statistically significantly different compared with the controls; however, a small effect size was detected for the differences between the two groups (ηp2 = 0.056 and 0.013, respectively). Conclusion: Breathing and relaxation exercises appear to be an effective and feasible approach to support mental health and sleep quality during the COVID-19 pandemic. Especially in highly contagious diseases such as COVID-19, telerehabilitation approaches may be useful for safely reaching individuals by eliminating human-to-human contact.