Long-COVID patients see improvement with online program

online exercise


An 8-week online rehabilitation program helped long-COVID patients improve their quality of life, according to a new study published in The BMJ.

Compared to standard care, UK patients who completed online group sessions as part of the REGAIN program saw less fatigue, pain, and depression, in one of the first trials to measure outcomes of a long-COVID rehab program. The trial took place between January 2021 and July 2022.

The trial participants included 585 adults (average age 56 years) who had been hospitalized for COVID-19 at least 3 months earlier and reported substantial lasting symptoms. Overall, 88% of participants were overweight or obese, and 34% had been admitted to the intensive care unit (ICU) for COVID.

Baseline health-related quality of life was low, and 43% of participants had a mental health disorder, the authors said.

"The most common pre-existing medical conditions related to chest or breathing (444/585; 76%) and musculoskeletal conditions (275/585; 47%), and more than one third of participants were unable to work owing to post-covid-19 condition (222/585; 38%)," the authors wrote.

Half of the participants (287) were randomized to receive standard care (a single online session of advice) and 298 to the REGAIN intervention (eightweekly home-based, group exercise and psychological support sessions delivered online).

Improvements seen at 3 months

Participant outcomes were assessed at 3, 6, and 12 months.

At 3 months, 17% (39) of the intervention group reported that their overall health was "much better now" compared with 8% (20) in the usual-care group. One serious adverse event of fainting and vomiting after exercise was deemed possibly related to the intervention, and two adverse events (knee pain with exercise, and severe anxiety before exercise) were deemed definitely related, the authors said.

There were no improvements at the 6-month mark, but by 12 months participants in the REGAIN group showed significant improvements.

Overall participants in the REGAIN intervention group had higher odds (odds ratio 1.66; 95% confidence interval, 1.14 to 2.41) of being more physically active compared with participants in the usual care group.

Importantly, the magnitude of improvement in the REGAIN intervention group for post-traumatic stress disorder was twofold greater than in the control group.

"This is an important finding given the high levels of post-traumatic stress disorder witnessed in this population, and the known impact of this on health related quality of life and social and economic productivity," the authors said.

In an editorial on the study, professors of exercise science from two universities in Australia emphasized there were no cases of myalgic encephalomyelitis/chronic fatigue syndrome reported in the REGAIN group.

Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms.

"Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms, providing reassurance that individualised exercise at home in online groups supervised by a trained physiotherapist or exercise physiologist is safe," the authors wrote.

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