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Long Covid: Study Shows Self-Paced Exercise Improvement


Persistent fatigue ranks as the primary concern among those dealing with long Covid, leading patients to oppose treatment strategies promoting heightened physical activity levels. This apprehension arises from the dreaded post-exertional malaise, a debilitating aftermath of excessive exertion that patients are keen to sidestep.


Do Long Covid Rehabilitation Methods Work?


British researchers, recognizing the potential risks, partnered with long Covid patients to devise the REGAIN trial. This study aims to provide mental health support and exercise guidance to long Covid sufferers without worsening their condition. The goal is to aid individuals in managing symptoms, improving functionality, and reducing distress levels.


In a recent BMJ report, it was revealed that individuals engaged in an online program showed notable health improvements compared to those receiving standard care. The standard care involved a one-hour session advising on managing issues like fatigue, shortness of breath, brain fog, and muscle aches.


Gordon McGregor, a study co-author and professor of clinical exercise physiology and rehabilitation at University Hospitals Coventry & Warwickshire NHS Trust, emphasized that live online rehabilitation significantly enhanced the health-related quality of life for long Covid patients at both three and twelve months. This groundbreaking study establishes the effectiveness and safety of online rehabilitation for long Covid patients.


After being discharged from hospitalization for Covid-19 three months prior, the study involved 485 participants divided into two groups. One group of 287 individuals received standard one-on-one advice for managing their condition, while the intervention group of 298 participants engaged in hour-long sessions aimed at developing personalized, self-paced strategies. These strategies involved participating in eight-week group sessions incorporating psychological counseling and exercises.


The intervention development involved close collaboration with long Covid patients, healthcare experts, and researchers. McGregor stressed that community insights were pivotal in shaping the initiative.


Weekly remote sessions were tailored for accessibility, catering to a broad audience. Exercises ranged from simple to moderate complexity, customized to suit individual requirements. Physiotherapists and exercise physiologists supervised these sessions, supported by health psychologists. The overarching goal was to improve muscle strength, cardiovascular fitness, coordination, and balance, fostering confidence in physical activity engagement.


The intervention was designed with simplicity in mind, utilizing bodyweight exercises and avoiding strenuous activities like planks. McGregor emphasized the importance of movements that enhance strength, balance, and proprioception to promote physical activity.


After three months, 17% of participants in the intervention group reported improved overall health, compared to 8% in the standard care group. Depression rates were lower in the intervention group after 12 months, while cognitive function remained stable.


Early concerns raised by advocacy groups centered on the potential for exercise to worsen symptoms, similar to chronic fatigue syndrome. These concerns echoed those seen in the RECOVER study, which faced criticism for its exercise-focused approach.


Despite the positive outcomes observed, experts advise considering the nuances of the REGAIN study.


Insights on the REGAIN Trial from Experts


Emily Fraser, a respiratory medicine consultant at Oxford University Hospitals NHS Foundation Trust, underscores the distinct nature of the study's target group. Although not directly involved in the trial, Fraser emphasizes the importance of interpreting the findings for community-managed post-Covid patients with care. As the overseer of Oxford's post-Covid clinic, her insights provide valuable guidance for applying the study's results effectively and responsibly in broader healthcare contexts.


Matt Sydes, a professor specializing in clinical trials and methodology at University College London, offered valuable insights despite not being directly involved in the trial. He emphasized the significance of understanding the duration of participants' symptoms before joining the study, especially concerning the relevance of these findings for individuals experiencing prolonged symptoms of long Covid.


An editorial endorsing the trial's approach highlighted that consistent monitoring throughout the REGAIN trial revealed no worsening of symptoms following physical exertion. This finding instills confidence in the safety and effectiveness of home-based, online group exercise programs supervised by qualified professionals.



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