Tele-rehabilitation for individuals with long COVID: a randomised clinical trial

Most trials in long COVID rehabilitation included only previously hospitalised patients and omitted outcome measures such as mobility, an important outcome for assessing life impact. The primary objective was to investigate whether an 8-week tele-rehabilitation programme for individuals with long COVID improves functional mobility compared with usual care.

This was a randomised controlled trial involving individuals with long COVID and persistent symptoms of reduced mobility, muscle weakness, dyspnoea or fatigue. Participants were randomised to either an individualised 8-week tele-rehabilitation programme plus usual care or usual care. In both groups, usual care was supplemented with generic guidance on physical activity and symptom management. The primary outcome was activity measure for post-acute care (AM-PAC) mobility. The secondary outcomes were dyspnoea, fatigue, quality of life, physical function, mental health, acceptability and adverse events.

132 participants were randomised (65 intervention; 67 control; 48±11.8 years; 75% female), with 78% not previously hospitalised. Adherence was high (96%), although 39% of intervention participants were unable to progress their exercises. No significant between-group differences were found in AM-PAC mobility (mean difference (MD) 0.61; 95% CI -0.91-2.13). The intervention group showed greater improvements in EQ-5D-5L pain (MD -0.36; 95% CI -0.70- -0.03), health status (MD 7.74; 95% CI 1.05-14.43), fatigue (MD -0.90; 95% CI -1.78- -0.02) and dyspnoea (MD 1.24; 95% CI 0.10-2.37). No serious adverse events occurred.

In the context of limited evidence around exercise in non-hospitalised individuals with long COVID, our study offers important insights into feasibility, safety and clinical relevance.