A rehabilitation programme for people with long COVID has yielded “impressive” results, UK researchers report today.
The six-week programme, which is based on a gradual or paced increase in a patient’s physical activity, has been described as “exciting” because it has helped participants to become more active with fewer “crashes”. They also reported a “moderate improvement” in their ability to be active and better quality of life.
Run by the long COVID service at Leeds Community Healthcare NHS Trust, and evaluated by clinicians and scientists at the University of Leeds and Leeds Beckett University, the findings are reported in the Journal of Medical Virology.
Dr Manoj Sivan, associate clinical professor in the School of Medicine at the University of Leeds as well as research and service evaluation lead for the long COVID service at Leeds Community Healthcare Trust, said: “Long COVID affects around two million people in the UK and it has an impact on their quality of life and in some cases, their ability to work. It is distressing and disabling.
“Post-exertional malaise or post-exertional symptom exacerbation, or simply ‘crashes’, as described by patients, is a defining and important symptom of long COVID.
“When patients get a crash, they experience feelings of complete exhaustion and wipe out and are unable to resume activities for hours or sometimes days.
“The findings of this research are exciting because this is the first time that crashing episodes have been used as a marker for the condition and a structured pacing programme has now been shown to substantially reduce symptoms and improve quality of life.”
The programme recruited 31 people with long COVID who, on average, had been experiencing long COVID for about 17 months. Symptoms included fatigue, including brain fog, breathlessness, headache and palpitations.
They followed a gradual return to physical activity programme called the World Health Organization (WHO) CR-10 Borg pacing protocol, which was devised for WHO Dr Sivan, the WHO advisor for long COVID rehabilitation policy in Europe, and his team.
The five-step programme is followed at home, with the first phase being preparation for return to activity, breathing exercises and gentle stretching. The fifth phase involves activities the patients did before they were ill such as regular exercise or sports.
They were told to stay at each level for at least seven days and not to overexert themselves, and received weekly phone calls from their long COVID clinician to check on their progress. The participants also completed a questionnaire to assess their exertion levels and crashes each week before a decision was made whether to progress to the next level of the pacing protocol.
Over the six weeks, participants reported fewer crashing episodes, improvements in activity level and quality of life, and reduction in fatigue, breathlessness and headaches.
The authors write: “This study adds to the current understanding by demonstrating the potential of a structured pacing protocol to gradually improve activity levels… Yet, current advice on safely returning to physical activity without worsening their symptoms is unclear, with patients reporting receiving differing advice from health care professionals.”
The researchers are also conducting a major pan-UK platform study, LOCOMOTION, that is developing a gold standard of care for the condition.
Effect of using a structured pacing protocol on post-exertional symptom exacerbation and health status in a longitudinal cohort with the post-COVID-19 syndrome. Journal of Medical Virology 16 December 2022; doi: 10.1002/jmv.28373
Leave a Reply