by Online group rehabilitation including gentle exercise and mental health support can improve quality of life for adults with prolonged Covid, a new study suggests.
The eight-week sessions led to improvements in fatigue, pain and depression compared to standard care, according to researchers.
Experts say this accessible, resource-efficient program can be delivered at scale and could help doctors treating the complex condition.
Long Covid is defined as symptoms that persist or new symptoms that appear more than four weeks after the initial infection.
Data suggests that as of March 2023, 1.9 million people in the UK reported Covid-19 symptoms lasting longer than 12 weeks, 1.3 million over one year, and more than 750,000 after two years.
Symptoms include extreme tiredness (fatigue), shortness of breath, memory loss and muscle pains, all of which can affect quality of life, social interaction and economic productivity.
The Recovery Exercise and psychological support program after the Covid-19 infection (Regain) consists of live, online, at-home, supervised weekly sessions, group exercise and psychological support.
The exercises involve movements such as step-ups and squats without equipment, focusing on strength and balance.
For some, the exercises were chair-based.
William, a man in his 50s, who had almost died from a severe coronavirus with multiple respiratory, pulmonary, muscular and psychological problems caused by the virus, took part in the trial.
He said: “I couldn’t get out of bed after I was brought home from intensive care, and spent a year learning, with great difficulty, to walk the short distance to the end of my street again.
“But after a year, I was lucky enough to participate in the Regain program, which provided me with a strong base and platform, from which I can face my physical and psychological problems and, secondly , to understand.”
“Along with the tailored exercise program, the Regain program gave me the practical tools I needed to continue my recovery in a measured way at my own pace.”
Gordon McGregor, professor of clinical exercise physiology and rehabilitation at the University of Warwick, who led the clinical trial, said: “There was no precedent for how best to treat people with prolonged Covid.
“We knew that centre-based NHS rehabilitation services did not have the capacity to support the number of people recovering from Covid-19, so other long-term strategies were needed.
“We are very pleased that Regain’s intervention has been well received and has improved quality of life.
“This program has the potential to reduce the chronic burden of Covid-19.
“Apart from the direct benefits for those affected, improving the general health of people with prolonged Covid can reduce demand on health and social care more broadly and improve economic productivity.”
Martin Underwood, professor of clinical trials, who was a senior investigator on the trial, said: “Supervised online rehabilitation programs such as Regain may help to expand access to rehabilitation services beyond the long Covid.”
The trial involved 585 adults who had been discharged from hospital at least three months previously after a Covid-19 infection and reported significant lasting effects they attributed to the virus.
About 287 people received the usual care (a single session of online advice and support with a trained practitioner) and 298 were involved in the Regain sessions (weekly home, live, supervised sessions, group exercise and online psychological support over eight weeks. ).
According to the results, at three months, 17% of the Regain group reported that their overall health was “much better now” compared to 8% in the usual care group.
The experts said discussions were taking place about rolling out the program more widely across the NHS, but that this was a decision for policymakers.
Professor McGregor said he hoped the findings would go some way to dispelling the long-held myth that Covid is a mental health condition.
When asked what advice he would have for people wanting to do their own exercises at home, he explained that the trial approach had been well thought out, and that people who wanting to undertake activities on their own.
Prof McGregor said people with chronic fatigue as part of their long Covid should “gently increase their activity” over time to avoid increasing the symptoms of fatigue.
The research was funded by the National Institute for Health Research (NIHR) Covid-19 Recovery and Learning programme.
Published in the British Medical Journal (BMJ), the study was carried out by researchers at University Hospital Coventry and Warwickshire NHS Trust and the University of Warwick.
