Improvements in long COVID symptoms, functional level [& illness perceptions] after concentrated micro-choice-based rehabilitation…, 2026, Jürgensen+

SNT Gatchaman

SNT Gatchaman

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Improvements in long COVID symptoms, functional level and the impact of illness perceptions after concentrated micro-choice-based rehabilitation: A 1-year prospective uncontrolled study
Jürgensen; Frisk; Kvale; Espehaug

BACKGROUND
Patients with long COVID face persisting physical and psychiatric symptoms. Illness perceptions are associated with increased symptom burden and poorer recovery. However, little is known about how changes in illness perceptions in rehabilitation impact symptoms and functional levels. This study assessed longitudinal changes in symptoms of anxiety and depression, insomnia, fatigue, dyspnea, illness perception, and functional levels in patients with long COVID following a micro-choice-based intervention.

METHODS
This prospective uncontrolled study with 12-month follow-up included 78 patients with long COVID aged 19–67 years, mean age 40.3 ± 12.0 years. The intervention consisted of three equally important phases: pre-treatment preparation, a 3-day concentrated micro-choice-based intervention and integration of changes into daily life.

RESULTS
At 3- and 12-month follow-ups significant improvements were observed in symptoms of anxiety (p < 0.001), depression (p < 0.001), fatigue (p < 0.001), illness perceptions (p < 0.001) and functional levels (p < 0.001). Caseness of anxiety and depression were reduced from 26.9% at baseline to 10.0% 12-month follow-up and from 51.3% to 20.0%, respectively. Changes in functional level strongly correlated with changes in illness perception. Patients with a history of psychiatric illness did not experience the same short-term improvements in illness perception compared to those without such a history, but theses differences were not present at 12-month follow-up.

CONCLUSION
Patients with long COVID participating in a concentrated micro-choice-based rehabilitation showed consistent improvements in both psychiatric symptoms and functional levels, including those with a history of psychiatric illness. Changes in illness perception was associated with sustained reduction in symptom burden and increased functional levels.

CLINICAL TRIALS REGISTRATION
NCT05234281, with an approval date of 10 February 2022.

The study were approved by the Western Norway Regional Committees for Medical and Health Research Ethics (REK 2020/101648).

HIGHLIGHTS
• Rapid and lasting improvements in psychiatric and somatic long COVID symptoms.

• Caseness of anxiety and depression was reduced with more than 50%.

• Improvements in functional levels regardless of prior psychiatric illness.

• Changes in illness perceptions were associated with increased functional levels.

Web | DOI | Journal of Psychosomatic Research | Open Access
 
Follow-on from Sustained improvements in sick leave, fatigue and functional status following a concentrated micro-choice based treatment for patients with long COVID: A 1 year prospective uncontrolled study (2025)

The main objective is to examine secondary outcomes symptoms variables including General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Bergen Insomnia Scale (BIS), Chalder Fatigue Scale (CFQ-11) and Dyspnea-12 in relation to the primary outcome of illness perception, The Brief Illness Perception Questionnaire (B-IPQ) and the secondary outcomes functional level measured with Work and Social Adjustment Scale (WSAS) and visual analogue scale (VAS).
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The non-randomised study design without a control group presents a limitation.
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Uncontrolled study, subjective self-report outcomes, coming out of Norway. All proving once again that they are doing nothing more than inducing modest changes in some patients in their questionnaire response behaviour, and puffing it up as a therapeutic benefit.

The usual non-result.
 
Worthless from beginning to end, but this is so blatantly CBT without calling it CBT that it might as well be the Simpsons joke "A certain agitator, for privacy sake, let's call her "Lisa S." No that's too obvious., let's say "L. Simpson," has raised concerns about certain school policies."

In a sane world, the people who keep approving this mindless crap would face serious problems over blatant mismanagement of resources. They are making a joke out of both science and medicine.
 
About what "micro-choice-based rehabilitation" is:

The article said:
One of the main features of this rehabilitation programme was a shift in focus from monitoring symptoms to making micro-choices, which refer to small, daily decisions that can impact behavior and symptom management.

Throughout the intervention, the focus was on how to initiate and maintain change by identifying and breaking individual inflexible patterns of symptom regulation.

Patients worked alongside their peers and closely together with the interdisciplinary team, to become aware of symptom-driven responses in everyday contexts and practice selecting alternative behaviours consistent with their planned activities, even when symptoms were present.
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There is more information about "micro-choice-based rehabilitation" in the protocol article:

The protocol article said:
Patient education will be provided on how to initiate and maintain relevant change and, at the same time, accept those things that cannot be changed or controlled (eg, history, thoughts, and feelings [for post–COVID-19 symptoms and type 2 diabetes: getting the infection/having the illness]). It will be underscored that change starts with an active decision and that the goal of the treatment is to increase flexibility and to live a life where the symptoms do not decide.
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The protocol article said:
Microchoices will be used as a term that refers to the moments when you discover specifically how and where in your everyday life the symptoms are making choices on behalf of you, and where you have an option to choose differently. Participants will be encouraged to do things they have avoided in fear of symptom worsening.

It will be emphasized that change is measured in behavior (what you do) and not in the reduction of symptoms. Symptom reduction, on the other hand, will be described as a positive and valuable side effect of behavioral change. This shift in focus from symptoms to deliberate behavior implies that change is within reach.

Furthermore, participants will be challenged to do a value-based microchoice each day, for example, call a friend or relative whom they had neglected due to the health problems.
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Somehow this sounds familiar.

I fear that we will hear more about micro-choices in the future, especially our friends in Norway.

www.researchprotocols.org

Evaluation of Novel Concentrated Interdisciplinary Group Rehabilitation for Patients With Chronic Illnesses: Protocol for a Nonrandomized Clinical Intervention Study

Background: An aging population with a growing burden of chronic complex illnesses will seriously challenge the public health care system. Consequently, novel and efficacious treatment approaches are highly warranted. Based on our experiences with concentrated treatment formats for other health...
www.researchprotocols.org www.researchprotocols.org
 
However, little is known about how changes in illness perceptions in rehabilitation impact symptoms and functional levels.​

After decades of studies on exactly that kind of question. What magical new perspective do they think they have invented this time around?
 
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