Sustained improvements in sick leave, fatigue and functional status following a concentrated micro-choice based treatment for... [LC] 2024 Frisk et al

Full title: 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

Highlights

• A safe and highly acceptable 3-day intervention for patients with long COVID.
• Patient activation and illness perceptions were clinically improved.
• Rapid, significant and lasting changes in sick leave, symptoms and function.
• The results provide hope for patients with long COVID.

Abstract

Background
Long COVID has affected approximately 200 million people globally, with substantial consequences for the individuals, healthcare systems and society. Treatment guidelines lack clear recommendations regarding increased activity. This study aimed to evaluate primary outcomes as patients' satisfaction, illness perception and patient activation. In addition, potential changes in functional levels, sick leave, fatigue, dyspnea, and exercise capacity from baseline to 12-month follow-up after a concentrated micro-choice-based intervention in patients with long COVID.

Methods
This prospective interventional study, study start 26 May 2021, with 12-month follow-up included 78 patients with long COVID aged 19–67 years, mean age 40.3 ± 12.0 years. The intervention was structured into three equally important phases: pre-treatment preparation, a 3-day concentrated micro-choice-based intervention and integrating the changes into everyday living.

Results
At 3 and 12-month follow-ups, 71 (91 %) and 65 (83 %) patients, respectively completed questionnaires and physical tests. The patients reported significant enhancements in illness perception and health activation. Sick leave decreased significantly from 63 % at baseline to 43 % and 23 % at 3 and 12-month, respectively (p < 0.001). Fatigue decreased significantly at 3-month (mean difference (MD) = −5.5, 95 % CI: −6.6 to −4.3) and at 12-month (MD = −7.0, CI: −8.3 to −5.7). Functional level and exercise capacity increased (p < 0.001), and dyspnea decreased (p < 0.001), at both follow-ups regardless of baseline fatigue severity.

Conclusion
The micro-choice-based intervention for patients with long COVID was safe, highly satisfactory and significantly enhanced health activation alongside rapid improvements in functional levels and fatigue which continued improving throughout the follow-up year, together with significant reduction in sick leave.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399924004355

 

"The clinical intervention was structured into three equally important phases: 1) pre-treatment preparation, 2) the concentrated intervention and 3) integrating the changes into everyday living (Fig. 1), and as detailed in a protocol paper for concentrated interdisciplinary group rehabilitation intended for individuals with chronic illnesses [13]."

Ref 13 is to Evaluation of Novel Concentrated Interdisciplinary Group Rehabilitation for Patients With Chronic Illnesses..., 2021, Kvale et al

 

A part of the COFFI universe. Prof. Frisk used to work at the rehabilitation center "Helse i Hardanger" as a physiotherapist together with psychiatrist Marte Jürgensen (previous ME patient and from Recovery Norge), treating people with prof. in psychology Gerd Kvale's four-day intervention (basically LP light). Gerd Kvale co-authored a study on ME treatment together with psychiatrist Bjarte Stubhaug on a similar method.

Helse i Hardanger is now closed, but they are resurfacing with this online clinic:
https://www.safechoice.global/vart-team

 

It was non-randomised, so the entire difference could be due to natural recovery.

 

Or due to 1 in five people dropping out.