Tele-rehabilitation for individuals with long COVID: a randomised clinical trial, 2026, Janaudis-Ferreira et al.

[Chandelier]

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

Spoiler: Authors

Janaudis-Ferreira, Tania; Beauchamp, Marla K.; Rizk, Amanda K.; Tansey, Catherine M.; Ross, Bryan A.; Sedeno, Maria; Bourbeau, Jean; Benedetti, Andrea; Barreto, Laura; Li, Pei Zhi; Agarwal, Kriti; Zucco, Rebecca; Lopez, Julie; Crowley, Emily; Cloutier, Julie

Abstract​

Background​

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.

Methods​

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.

Results​

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.

Conclusions​

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.

Web | DOI | PMC | PDF | ERJ Open Research | Open Access

 

[Utsikt]

AM-PAC mobility asks if you can do something, so it’s not suitable for people with PEM.

The minimal detectable change (MDC) for AM-PAC basic mobility and the minimal clinically important difference (MCID) is 3.3 [21].

No significant between-group differences were found in AM-PAC mobility (mean difference (MD) 0.61; 95% CI −0.91–2.13).

They couldn’t even get the CI above the MCID.

We applied the Benjamini–Hochberg false discovery rate (FDR) method to control for type I errors. Among the 25 outcomes presented in table 2 comparing changes between the two arms, none remained statistically significant after applying the Benjamini–Hochberg procedure using an FDR threshold of 0.25.

The abstract failed to mention that none of the differences were statistically significant. They also fail to mention this is the discussions.

Our findings offer unique contributions to the literature. (…) Second, to our knowledge, this is the first RCT to include individuals with PEM.

They must have been living under rocks.

The robust RCT methodology, high adherence and low dropout rate are additional strengths.

Yeah, sure. Subjective outcomes and no blinding is robust methodology.

Rehabbers being rehabbers, I guess. They even suggest that the results can be further enhanced by adding multidisciplinary components (read: psychology).