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Hope for long Covid patients as the exercises that can help recovery revealed

Long Covid patients have been given hope after an online programme of group exercises led to a “sustained improvement in quality of life” when tested after three months and after a year.

Participants reported particular improvements in fatigue, depression, pain and sleep, in the first clinical trial to assess the benefits of mild exercises.

The exercises involved movements such as steps, squats and breathing, without equipment, focusing on strength and balance – as well as mental health support.

For some people who were unable to stand, the exercises were chair-based.

It had been thought that rehabilitation treatment programmes may help people with long Covid, but, until now, there had been no trial to demonstrate whether it could help – or potentially hinder – recovery.

This is the first time a clinical trial has found that these kind of long Covid rehabilitation exercises are effective.

There are currently no drugs for long Covid and so exercises are the best kind of treatment on offer.

As such, the researchers say the cost effective programme they tested in the trial, known as Regain, “can be delivered at scale and will assist clinicians in the treatment of this complex condition”.

“This programme has the potential to reduce the chronic burden of Covid-19. The Regain intervention.. improved quality of life,” said Professor Gordon McGregor, at the University of Warwick, who led the trial.

“There was no precedent for how best to treat people with long Covid. We knew that centre-based NHS rehabilitation services did not have the capacity to support the numbers of people recovering from Covid-19, so alternative long-term strategies were needed,” he said.

Professor McGregor said he hoped the findings would go some way towards dispelling the myth that long Covid is a mental health condition.

Professor Martin Underwood, of University Hospitals Coventry & Warwickshire, added: “Supervised on-line rehabilitation programmes such as Regain may help widen access to rehabilitation services beyond just long-Covid”.

Scientists said conversations were ongoing about rolling out the programme more widely across the NHS, but that this was a decision for policy makers.

The eight-week programme consists of weekly live, online, home based, supervised, group exercise and psychological support sessions.

At three months, 17 per cent of the ‘intervention group’ reported that their overall health was “much better now” compared with 8 per cent in the group that got the usual care, which is much less comprehensive. And 50 per cent felt “at least somewhat better after three months”.

And overall, the results show “sustained improvements in health related quality of life at three and 12 months compared with usual care, driven mostly by improved fatigue, pain, and depression,” the report said.

However, scientists said anyone thinking of doing exercises at home should proceed with caution because over-exertion can make the condition worse – pointing out that the sessions in the programme were supervised.

Asked what advice he would have for people trying to do their own exercises at home, Professor McGregor explained that the trial approach had been very considered, and people trying to undertake activities on their own may experience problems.

He said people with chronic fatigue as a part of their long Covid should “very gently increase their activities” over a period of time so that they do not exacerbate symptoms of fatigue.

Emily Fraser, clinical lead of the long Covid clinic R Oxford University Hospitals NHS Foundation Trust, who was not involved in the study, welcomed its findings.

“I think this study is good. The emphasis is on what can practically be done to support patients struggling with the after-effects of Covid.

“A focus on rehabilitation and holistic care is essential for both management of symptom burden and supporting recovery of these patients, and group programmes that are online and accessible have been shown at our local level to be really beneficial.”

“Feeling supported, understood and reducing the sense of isolation that many patients have after hospital discharge is really important, alongside setting realistic expectations of recovery and what this looks like.”

Professor Matt Sydes, of University College London, however, said the effects of the rehabilitation were “modest”.

William’s story

One of those who took part was William, a man in his 50s, who had nearly died from severe coronavirus with multiple respiratory, pulmonary, muscular and psychological problems caused by the virus.

“I literally could not get out of bed after being brought home from intensive care, and spent a year just learning, with great difficulty, to once again walk the short distance to the end of my street, ” he says.

“But after a year, I was fortunate enough to take part in the Regain programme, which provided my with a solid base and platform, from which to, firstly, address and, secondly, understand my physical and psychological problems.”

“As well as the tailored exercise programme, the Regain programme gave me the practical tools I needed, to continue my rehabilitation in a measured way at my own pace.”

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