A Personalised Pacing and Active Rest Rehabilitation Programme for Post-Exertional Symptom Exacerbation and Health Status in Long COVID (PACELOC): A Prospective Cohort Study.

Godfrey, B.; Shardha, J.; Witton, S.; Bodey, R.; Tarrant, R.; Greenwood, DC.; Sivan, M.

A Personalised Pacing and Active Rest Rehabilitation Programme for Post-Exertional Symptom Exacerbation and Health Status in Long COVID (PACELOC): A Prospective Cohort Study.

All Authors

Godfrey, B.

Shardha, J.

Witton, S.

Bodey, R.

Tarrant, R.

Greenwood, DC.

Sivan, M.

LTHT Author

Sivan, Manoj
Sivan, Manoj

LTHT Department

Complex Rehabilitation

Publication Date

2024

Item Type

Journal Article

Abstract

Background: Post-COVID-19 Syndrome or long COVID (LC) is a novel public health crisis and, when persistent (>2 years), is a long-term condition. Post-exertional symptom exacerbation (PESE) is a characteristic symptom of LC and can be improved in a structured pacing rehabilitation programme. Aims: To evaluate the effect of an 8-week structured World Health Organisation (WHO) Borg CR-10 pacing protocol on PESE episodes, LC symptoms, and quality of life in a cohort of individuals with long-term LC. Methods: Participants received weekly telephone calls with a clinician to discuss their activity phase, considering their PESE symptoms that week. They completed the Leeds PESE questionnaire (LPQ), C19-YRS (Yorkshire Rehabilitation Scale), and EQ-5D-5L at the beginning of the programme (0 weeks), the end of programme (8 weeks), and at final follow-up (12 weeks). Results: Thirty-one participants (duration of LC symptoms: 29 months) completed the programme. The PESE episodes decreased in number each week (15% fewer each week, 95% CI: 11% to 20%, p < 0.001) and were of shorter duration and milder severity each week. The changes in C19YRS symptom severity and functional disability (0-12 weeks) were statistically significant but not clinically significant. The EQ5D-5L index score change was not statistically significant. Conclusions: A structured pacing protocol effectively reduced PESE episode frequency, duration, and severity but did not produce clinically significant changes in LC symptoms, reflecting the long-term nature of the condition in this cohort.