Rédaction Africa Links 24 with Elizabeth Cooney
Published on 2024-02-07 23:30:25
Fatigue has emerged as the most persistent problem experienced by those with long Covid. This has led to pushback against treatment approaches that encourage increasing levels of exercise for a condition that researchers are still trying to fully comprehend, out of concern for post-exertional malaise. Researchers from the U.K. were well aware of these potential harms, and thus designed a trial called REGAIN to test a way to provide mental health therapy and exercise guidance to long Covid patients without exacerbating their conditions. Their goal was to help people manage their symptoms, improve their functioning, and reduce their distress.
Their findings, reported in BMJ, indicated that enrolled patients in the online program reported greater health improvement compared to those who received standard care. The study, led by Professor Gordon McGregor, confirmed that rehabilitation delivered online was beneficial without any associated harm. The trial, involving 485 study subjects who had been discharged three months earlier from hospital stays for Covid-19, divided participants into two groups, with one group receiving general advice on coping, and the other group engaging in an individual, self-paced approach to eight-week group sessions of psychological counseling and exercises. This intervention was developed in collaboration with patients, clinicians, academics, and other stakeholders, with a strong emphasis on input from the long Covid community. The weekly home-based sessions were online, incorporating simple exercises supervised by trained professionals, with the goal of improving muscle strength and endurance, cardiovascular fitness, coordination, and balance. The results showed that 17% of people in the intervention group reported much better overall health after three months, compared to 8% in the usual care group.
These findings offer valuable insight for clinicians and treatment strategies, especially in light of concerns stemming from post-viral conditions such as myalgic encephalomyelitis or chronic fatigue syndrome, which are associated with intense fatigue and worsening of other health issues following exertion. Advocacy groups have voiced their worries about exercise training, and questions about the study’s duration and participants’ symptoms prior to joining. However, a companion editorial commended the trial’s approach and emphasized that individualized exercise in online groups is safe.
The study concluded that online rehabilitation improved health-related quality of life for people with long Covid. The patients in the intervention group reported a 17% improvement in overall health after three months, compared to 8% in the usual care group. Additionally, the intervention group experienced lower depression levels after 12 months, with no significant difference in cognitive function. Amidst these findings, the researchers maintained a modest tone, acknowledging that REGAIN is not a cure-all, but it offers valuable insights for clinicians and treatment strategies. Overall, careful consideration of the findings is warranted before applying them to a broader population of post-Covid patients.
In conclusion, REGAIN study provides a pioneering approach for the management and rehabilitation of long Covid patients, establishing that an online program has the potential to improve health-related quality of life without causing harm. With an increasing number of people experiencing long-term effects of Covid-19, these findings offer valuable guidance for clinicians and health professionals in supporting the physical and mental well-being of affected individuals.
