Group physical and mental health rehabilitation improves life quality for people with long covid

A new study has found that an on-line rehabilitation programme improves quality of life for adults with long covid.

This is the first randomised trial to show a benefit from rehabilitation for people with long covid, and the first high quality evidence confirming the sustained clinical benefit and lack of harm with rehabilitation programmes for long covid. It is The Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN’ (REGAIN) trial.

Over 1 million people in the UK report covid-19 symptoms persisting beyond 12 weeks, with over 750,000 reporting ongoing symptoms more than two years after infection. Common debilitating symptoms include fatigue, shortness of breath, cognitive dysfunction, pain, reduced physical capacity, and poor emotional wellbeing, all of which can profoundly affect quality of life.

Published today in the British Medical Journal (BMJ), researchers at University Hospitals Coventry and Warwickshire NHS Trust and The University of Warwick have shown that a structured programme of exercise and psychological support delivered live online improves quality of life for people with long covid. Improvements were seen in fatigue, anxiety, depression, pain, and other measures of general health.

The eight-week REGAIN programme consists of weekly live, online, home based, supervised, group exercise and psychological support sessions. At three months, 17% of the intervention group reported that their overall health was "much better now" compared with 8% in the usual care group. It was also shown to be clinically effective at improving health related quality of life at 12 months compared with usual care.

585 participants were randomly assigned to either the physical and mental health rehabilitation programme or to a control group, who received best practice usual care which involved a single session of advice from a trained practitioner. Those recruited had been hospitalised with covid-19, and reported suffering substantial ongoing physical and/or mental health problems more than three months after being discharged.

Gordon McGregor, Professor of Clinical Exercise Physiology & Rehabilitation, at the University of Warwick, who led the clinical trial said: "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. We are very pleased that the REGAIN intervention was well tolerated and improved quality of life.

"This programme has the potential to reduce the chronic burden of covid-19. Apart from the direct benefits for those concerned, improving the general health of people with long covid can reduce demand on health and social care more widely and improve economic productivity."

Martin Underwood, Professor of Clinical Trials, who was a senior investigator on the trial said: "Supervised on-line rehabilitation programmes such as REGAIN may help widen access to rehabilitation services beyond just long-covid".

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."

To find out more about ’Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN’ (REGAIN), study, search: doi: 10.1136/bmj-2023-076506