Patients with long coronavirus disease (COVID-19) experience multisystem symptoms andreduced quality of life (QOL). Proactive interventions are needed to enhance healthoutcomes.To investigate the effects of a 12-week tele-exercise training program on longCOVID symptoms, cardiorespiratory fitness, and QOL.
Long COVID is a multi-organ condition with persistent or delayed symptoms lasting weeks
after infection, affecting physical and psychological function and reducing quality of
life. It can occur regardless of age or initial disease severity, with prevalence ranging
from 30% to 87.4%. Common symptoms include fatigue, cardiopulmonary issues, and
neurological problems, collectively impairing daily functioning and mental health.
Exercise-based rehabilitation, including tele-exercise training, has emerged as a
practical management strategy and may improve symptoms, cardiorespiratory fitness, and
quality of life. However, current evidence remains limited due to small sample sizes and
inconsistent protocols. Therefore, this study evaluated the effects of a 12-week
tele-exercise program on symptoms, fitness, and quality of life in Taiwanese patients
with long COVID compared with usual care.
Device: Telehealth exercise training program
Each participant received an individual exercise counselling session lasting 10-15
minutes, based on the guidelines of the American College of Sports Medicine.
Participants in the home-based telehealth exercise group were provided with a mobile
exercise application integrated with heart rate-monitoring clothing. The app delivers
real-time heart rate feedback during each session and includes an alert system to ensure
participants maintain their prescribed target heart rate based on individualized exercise
prescriptions. Upon completion of each session, exercise duration and heart rate data are
automatically uploaded to the medical center's cloud system via the monitoring device.
An experienced nurse regularly reviewed the cloud-based data to monitor adherence.
Additionally, communication between participants and researchers was facilitated through
the LINE platform, enabling timely interaction and support.
Behavioral: Education and self-exercise
Each participant received an individual exercise counselling session lasting 10-15
minutes, based on the guidelines of the American College of Sports Medicine.
Participants received usual outpatient care for long COVID, which included general
guidance on physical activity, physician-led management of persistent symptoms (e.g.,
fatigue, dyspnea, and reduced exercise tolerance), and routine follow-up visits as
clinically indicated.
Inclusion Criteria:
- Aged 20-80 years
- Diagnosed with long COVID based on the criteria of the World Health Organization
- Able to speak and understand Mandarin
- Able to ambulate independently
- Owns a mobile phone with Internet access
- Willing to participate and undergo randomization
Exclusion Criteria:
- History of arrhythmia
- History of mental illness
- Pregnancy
- Acute or unstable chronic diseases (e.g., recent stroke, ongoing cancer treatment,
end-stage renal disease requiring dialysis, or major surgery within the previous 3
months) Comorbid neurological or musculoskeletal conditions (e.g., stroke,
Parkinson's disease, or dementia) resulting in moderate-to-severe physical
disability
Tri-service general hospital
Taipei, Neihu, Taiwan
Shang-Lin Chiang, PhD, Principal Investigator
Tri-Service General Hospital