An opportunity for management of fatigue, physical condition, and (QoL) through asynchronous telerehabilitation in post-acute COVID-19..., 2024

[rvallee]

An opportunity for management of fatigue, physical condition, and quality of life through asynchronous telerehabilitation in post-acute COVID-19 patients: a randomized controlled pilot study
https://www.sciencedirect.com/science/article/abs/pii/S0003999324009869

Objective
To compare the preliminary efficacy of asynchronous telerehabilitation in post-acute COVID-19 on fatigue, physical condition, quality of life, and feasibility of this pilot study, versus a booklet format.

Intervention
The intervention consisted of a 12-week multimodal rehabilitation program, via telerehabilitation or by a booklet.

Main outcome measures
Fatigue as main outcome, and functional status, quality of life, and feasibility as secondary outcomes were evaluated.

Results
After the intervention, there was no significant difference between groups in fatigue but there were significant differences in favor of the ATG 6MWT (p=0.008), the 30" STST (p=0.019), and physical quality of life (p=0.035). These improvements were maintained throughout the 6-month follow-up. Telerehabilitation was shown to be a viable option, without incidents and with a higher adhesion (p=0.028) than the booklet format.

Conclusion
A multimodal rehabilitation program by means of asynchronous telerehabilitation appears as a more effective option than traditional formats in improving post-acute COVID-19 sequelae.


Multimodal strategies, including therapeutic exercise and education, stands as a requisite to achieve comprehensive recovery and restoration of pre-COVID-19 functionality.12 The adapted and personalized exercise programs may be an effective multisystemic therapy for COVID-19, considering the diversity of cases and symptoms.13,14 A multicomponent exercise program that includes aerobic, strength, and pulmonary exercises is proposed as the best therapeutic intervention for the treatment of COVID-19 patients.

 

[rvallee]

The formulaic pattern continues: take some useless treatment model, compare it to a slightly less biased approach, find that it's generally just as ineffective, but argue that both must be effective anyway, entirely out of assumptions that exercise is good for everyone.

You can't get away with something this ridiculous in most junior positions. But here it's an entire industrial circle jerk.

 

[Eleanor]

35 hospitalised patients.

the non-significant findings in fatigue may be related to the variability of the data. These will be eliminated in a larger clinical trial.

 

[Hutan]

Multimodal strategies, including therapeutic exercise and education, stands as a requisite to achieve comprehensive recovery and restoration of pre-COVID-19 functionality.

Maybe, just maybe, in their 'larger clinical trial', they could have some controls who don't get the benefit of any of this very clever requisite multimodal rehabilitation? Who knows, perhaps they would find that some people recover just fine without any inputs?

The adapted and personalized exercise programs may be an effective multisystemic therapy for COVID-19, considering the diversity of cases and symptoms.

Maybe, just maybe, in their 'large clinical trial', they could stratify their samples, to minimise the diversity of cases and symptoms? Who knows, perhaps they would find that people with completely different problems need completely different care?

 

[bobbler]

there is a big issue isn't there where the idea of both exercise and any old thing as a pretend psych 'therapy' being helpful for 'fatigue' having become a truism in the medical profession and pushed into other vocations.

It is like the untouchable as if someone is suggesting smoking is good for someone these days.

Or as assumed as like not having enough oxygen is bad.

To suggest you don't just 'build up slowly and get better from being pushed a little bit' and if it doesn't work then maybe push a little more or less but don't stop with the pushing.

And it isn't just through the ME stuff, although I think ours was first. The old pyjama paralysis - which to me sounds like a classic myth in the way it is worded and yet is sucked up like utter fact - is pushed and what is behind attitudes in hospital.

Scary when that attitude drifts into science where people literally can't see that there could be a null hypothesis.

You get this strange stuff from mad people thinking if someone didn't progress it must be their not doing it right or thinking wrong or all sorts of things that if you stepped back as a scientist without said blinkers would seem, in people who genuinely tend to be sincere and dedicated and tenacious, unfeasible.

It is interesting when you compare to laypersons not in these certain jobs and sectors which is I assume just what humans normally think combined with culture and post-hoc justification for doing what works for them or their company they have to be a manager in. There simply isn't the constant indoctrination and then usage of ad populus to make people not dare think anything different etc.

It doesn't mean you don't get so and sos who believe you need to get up and walk but the attitude comes from somewhere different, and at least you know they both don't care about thinking and are indeed looking to just say something to judge, and just don't believe in disabiltiy in the first place. Whereas the trying to square the circle to claim being a nice person or good 'whatever your role is as a caring person' by suggesting you believe in disability you are just happy to believe they could improve it there is just 'something standing in their way that only needs motivating or behavioural psych' they don't realise is the same thing - hence they don't recognise they are the psychosomaticists often.

The issue here with mentioning this is that people will be getting enough of all of this 'culture' as a new experience and so the cognitive dissnonance mad-making attitude that could be inadvertently implicit in the telehealth stuff for those who aren't finding the therapies help will in itself have a distorting effect on drop-outs. You just aren't going to zoom in to have some up themselves person superior-ing you as if you must be a little something and that's why it isn't working.

Surely one big thing therefore missing from any of these studies - if they are going to genuinely be open-minded to null hypotheses is communication training to ensure they aren't using CBT techniques and are trained in active listening and appropriate body language and responses for those who do display PEM and aren't going to gaslight or have weird attitudes (that they mightn't realise they instinctively adopt) to certain feedback?

You wouldn't be allowed to pull faces or be snide if running a focus group but I suspect it is allowed to be left 'trained-in' here because they think it's some sort of norm? BUt it is very important for the validity and robustness of the research?