Review Effectiveness and tolerance of exercise interventions for long COVID: a systematic review of randomised controlled trials, 2025, McDowell et al

Hutan said:
So, it's like comparing
Benefit of A minus benefit of B
Benefit of C minus benefit of A
and then working out the average of those two completely different things and suggesting it means something.
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Don't quite understand what you mean by this? Isn't the problem simply that these trials did not include a non-exercise control group (and thus cannot estimate the effect of exercise)?
 
Looked at some of these studies like Li 2022 or Romanet 2023 and they focused on patients discharged from hospital with pulmonary problems so quite different from the ME/CFS subtype of Long Covid.
 
ME/CFS Skeptic said:
Don't quite understand what you mean by this? Isn't the problem simply that these trials did not include a non-exercise control group (and thus cannot estimate the effect of exercise)?
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Well, yes. But it is even worse than that.

J-A: Exercise vs leaflet
J-A: Exercise vs leaflet
Li: Telerehab vs brief instructions at baseline
Okan: Exercise vs brochure
R-B: Telerehab vs nothing
Romanet: Supervised exercise vs physiotherapy
Rutkowski: Virtual reality exercise vs supervised exercise
Vallier: In hospital rehab including exercise vs home based rehab including exercise

Because not only do some of the trials not have a non-exercise control group, but the controls in some of the trials are the same as the treatments in some of the others.

For example, for Rutkowski, they studied exercise using virtual reality versus supervised exercise. For Vallier, the control was home-based rehab including exercise, but in other studies (Li and R-B), the active treatment was home-based exercise.

The studies did all sorts of things, and for as little as 2 or 3 weeks in some, and the review just combined the effects all together.
 
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