Long COVID fatigue eased by four-week occupational therapy program, Irish study finds
Promising findings from a pilot long COVID rehabilitation program in Ireland are being presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Lisbon, Portugal (23-26 April).
Post-COVID-19 syndrome, also known as long COVID, is estimated to affect at least 10% of people in Ireland who have had COVID. People from all ages and backgrounds are affected, with extreme fatigue one of the main symptoms.
This fatigue is beyond ordinary tiredness and affects day-to-day activities, including personal care, leisure activities and employment. Even basic tasks such as getting dressed and climbing the stairs can be exhausting.
"Long COVID is a new phenomenon and the exact long-term implications are unknown," says Louise Norris, senior occupational therapist St James's Hospital, Dublin, Ireland, who led the research.
"We became concerned after seeing increasing numbers of patients who were having difficulty carrying out everyday activities because of fatigue. Fatigue was also affecting their return to work.
"One of the key roles, and skills, of occupational therapy is to help people get back to their everyday activities. We've previously helped those with other conditions, such as multiple sclerosis and rheumatoid arthritis, learn techniques to manage their fatigue and felt we could use that experience to address the needs of those with long-term fatigue post COVID."
To find out more, Louise Norris and colleagues at St James's Hospital and Trinity College Dublin developed a pilot occupational therapy Fatigue Management Education program (FaME-PC).
The pilot program in St James's Hospital involved 53 patients (73% female), with a median age of 51, who had self-reported fatigue that was affecting their ability to take part in everyday activities.
Post-COVID symptom duration between 12 weeks and 12 months was reported by 36 (68%) participants. 13 (25%) reported post-COVID symptom duration >12 months.
At the start of the study, 52 participants (98%) reported moderate to severe fatigue. 38 participants (72%) reported moderate to severe breathing difficulties and half had difficulty with concentration and memory, known as brain fog
These symptoms caused moderate to severe disruption to return to work in 39 participants (74%), engagement in leisure activity in 34 participants (64%) and completion of everyday activities, such as preparing meals, driving or going for a walk, in 31 participants (58%).
The participants took part in three 1.5-hour-long group-based interventions delivered online by an occupational therapist over a four-week period.
These focused on self-management techniques to address everyday fatigue and brain-fog. Topics covered included energy planning, dealing with stress and sleep hygiene.
Emphasis was placed on showing the participants how to identify their body and brain's limit—allowing them to take a break before they reached the point of exhaustion.
The aim was to equip the participants with techniques they could practice in their day-to-day lives as much as possible.
Questionnaires about fatigue and energy levels, quality of life and concerns about well-being were filled in by the participants before the study and two weeks after the end of the four-week program.
Preliminary analysis of the results showed significant improvements in all three areas: fatigue, quality of life and well-being concerns.
Louise Norris says: "There is an urgent need to find new and better ways of managing post-COVID fatigue and its wide-ranging, and in some cases, devastating, effects on people's lives.
"Initial results from our pilot program are highly promising. They show equipping patients with a range of practical techniques can result in meaningful improvements in fatigue and quality of life. Patients also have fewer concerns about their well-being."
The pilot has been extended and data collection is ongoing.
