Effectiveness of a Mobile-Based Telerehabilitation Exercise Program on Cardiorespiratory Fitness, Gait Speed, and Symptoms in Individuals with Long COVID: A Randomized Controlled Trial (Preprint)

BACKGROUND Telerehabilitation has emerged as a promising intervention, with evidence indicating potential benefits for physical function, symptoms, and quality of life (QOL) in individuals with long COVID. However, current research remains limited and shows inconsistent results, particularly regarding its effects on gait speed. OBJECTIVE To evaluate the efficacy of a 12-week mobile-based telerehabilitation exercise program on cardiorespiratory fitness (CRF), gait speed, symptom relief, sleep quality, and QOL in participants with long COVID. METHODS This randomized controlled trial was conducted at a rehabilitation outpatient clinic at a medical center in northern Taiwan. A total of 120 eligible participants aged 20–80 years with long COVID who attended the outpatient clinic were enrolled. Both the experimental group (EG, n =57) and comparison group (CG, n =63) received face-to-face physical activity promotion counseling delivered by a research nurse. In addition, the EG participated in a 12-week mobile-based, physical therapist-assisted telerehabilitation program that combined aerobic and resistance training. Primary outcomes included CRF, gait speed, and symptoms of long COVID were assessed in person by the other research nurse who was a blinded assessor. Secondary outcomes included body composition, sleep quality (Pittsburgh Sleep Quality Index), and QOL (World Health Organization Quality of Life-BREF), were assessed via a combination of in-person measurements and self-administered questionnaires. RESULTS Compared to the CG, the EG demonstrated significantly greater improvements in CRF (peak VO₂, β = 2.12, p = 0.01) and gait speed (β = 0.07, p < 0.001), along with a lower risk of symptoms such as fatigue (odds ratio = 0.20, p < 0.001). At 12 weeks, the EG also showed increased lean mass (β = 1.32, p < 0.001), improved sleep quality (β = –0.58, p = 0.034), and enhanced physical (β = 0.97, p = 0.0033) and social (β = 0.77, p = 0.049) domains of QOL compared to the CG. CONCLUSIONS A 12-week mobile-based telerehabilitation exercise program yielded beneficial effects on CRF, gait speed, body composition, symptoms of long COVID, sleep quality, and QOL in participants with long COVID. These findings support the feasibility and effectiveness of telerehabilitation as an approach to promote recovery and well-being in this population. CLINICALTRIAL This trial was prospectively registered at ClinicalTrials.gov (Identifier: NCT05922865).