{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:28:37Z","timestamp":1794317317497,"version":"4.9.0"},"reference-count":36,"publisher":"BMJ","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National\n                                    Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                    <jats:sec>\n                        <jats:title>Objective<\/jats:title>\n                        <jats:p>To evaluate whether a structured online supervised group physical\n                            and mental health rehabilitation programme can improve health related\n                            quality of life compared with usual care in adults with post-covid-19\n                            condition (long covid).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Design<\/jats:title>\n                        <jats:p>Pragmatic, multicentre, parallel group, superiority randomised\n                            controlled trial.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Setting<\/jats:title>\n                        <jats:p>England and Wales, with home based interventions delivered remotely\n                            online from a single trial hub.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Participants<\/jats:title>\n                        <jats:p>585 adults (26-86 years) discharged from NHS hospitals at least\n                            three months previously after covid-19 and with ongoing physical and\/or\n                            mental health sequelae (post-covid-19 condition), randomised (1:1.03) to\n                            receive the Rehabilitation Exercise and psycholoGical support After\n                            covid-19 InfectioN (REGAIN) intervention (n=298) or usual care\n                            (n=287).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Interventions<\/jats:title>\n                        <jats:p>Best practice usual care was a single online session of advice and\n                            support with a trained practitioner. The REGAIN intervention was\n                            delivered online over eight weeks and consisted of weekly home based,\n                            live, supervised, group exercise and psychological support\n                            sessions.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Main outcome measures<\/jats:title>\n                        <jats:p>The primary outcome was health related quality of life using the\n                            patient reported outcomes measurement information system (PROMIS)\n                            preference (PROPr) score at three months. Secondary outcomes, measured\n                            at three, six, and 12 months, included PROMIS subscores (depression,\n                            fatigue, sleep disturbance, pain interference, physical function, social\n                            roles\/activities, and cognitive function), severity of post-traumatic\n                            stress disorder, general health, and adverse events.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Between January 2021 and July 2022, 39\u2009697 people were invited to\n                            take part in the study and 725 were contacted and eligible. 585\n                            participants were randomised. Mean age was 56 (standard deviation (SD)\n                            12) years, 52% were female participants, mean health related quality of\n                            life PROMIS-PROPr score was 0.20 (SD 0.17), and mean time from hospital\n                            discharge was 323 (SD 144) days. Compared with usual care, the REGAIN\n                            intervention led to improvements in health related quality of life\n                            (adjusted mean difference in PROPr score 0.03 (95% confidence interval\n                            0.01 to 0.05), P=0.02) at three months, driven predominantly by greater\n                            improvements in the PROMIS subscores for depression (1.39 (0.06 to\n                            2.71), P=0.04), fatigue (2.50 (1.19 to 3.81), P&lt;0.001), and pain\n                            interference (1.80 (0.50 to 3.11), P=0.01). Effects were sustained at 12\n                            months (0.03 (0.01 to 0.06), P=0.02). Of 21 serious adverse events, only\n                            one was possibly related to the REGAIN intervention. In the intervention\n                            group, 141 (47%) participants fully adhered to the programme, 117 (39%)\n                            partially adhered, and 40 (13%) did not receive the\n                            intervention.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>In adults with post-covid-19 condition, an online, home based,\n                            supervised, group physical and mental health rehabilitation programme\n                            was clinically effective at improving health related quality of life at\n                            three and 12 months compared with usual care.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Trial registration<\/jats:title>\n                        <jats:p>ISRCTN registry<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"ISRCTN11466448\" ext-link-type=\"isrctn\">ISRCTN11466448<\/jats:ext-link>.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/bmj-2023-076506","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T11:22:43Z","timestamp":1707823363000},"page":"e076506","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":92,"title":["Clinical effectiveness of an online supervised group physical and mental\n                        health rehabilitation programme for adults with post-covid-19 condition\n                        (REGAIN study): multicentre randomised controlled trial"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"isrctn11466448","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-9107","authenticated-orcid":false,"given":"Gordon","family":"McGregor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harbinder","family":"Sandhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartholomew","family":"Sheehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"McWilliams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Lara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharisse","family":"Alleyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Lall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Ratna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Ennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Heine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Abraham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Mason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Nwankwo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien","family":"Nichols","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Seers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Underwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"2024021307402932000_384.feb07_7.e076506.1","unstructured":"Institute for Health Metrics and Evaluation. 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Prevalence of ongoing\n                            symptoms following coronavirus (COVID-19) infection in the UK: 30 March\n                            2023.\n                            https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk\/30march2023:\n                            ONS website, statistical bulletin; 2023."},{"key":"2024021307402932000_384.feb07_7.e076506.3","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00846-2"},{"key":"2024021307402932000_384.feb07_7.e076506.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032979"},{"key":"2024021307402932000_384.feb07_7.e076506.5","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002735"},{"key":"2024021307402932000_384.feb07_7.e076506.6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003793.pub3"},{"key":"2024021307402932000_384.feb07_7.e076506.7","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-020-04978-9"},{"key":"2024021307402932000_384.feb07_7.e076506.8","doi-asserted-by":"publisher","DOI":"10.3310\/nihropenres.13371.2"},{"key":"2024021307402932000_384.feb07_7.e076506.9","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-022-01640-7"},{"key":"2024021307402932000_384.feb07_7.e076506.10","unstructured":"Office for National Statistics. Prevalence of ongoing\n                            symptoms following coronavirus (COVID-19) infection in the UK: 3 March\n                            2022.\n                            https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk\/3march2022:\n                            ONS website, statistical bulletin; 2022."},{"key":"2024021307402932000_384.feb07_7.e076506.11","unstructured":"NHS England. Your COVID Recovery.\n                            https:\/\/www.yourcovidrecovery.nhs.uk; 2021."},{"key":"2024021307402932000_384.feb07_7.e076506.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.09.2752"},{"key":"2024021307402932000_384.feb07_7.e076506.13","unstructured":"WordPress. The PROMIS-Preference Score. 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UK Chief\n                            Medical Officers\u2019 Physical Activity Guidelines.\n                            https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/832868\/uk-chief-medical-officers-physical-activity-guidelines.pdf:\n                            NHS England, HM Government: Crown Copyright;\n                            2019."},{"key":"2024021307402932000_384.feb07_7.e076506.26","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-29513-z"},{"key":"2024021307402932000_384.feb07_7.e076506.27","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.21m14116"},{"key":"2024021307402932000_384.feb07_7.e076506.28","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2012.707258"},{"key":"2024021307402932000_384.feb07_7.e076506.29","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.066738"},{"key":"2024021307402932000_384.feb07_7.e076506.30","unstructured":"Royal College of Physicians. 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Covid-19 \u2013 Notice under Regulation 3(4)\n                            of the Health Service Control of Patient Information Regulations 2002.\n                            https:\/\/digital.nhs.uk\/coronavirus\/coronavirus-covid-19-response-information-governance-hub\/control-of-patient-information-copi-notice#download-the-copi-notice:\n                            NHS England, HM Government: Crown Copyright;\n                            2022."}],"updated-by":[{"DOI":"10.1136\/bmj.q988","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000}}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj-2023-076506","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj-2023-076506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T11:22:53Z","timestamp":1707823373000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj-2023-076506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,7]]},"references-count":36,"alternative-id":["10.1136\/bmj-2023-076506"],"URL":"https:\/\/doi.org\/10.1136\/bmj-2023-076506","relation":{"correction":[{"id-type":"doi","id":"10.1136\/bmj.q988","asserted-by":"object"}]},"ISSN":["1756-1833"],"issn-type":[{"value":"1756-1833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,7]]}}}