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PCS impacts nearly every organ system, posing significant challenges for healthcare systems and patients. Despite this, effective guidelines for multimodal training or rehabilitation remain absent. The app-based physical intervention for long- and post-COVID treatment (A PILOT) study is a prospective, multicentre, two-armed, randomised controlled trial to evaluate the effectiveness of an app-based multimodal training intervention in patients with PCS. 100 participants will be randomly assigned to an intervention group (IG) or a control group (CG). Over 2\u2009months, the IG will follow a standardised app-based intervention programme incorporating breathing exercises, endurance and strength training and progressive muscle relaxation. The CG will adhere to general WHO exercise recommendations during the waiting period and gain access to the app after the study concludes. Comprehensive assessments, including physical examinations, blood tests, psychological questionnaires, transthoracic echocardiography, electrocardiography and cardiopulmonary exercise testing, will be conducted pre- and post-intervention. The primary endpoints are the effects of app-based multimodal training on physical performance, neurocognitive function and health-related quality of life. Secondary endpoints include mental health outcomes (eg, depression, perceived stress, sleep quality and daytime sleepiness), echocardiographic and anthropometric measures and alterations in inflammatory markers and metabolites of the kynurenine pathway. This study aims to provide critical insights into structured app-based programmes, potentially establishing a framework for improving recovery in PCS patients.<\/jats:p>","DOI":"10.1136\/bmjsem-2025-002540","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T07:14:23Z","timestamp":1741331663000},"page":"e002540","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of an app-based physical training for long- and post-COVID treatment (A PILOT) study: protocol for a multicentre randomised controlled trial"],"prefix":"10.1136","volume":"11","author":[{"given":"Sarah Isabel","family":"Krieg","sequence":"first","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Matits","sequence":"additional","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"},{"name":"Clinical & Biological Psychology, Ulm University, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart","family":"Mentz","sequence":"additional","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Kirsten","sequence":"additional","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Friedmann-Bette","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Niess","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Medical Clinic, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Deibert","sequence":"additional","affiliation":[{"name":"Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Maier","sequence":"additional","affiliation":[{"name":"Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mich\u00e8le","family":"Natale","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar","family":"Erz","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Medical Clinic, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Alexander","family":"Bizjak","sequence":"additional","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7467-2614","authenticated-orcid":false,"given":"Jana","family":"Schellenberg","sequence":"additional","affiliation":[{"name":"Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"2025083110251548000_11.1.e002540.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00846-2"},{"key":"2025083110251548000_11.1.e002540.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03173-6"},{"key":"2025083110251548000_11.1.e002540.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-071050","article-title":"Post-acute sequelae of covid-19 six to 12 months after infection: population based study","volume":"379","author":"Peter","year":"2022","journal-title":"BMJ"},{"key":"2025083110251548000_11.1.e002540.4","doi-asserted-by":"crossref","unstructured":"Peter RS , Nieters A , G\u00f6pel S , et al . 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