{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:30:59Z","timestamp":1762255859447,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of a football club community trust exercise rehabilitation programme on physical function and quality of life in individuals with PCC. Method: A mixed-methods retrospective design was employed, utilising a framework to assess the programme\u2019s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). Quantitative data (questionnaires and physiological assessments) were collected at baseline, 6 weeks, and 12 weeks during the programme, and at 6 months post-intervention (n = 7). Qualitative data were gathered through semi-structured focus groups at week 12 (n = 7) and 12 months (n = 5) post-intervention. Quantitative data and qualitative data were analysed using repeated measures ANOVAs and thematic analysis, respectively. Results: The programme led to significant improvements in physical function, including increased six-minute walking distance (6MWT, p &lt; 0.001), one-minute sit-to-stand repetitions (1MSST, p &lt; 0.035), and lung function (spirometry; MIP: p = 0.048, MEP: p = 0.024). Participants also reported enhanced QoL (HRQoL-14, p = 0.004), reduced anxiety (GAD-7, p = 0.008) and depression (PHQ-9, p = 0.008), and increased confidence and self-efficacy. The programme was well-received, with participants valuing the supportive environment and personalised approach. Conclusions: Football community trust exercise rehabilitation programmes can effectively improve physical function and quality of life in individuals with PCC, offering a promising model for community-based rehabilitation. Further studies are needed with larger sample sizes to assess the scalability of similar programmes.<\/jats:p>","DOI":"10.3390\/ijerph22111672","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:11:16Z","timestamp":1762254676000},"page":"1672","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Mixed-Methods Evaluation of a Post-COVID-Condition Rehabilitation and Recovery Intervention Delivered in a Football Club Community Trust"],"prefix":"10.3390","volume":"22","author":[{"given":"Steven","family":"Rimmer","sequence":"first","affiliation":[{"name":"Human Performance and Health Laboratory, Birmingham City University, Birmingham B15 3TN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8964-0087","authenticated-orcid":false,"given":"Adam J.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Human Performance and Health Laboratory, Birmingham City University, Birmingham B15 3TN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4929-1067","authenticated-orcid":false,"given":"Adam L.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Human Performance and Health Laboratory, Birmingham City University, Birmingham B15 3TN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7544-1386","authenticated-orcid":false,"given":"Irfan","family":"Khawaja","sequence":"additional","affiliation":[{"name":"Human Performance and Health Laboratory, Birmingham City University, Birmingham B15 3TN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Lee","sequence":"additional","affiliation":[{"name":"Burton Albion Community Trust, Burton-Upon-Trent DE13 0AR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1115-7559","authenticated-orcid":false,"given":"Lewis A.","family":"Gough","sequence":"additional","affiliation":[{"name":"Human Performance and Health Laboratory, Birmingham City University, Birmingham B15 3TN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref_1","unstructured":"National Institute for Health and Care Excellence (NICE) (2020). Post-COVID-Condition Syndrome (Long COVID), National Institute for Health and Care Excellence."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1093\/infdis\/jiac136","article-title":"Global prevalence of post-acute sequelae of Covid-19 (PASC) or long covid: A meta-analysis and systematic review","volume":"226","author":"Chen","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_3","unstructured":"Office for National Statistics (2023). Prevalence of Long COVID Symptoms and Associated Activity Limitations, Office for National Statistics."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1515\/mr-2024-0030","article-title":"Review of organ damage from COVID and Long COVID: A disease with a spectrum of pathology","volume":"5","author":"Ewing","year":"2024","journal-title":"Med. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S2213-2600(20)30076-X","article-title":"Pathological findings of COVID-19 associated with acute respiratory distress syndrome","volume":"8","author":"Xu","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1161\/CIRCRESAHA.120.317015","article-title":"Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system","volume":"126","author":"Gheblawi","year":"2020","journal-title":"Circ. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8198963","DOI":"10.1155\/2020\/8198963","article-title":"Cytokine storm in COVID-19 patients, its impact on organs and potential treatment by QTY code-designed detergent-free chemokine receptors","volume":"2020","author":"Mustafa","year":"2020","journal-title":"Mediat. Inflamm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2402152","DOI":"10.1183\/13993003.02152-2024","article-title":"Post-Hospitalisation COVID-19 Rehabilitation (PHOSP-R): A randomised controlled trial of exercise-based rehabilitation","volume":"65","author":"Daynes","year":"2025","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"130","DOI":"10.23736\/S1973-9087.24.08487-9","article-title":"Exercise rehabilitation in post COVID-19 patients: A randomized controlled trial of different training modalities","volume":"61","author":"Sick","year":"2025","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e076506","DOI":"10.1136\/bmj-2023-076506","article-title":"Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): Multicentre randomised controlled trial","volume":"384","author":"McGregor","year":"2024","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1249\/MSS.0000000000003280","article-title":"Effect of Physical Exercise\u2013Based Rehabilitation on Long COVID: A Systematic Review and Meta-analysis","volume":"56","author":"Zheng","year":"2023","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wright, J., Astill, S.L., and Sivan, M. (2022). The Relationship Between Physical Activity and Long COVID: A Cross-Sectional Study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095093"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1080\/14660970.2014.920625","article-title":"Effect of a health-improvement pilot programme for older adults delivered by a professional football club: The Burton Albion case study","volume":"15","author":"Pringle","year":"2014","journal-title":"Soccer Soc."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Rutherford, Z., Zwolinsky, S., Kime, N., and Pringle, A. (2021). A Mixed-Methods Evaluation of CARE (Cancer and Rehabilitation Exercise): A Physical Activity and Health Intervention, Delivered in a Community Football Trust. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18063327"},{"key":"ref_15","unstructured":"RE-AIM (2023, December 01). Home\u2013Reach Effectiveness Adoption Implementation Maintenance. RE-AIM. Available online: https:\/\/re-aim.org\/."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Cotler, J., Holtzman, C., Dudun, C., and Jason, L.A. (2018). A Brief Questionnaire to Assess Post-Exertional Malaise. Diagnostics, 8.","DOI":"10.3390\/diagnostics8030066"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"V\u00f8llestad, N.K., and Mengshoel, A.M. (2023). Post-exertional malaise in daily life and experimental exercise models in patients with myalgic encephalomyelitis\/chronic fatigue syndrome. Front. Physiol., 14.","DOI":"10.3389\/fphys.2023.1257557"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1080\/21679169.2022.2086293","article-title":"The Borg scale is a sustainable method for prescribing and monitoring self-administered aerobic endurance exercise in patients with chronic kidney disease","volume":"25","author":"Svensson","year":"2022","journal-title":"Eur. J. Physiother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2147\/VHRM.S165524","article-title":"Clinical accuracy of the Omron M3 Comfort\u00ae and the Omron Evolv\u00ae for self-blood pressure measurements in pregnancy and pre-eclampsia\u2014Validation according to the Universal Standard Protocol","volume":"14","author":"Topouchian","year":"2018","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_20","unstructured":"Salter (2024, January 04). Pulse Oximeter. Available online: https:\/\/salter.com\/oxywatch-fingertip-pulse-oximeter\/."},{"key":"ref_21","unstructured":"Health Management (2025, October 17). Respiratory Muscle Exerciser\/Hand-Held MicroRPM. Available online: https:\/\/healthmanagement.org\/c\/icu\/products\/respiratory-muscle-exerciser-hand-held-microrpm."},{"key":"ref_22","unstructured":"Sport England (2018). Active Lives Adult Survey: November 2017\u2013November 2018, Sport England."},{"key":"ref_23","unstructured":"National Health Service (NHS) Foundation Trust (2023, December 05). Six-Minute Walk and One-Minute Sit to Stand Tests. Royal Brompton & Harefield Hospitals., Available online: https:\/\/www.rbht.nhs.uk\/our-services\/heart\/pulmonary-hypertension-service\/tests."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jad.2017.06.009","article-title":"Multimorbidity and depression: A systematic review and meta-analysis","volume":"221","author":"Read","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Muls, A., Georgopoulou, S., Hainsworth, E., Hartley, B., O\u2019Gara, G., Stapleton, S., and Cruickshank, S. (2022). The psychosocial and emotional experiences of cancer patients during the COVID-19 pandemic: A systematic review. Seminars in Oncology, Elsevier.","DOI":"10.1053\/j.seminoncol.2022.08.001"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1007\/s11606-007-0333-y","article-title":"Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis","volume":"22","author":"Gilbody","year":"2007","journal-title":"J. Gen. Intern. Med."},{"key":"ref_28","unstructured":"Public Health Scotland (2021). The Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), NHS Health Scotland."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/phr03020","article-title":"Football Fans in Training (FFIT): A randomised controlled trial of a gender-sensitised weight loss and healthy living programme for men\u2014End of study report","volume":"3","author":"Wyke","year":"2015","journal-title":"Public Health Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1093\/her\/cyu009","article-title":"Health improvement for men and hard-to-engage-men delivered in English Premier League football clubs","volume":"29","author":"Pringle","year":"2014","journal-title":"Health Educ. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2021","journal-title":"Qual. Res. Psychol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/j.1469-185X.2007.00027.x","article-title":"Effect size, confidence interval and statistical significance: A practical guide for biologists","volume":"82","author":"Nakagawa","year":"2007","journal-title":"Biol. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front. Psychol., 4.","DOI":"10.3389\/fpsyg.2013.00863"},{"key":"ref_34","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Gerlis, C., Barradell, A., Gardiner, N.Y., Chaplin, E., Goddard, A., Singh, S.J., and Daynes, E. (2022). The Recovery Journey and the Rehabilitation Boat\u2014A qualitative study to explore experiences of COVID-19 rehabilitation. Chronic Respir. Dis., 19.","DOI":"10.1177\/14799731221114266"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s11136-023-03513-y","article-title":"Long COVID quality of life and healthcare experiences in the UK: A mixed method online survey","volume":"33","author":"Owen","year":"2023","journal-title":"Qual. Life Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/11\/1672\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:21:26Z","timestamp":1762255286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/11\/1672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["ijerph22111672"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22111672","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]}}}