Study Overview
Official Title:
Impact of Functional and Cognitive Rehabilitation, in Adults with Chronic Noncommunicable Diseases and Long Covid-19 , on Their Functional and Cognitive Capacity, Quality of Life, and the Evolution of Their Baseline Condition, in Bogotá D.C.
Status:
NOT_YET_RECRUITING
Status Verified Date:
2025-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Brief Summary:
This study aims to evaluate the impact of a functional and cognitive rehabilitation strategy compared to evidence-based informational messages, on functional capacity, cognitive abilities, quality of life, and disease progression in adults with chronic non-communicable diseases (NCDs) and Long Covid-19.
Researchers will compare a structured rehabilitation program to informational support through evidence-based messages to determine if rehabilitation leads to better functional and cognitive outcomes in patients with Long Covid-19.
Participants will be randomly assigned to one of two groups:
1. Functional and cognitive rehabilitation: Attending weekly in-person sessions for 8 weeks, including supervised physical and cognitive exercises.
2. Informational support: Receiving weekly evidence-based educational messages for 8 weeks.
Participants will undergo assessments at baseline, post-intervention, and six months later, including a six-minute walk test, handgrip strength measurement, and questionnaires on disability, anxiety, depression, fatigue, dyspnea, cognitive function, and quality of life.
Detailed Description:
Study Objective
The primary goal of this study is to evaluate the impact of a functional and cognitive rehabilitation strategy compared to evidence-based informational messages, on functional capacity, cognitive abilities, quality of life, and disease progression in adults with chronic non-communicable diseases (NCDs) and Long Covid-19.
Specific Objectives
* Determine the prevalence of Long Covid-19 among participants from previous Covid-19 institutional registries, describing the primary clinical manifestations based on symptom recurrence and severity.
* Administer a functional and cognitive rehabilitation strategy in patients with NCDs and Long Covid-19, and compare it with evidence-based informational messages
Evaluate the impact of both interventions on key clinical outcomes, including:
* Six-minute walk test performance (functional capacity)
* Montreal Cognitive Assessment (MoCA) score (cognitive function)
* EQ-5D-5L (quality of life assessment)
* Incidence of events indicating worsening of underlying conditions
Methodology
The study has been conducted in two phases. The second phase is the one being registered on this platform:
1. Phase 1: Identification and Diagnosis of Long Covid-19
* Study Design: Identification of eligible patients through institutional registries at Fundación Cardioinfantil - Instituto de Cardiología (FCI-IC) and Hospital Militar Central (HOMIL).
* Eligible Population: Adults (≥18 years) with a history of hypertension or type 2 diabetes mellitus who had a suspected acute SARS-CoV-2 infection between March 2020 and December 2021.
* Sample Size and Recruitment: Approximately 2,240 individuals were contacted, with an expected 30% prevalence of long COVID, yielding at least 672 eligible participants for the clinical trial.
Screening Procedures:
* Telephone contact using a pre-established script adapted from one of the registries.
* Administration of a structured questionnaire on persistent symptoms, functional limitations, and prior health conditions.
Criteria for Long Covid-19 diagnosis:
* Presence of at least two persistent, intermittent, or recurrent symptoms for at least four weeks.
* At least one symptom significantly impacting daily activities.
* Symptoms unexplained by pre-existing health conditions.
Data Management: Information has been recorded in the REDCap platform, ensuring secure data collection and monitoring.
2. Phase 2: Randomized Clinical Trial
* Study Design: A parallel-group, randomized controlled trial (RCT) with active control.
* Eligible Participants: Those diagnosed with Long Covid-19 in Phase 1.
Randomization (1:1):
* Experimental Group: Functional and cognitive rehabilitation strategy.
* Control Group: Informational support with evidence-based messages.
Inclusion Criteria:
* Confirmed Covid-19 diagnosis.
* History of hypertension or diabetes before the SARS-CoV-2 infection.
* Persistent symptoms affecting daily life.
* Ability to participate in in-person rehabilitation or receive informational support.
Exclusion Criteria:
* Age \>80 years.
* Advanced chronic conditions (e.g., severe heart failure, advanced kidney disease).
* Hospitalizations in the year prior to study enrollment.
* Cognitive or physical impairments preventing participation.
* Interventions
Functional and Cognitive Rehabilitation:
Duration: 8 weeks, with one session per week at the study site.
1. Functional Rehabilitation (Supervised by trained health professionals)
* Warm-up (8 min)
* Aerobic exercise (20 min on treadmill/elliptical)
* Muscle toning (8 min)
* Cool-down (8 min)
2. Cognitive Rehabilitation (Guided by occupational therapy professionals) - 30-minute sessions focusing on memory, attention, and executive functions.
Informational Support with evidence-based messages (Active Control):
Weekly delivery of evidence-based health information via email, SMS, or WhatsApp. Topics include COVID-19 prevention, treatment, and prognosis.
Three informational messages per week for 8 weeks.
Outcome Measures
1. Primary Outcomes:
* Six-minute walk test.
* MoCA cognitive assessment.
* EQ-5D-5L quality of life questionnaire.
* Incidence of clinical events related to NCD deterioration.
2. Secondary Outcomes:
* Fatigue severity (Fatigue Severity Scale).
* Anxiety and depression (Hospital Anxiety and Depression Scale).
* Disability assessment (WHO Disability Assessment Schedule 2.0).
* Dyspnea severity (MRC Dyspnea Scale).
Additionally, complementary measurements will be taken at the initial visit, post-intervention, and six months after completion to assess:
* WHO Disability Assessment Questionnaire.
* Hospital Anxiety and Depression Scale.
* Fatigue Severity Scale.
* MRC Dyspnea Scale.
* Study Timeline and Follow-up Baseline assessment (before intervention).
* Post-intervention evaluation (within 4 weeks of completion).
* Six-month follow-up assessment.
* Evaluations conducted by trained, blinded assessors to ensure objectivity.
Ethical Considerations
* Confidentiality: Participant data will be managed per ethical guidelines and stored securely.
* Voluntary Participation: Participants may withdraw without affecting their standard medical care.
* Safety Measures: Rehabilitation sessions will be supervised to mitigate risks such as fatigue or dizziness.
* Insurance Coverage: A study-specific insurance policy will provide coverage for any adverse events related to the interventions.
This study will contribute to understanding Long Covid-19 management in patients with chronic conditions, providing evidence for the development of effective rehabilitation strategies to improve patient outcomes.
Study Oversight
Has Oversight DMC:
True
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?: