As millions suffer from long COVID across the globe, including in India, a unique rehabilitation programme led by an Indian-origin scientist has helped some of such patients reduce their symptoms and increase activity levels with "impressive" results.

Before the start of the programme, those who took part reported on average three "crashes" a week where they were left physically, emotionally or cognitively exhausted after mild physical or mental exertion.

Six weeks later, at the end of the programme, that was reduced to an average of one crash a week. The patients also experienced a "moderate improvement" in their ability to be active and better quality of life.

"Long COVID is distressing and disabling. Post-exertional malaise or post-exertional symptom exacerbation or simply 'crashesa', as described by patients, is a defining and important symptom of long COVID," said Dr Manoj Sivan, Associate Clinical Professor in the School of Medicine at the University of Leeds in the UK.

When patients get a crash, they experience feelings of complete exhaustion and wipe out and are unable to resume activities for hours or sometimes days.

"The findings of this research are exciting because this is the first time that crashing episodes have been used as a marker for the condition and a structured pacing programme has now been shown to substantially reduce symptoms and improve quality of life," explained Sivan, also a consultant in Rehabilitation Medicine at Leeds Teaching Hospital NHS Trust.

In a paper published in the Journal of Medical Virology, the research team analysed 31 people with long COVID. On average, they had been experiencing long COVID for around 17 months before entering this programme.

They were suffering from a range of symptoms along with fatigue, including brain fog, breathlessness, headache and palpitations.

The patients followed a gradual return to physical activity programme called the World Health Organisation (WHO) "CR-10 Borg pacing protocol", which takes them through five levels of activity. They followed the programme at home.

The first phase was preparation for return to activity and involves breathing exercises and gentle stretching. The fifth phase involved activities the patients were doing before they were ill such as regular exercise or sports.

Over the six weeks, not only was there a reduction in crashing episodes but there were also improvements in activity level and quality of life.

In terms of easing long COVID symptoms, the biggest benefit was seen in terms of reducing fatigue, breathlessness and headaches.

Dr Sivan's research team has been at the forefront of new initiatives to treat long COVID. They developed the first scale to standardise the measurement of long COVID symptoms, which has now been developed into a mobile phone app, used by patients.