eHealth-Guided Exercise Improves Peak Oxygen Uptake and Health-Related Quality of Life After COVID-19: A Randomized Controlled Trial.

Abstract

Purpose: Physical activity (PA) levels declined during the COVID-19 pandemic, contributing to reduced fitness and quality of life. eHealth tools may help increase PA. In a six-month randomized controlled trial, we evaluated Activity Quotient (AQ), an innovative eHealth tool designed to promote PA and improve peak oxygen uptake (V̇O2peak), compared with standard advice on national PA recommendations in physically inactive adults recovering from COVID-19.

Methods: Seventy-seven participants with previous COVID-19 infection were randomized 1:1 to either receive: 1) an eHealth-guided exercise intervention (n=38), using AQ to motivate for a PA dose that led to >100 weekly AQs, or 2) a control group (n=39) advised to follow standard PA recommendations. V̇O2peak scaled for fat-free mass (FFM) was the primary outcome, assessed in a subsample of participants who completed clinical assessment (n=33; eHealth group n=16, control n=17), while secondary outcomes included physical and mental scores of health-related quality of life (HRQoL). Linear mixed-effects models were used to analyze the effects of the intervention.

Results: Participants (79% women) were 41.4±10.0 years and had a BMI of 28.8±5.9 kg/m². Among 33 participants who completed clinical assessment, V̇O2peak increased 4.9 mL•kgFFM -1•min -1 (95%CI 1.2 to 8.7, p=0.0134) more in the eHealth group compared with controls. Mental HRQoL increased by 9.8 points (95% CI 2.5 to 17.0, p=0.009) more in the eHealth group compared with controls. No between-group difference was observed in physical score of HRQoL.

Conclusions: A six-month eHealth-guided exercise intervention using AQ was more effective than standard PA advice in improving V̇O2peak and mental HRQoL among physically inactive adults recovering from COVID-19. These findings highlight the potential of AQ as an effective and feasible approach for post-COVID rehabilitation.