PTCohortPhysical therapy2025

Primary Care Physical Therapy and Exercise Therapy for People With Persistent Complaints After a SARS-CoV-2 Infection: Secondary Analysis of the ParaCov Prospective Cohort Study.

Marissa H G Gerards, Arie C Verburg, Anne I Slotegraaf and 5 others

PMID 40344651

WHAT IT FOUND

Many people with persistent post-COVID symptoms showed meaningful improvements after primary care physical therapy or exercise therapy, but grip strength often did not change meaningfully.

This is real-world change, not proof treatment caused it.

Key findings

01Patients' most impaired self-selected activity improved by 4.1 points on a 0 to 10 scale after treatment, and 64% reached a clinically important improvement.

02Walking distance increased by 70 m on average, and 66% reached a clinically important improvement of at least 30.2 m.

03Grip strength increased by 3.0 kg on average, but 74% showed no clinically important difference.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was a cohort analysis, and the paper says it cannot support causal conclusions about physical therapy effectiveness. Natural recovery, regression to the mean, and response shift may explain some of the observed changes. Some participants were also treated by other allied health professionals, so the contribution of physical therapy or exercise therapy alone cannot be separated. About 10% of baseline characteristics were missing, and more data were missing for outcomes measured at the end of treatment. Therapists reported treatment goals and reasons for ending treatment about their own care, so socially desirable answers cannot be ruled out. Pulmonary complications were not specifically recorded, and psychological well-being was not included in the current analyses.

Declared interests

Funded by Maastricht University, Stichting Revalidatie en Wetenschap, Nivel Netherlands Institute for Health Services Research, and ZonMw Efficiency Studies. The paper states the funders played no role in design, conduct, or reporting. The supplied text does not give author conflict-of-interest declarations.

The easy way to misread this

Do not conclude that physical therapy or exercise therapy caused the improvements. This was a cohort study, not a randomised trial, and the paper says it cannot support causal conclusions. Natural recovery, regression to the mean, and response shift may explain some changes.

Read it on PubMed →