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

Importance Current insight into recovery and real-world treatment of people with persistent complaints after SARS-CoV-2 infection is limited. Objective The objective of this study was to describe the content, duration, and reasons for initiating and terminating physical therapist interventions and (factors contributing to) changes in outcomes before and after treatment. Design This was a prospective cohort study in Dutch primary care allied health care. Participants Participants were patients receiving allied health care treatment after SARS-CoV-2 infection. Intervention The intervention was primary care physical therapy. Main outcomes and measures Self-reported functioning (patient-specific functional scale [PSFS]), 6-min walk test (6MWT), sit-to-stand performance (5 times sit-to-stand [5TSTS]), grip strength, and treatment characteristics were measured pre- and post-treatment. Associations between baseline characteristics, pre-treatment scores, and clinically important improvement on PSFS were calculated. Results Nine hundred ninety-two patients (mean age 50 years [SD = 13]) were included. Median treatment duration was 24 weeks (IQR = 17-26) and 31 sessions (19-43). Most selected treatment goals were to improve endurance (74%) and physical functioning (72%). In 59% of treatment episodes, therapists reported that patients had achieved the main treatment goal. Mean change scores (95% CIs) were -4.1 points (-4.4 to -3.8) on the PSFS, 70 m (61-78) on the 6MWT, -3.0 s (-3.4 to -2.5) on the 5TSTS, and 3.0 kg (2.1-3.9) on grip strength. Females and participants with worse baseline scores on PSFS had greater odds of reporting a clinically important improvement on the PSFS. Patients with longer 5TSTS times had lower odds. Conclusion Most patients achieved their treatment goals and demonstrated clinically important improvements on PSFS and 6MWT. This study provides information on the most important therapeutic goals and provides estimates for realistic treatment episodes. Relevance This article provides insight into real-world physical therapy in patients experiencing persistent complaints after SARS-CoV-2 infection. Additionally, insight into their recovery is provided, showing that patients improve significantly and clinically important on self-reported functioning, 6-min walk test, and sit-to-stand performance.