Fatigue in Long COVID (FALCON)
Fatigue in Long COVID Managed With Conservative Care: An International, Randomized Controlled Trial (FALCON Trial)
Long COVID affects about 6 in 100 people after a COVID-19 infection. It can cause ongoing problems like ongoing tiredness, muscle pain, and "brain fog." We know very little about which treatments might be helpful for long COVID.
The goal of this trial is to compare two treatments for people with long COVID to try to manage their symptoms. The main question is to assess whether the Lightning Process is effective for people living with long COVID compared to activity pacing. Each person will be placed into one of the two groups randomly (by chance, like flipping a coin). Activity pacing helps people balance rest and daily activities. The Lightning Process teaches ways to change thought patterns and body responses to symptoms. We will include 100 adults with long COVID. Everything will be done online, including filling out surveys about health and daily life. The goal is to find out which approach helps people feel better and improve their daily activities.
調査の概要
詳細な説明
The COVID-19 pandemic presented an unprecedented global health crisis, affecting millions globally and causing significant health and economic consequences. Although most people recover from acute SARS-CoV-2 infection, a substantial minority, approximately 6 to 15%, develop persistent symptoms that last for months and impair daily function, commonly referred to as post-COVID-19 condition or long COVID. Common symptoms of long COVID include fatigue, myalgia, dyspnea, sleep disturbance, and cognitive dysfunction ("brain fog"). The prevalence of long COVID is difficult to establish because most symptoms are nonspecific and many data sources rely on study designs that cannot confidently attribute symptoms to prior SARS-CoV-2 infection. Despite this uncertainty, converging evidence points to a large global burden, with >65 million people estimated to be living with functional limitations attributed to long COVID. The Lightning Process (LP), is a mind-body training program that is hypothesized to help individuals to develop a conscious influence on their level of functioning, using practical tools such as discussion, gentle movement and meditation-like techniques. Emerging evidence suggests that gradually re-engaging long COVID patients in physical activation and modifying unhelpful beliefs may promote recovery. There are currently no established treatments for long COVID, and patients often use activity pacing to manage their symptoms. The purpose of this trial is to establish the efficacy and safety of LP vs. activity pacing in adults living with long COVID. We hypothesize that in our trial, people randomized to LP will report greater improvement in fatigue compared to those receiving activity pacing. Our trial will enroll people living with long COVID who are motivated and show willingness to change their condition through intervention. The trial will assess whether, among adults living with long COVID (post COVID-19 condition) and persistent, function limiting symptoms, LP improves fatigue and other patient important outcomes, compared to activity pacing.
The primary objective is to assess the effect of LP vs. activity pacing on fatigue among adults with long COVID.
The secondary objectives are to assess the effect of LP vs. activity pacing on
- Physical functioning
- Pain severity
- Post exertional malaise
- Health related quality of life
- Somatic symptom severity
- Functional impairment
- Respiratory function
- Adverse events and serious adverse events
Both LP and pacing interventions span 26 weeks. Patients assigned to the LP intervention will complete a brief preparatory phase, then attend three consecutive core sessions. The LP protocol includes two follow-up calls one week apart and a booster call at week 26. Patients assigned to the pacing intervention complete 15 sessions over 24 weeks-four weekly sessions, then sessions every two weeks until week 26.
Participants will complete outcome measures at 6 months, coinciding with the immediate the end of the intervention, and at 9 and 12 months. The post-treatment time point estimates the proximal effect of LP compared to pacing, where contamination is lowest, co-interventions are least likely to diverge across arms, and any harms (e.g., post-exertional worsening) are most plausibly related to the assigned strategy.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Dr. Jason Busse, PhD, Professor
- 電話番号:(905) 525-9140
- メール:bussejw@mcmaster.ca
研究連絡先のバックアップ
- 名前:Rozina Thobani, MSc
- メール:thobar1@mcmaster.ca
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
The inclusion criteria for participants are:
- Adults aged 18 to 65 years
- Meeting the WHO clinical case definition for long COVID and
- Self-reported experiencing long COVID symptoms such as fatigue, muscle pain, and brain fog.
- Reporting a minimum score of ≥35 on the Checklist Individual Strength CIS-fatigue domain.
- Able to speak and read English
- Scoring higher in contemplation, action or maintenance scores than the precontemplation phase on the readiness to change questionnaire
- Provides consent for study participation.
- Consistent access to an internet-connected device (e.g., smartphone, tablet, laptop) that can facilitate access to the study interventions.
Exclusion Criteria:
The exclusion criteria are:
- Long COVID participants whose presentation is primarily restricted to anosmia.
- Participants with Post-Intensive Care Syndrome (PICS) or serious organic sequelae of COVID-19, such as structural lung injury attributable to mechanical ventilation or other organ damage requiring ongoing specialist management.
- Participants who will not be able to attend intervention sessions or follow up visits due to anticipated significant life changes or relocation.
- Unable to provide informed consent (e.g. cognitive disability, language barrier)
- Co-morbidities that likely to impair function for as long or longer than long COVID
- Current participation in psychotherapy, structured physical rehabilitation (e.g., physiotherapy or occupational therapy), or another trial that does not permit co-enrollment.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Lightning Process
Lightning Process is a mind body intervention that focusses on identifying and interrupting negative thoughts that may affect fatigue.
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LP is a mind body intervention which is delivered over 3 consecutive days to individuals or in groups via video technology.
The sessions are approximately 4 hours long.
Experienced LP practitioners will deliver the LP intervention remotely and individually.
The intervention is comprised of a preparation phase, core sessions, and follow-up.
Preparation consists of an audio home-study module (about 4 hours total) and about 1 hour of preparatory coaching by telephone or videoconference in the days to weeks before delivery of the LP intervention to orient participants to the approach and address any questions.
|
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アクティブコンパレータ:Activity pacing
Activity pacing is a self-management strategy that balances activity and rest to manage fatigue, allowing individuals to maintain consistent energy levels throughout the day.
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Activity Pacing, a self-management strategy that balances activity and rest to manage fatigue, allowing individuals to maintain consistent energy levels throughout the day.
The aim of activity pacing is to avoid symptom exacerbations whilst achieving as much as possible with limited energy.
Pacing focusses on developing awareness not only of the symptoms but also more subtle indicators that herald a future exacerbation of symptoms (listening to your body) and becoming aware of effect of activity or lack of rest on disability.
Senior occupational therapy students will deliver activity pacing remotely and individually by videoconference.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Fatigue (Checklist Individual Strength-Fatigue)
時間枠:12 months
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The primary outcome will be the mean change in fatigue scores between Lightning Process and activity pacing group at 12 months post randomization.
This will be assessed on the fatigue domain of the 8-item Checklist Individual Strength (CIS-fatigue) at 12 months follow-up.
The CIS-fatigue domain consists of 8 items with a total score ranging from 8 to 56, with higher scores indicating more severe fatigue.
|
12 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Respiratory function (Dyspnea-12)
時間枠:6 months, 9 months, and 12 months
|
Change in respiratory functioning will be assessed with the Dyspnea-12 (D-12) Scale which measures the current level of a patient's breathlessness severity, incorporating both physical and affective aspects, and does not depend on activity limitation.
Each item scored from 0-3, for a total score range of 0-36.
Higher scores indicate worse dyspnea.
|
6 months, 9 months, and 12 months
|
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Post Exertional Malaise (De Paul Symptom Questionnaire)
時間枠:Baseline, 6 months, 9 months, and 12 months
|
Change in post exertional malaise (PEM) will be measured using a brief questionnaire derived from De Paul Symptom Questionnaire (DSQ).
It is a 5-item self-report tool that evaluates common symptoms of long COVID, including worsening after physical or mental activity, recovery duration and activity intolerance.
Each item is scored 0-4 on 5-point Likert scale.
A score of ≥2 for frequency and ≥2 for severity on any item suggests PEM.
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Baseline, 6 months, 9 months, and 12 months
|
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Daily Pain (Brief Pain Inventory Short Form)
時間枠:6 months, 9 months, and 12 months
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Change in pain will be assessed using Brief Pain Inventory short form (BPI-SF).
This is a 9-item questionnaire used to evaluate the severity of a patient's pain and the impact of their pain on daily functioning.
The BPI-SF evaluates pain severity at its worst, least, and average during the previous week, as well as current pain level, with 0 representing no pain and 10 the worst pain imaginable.
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6 months, 9 months, and 12 months
|
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Fatigue (Checklist Individual Strength-Fatigue)
時間枠:6 months and 9 months
|
Change in fatigue scores will be measured at 6 and 9 months post randomization.
This will be assessed on the fatigue domain of the 8-item CIS-fatigue scale at 6 and 9 months follow-up.
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6 months and 9 months
|
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Physical function (SF-12)
時間枠:Baseline, 6 months, 9 months, and 12 months
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Change in physical functioning will be measured using Short Form Health Survey (SF-12) scale, a 12-item questionnaire that assesses physical and mental health status.
|
Baseline, 6 months, 9 months, and 12 months
|
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Health related quality of life (EuroQol-5 Dimensions)
時間枠:Baseline, 6 months, 9 months, and 12 months
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Health related quality of life will be measured using the EuroQol-5 Dimensions (EQ-5D) scale that provides a generic measure of health for clinical and economic appraisal.
Its a continuous (scale 0-100).
Higher scores relate to better health.
|
Baseline, 6 months, 9 months, and 12 months
|
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Severity of somatic symptoms (Patient Health Questionnaire-15)
時間枠:6 months, 9 months, and 12 months
|
Change in somatic symptoms will be measured using Patient Health Questionnaire-15 (PHQ-15) that screens for somatization concerns and monitors symptom severity.
Its a continuous (scale 0-30).
Higher scores relate to greater somatic symptom severity.
|
6 months, 9 months, and 12 months
|
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Functional impairment (Work and Social Adjustment Scale)
時間枠:6 months, 9 months, and 12 months
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Change in functional impairment will be measured through Work and Social Adjustment Scale (WSAS) scale.
Its a 5-item continuous scale (0-40) of functional impairment attributable to an identified problem.
Higher scores relate to severely impaired.
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6 months, 9 months, and 12 months
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Adverse Events (AEs)
時間枠:Up to 12 months
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To ensure participant safety, adverse events (AEs) will be documented at each follow-up visit.
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Up to 12 months
|
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Serious Adverse Events (SAEs)
時間枠:Up to 12 months
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To ensure participant safety, serious adverse events (SAEs) will be documented at each follow-up visit.
|
Up to 12 months
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- Project ID-20247
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個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
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長い COVIDの臨床試験
-
Pfizer積極的、募集していないCOVID-19(新型コロナウイルス感染症) | コロナウイルス病 2019 (COVID-19) | COVID-19 感染 | COVID-19 ワクチン | SARS-CoV-2 感染、COVID19 | COVID-19 ワクチン接種 | SARS-CoV-2 感染、COVID-19 | COVID-19 (コロナウイルス病 2019) | COVID-19 SARS-CoV-2 感染症アメリカ
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Pfizer積極的、募集していない気道疾患 | COVID-19(新型コロナウイルス感染症) | 肺炎 | 肺疾患 | コロナウイルス 病気 2019年 | コロナウイルス病 2019 (COVID-19) | COVID-19 感染 | 上気道感染症 | 気道感染症 | COVID-19 (コロナウイルス病 2019) | COVID-19 SARS-CoV-2 感染症ベルギー
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Indonesia University募集COVID-19後症候群 | 長い COVID | COVID-19 後の状態 | COVID後症候群 | 長い COVID-19インドネシア
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Academisch Medisch Centrum - Universiteit van Amsterdam...募集
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European Institute of OncologyFondazione I.R.C.C.S. Istituto Neurologico Carlo Besta; Azienda Ospedaliera Niguarda Cà Granda; Papa Giovanni XXIII Hospital と他の協力者完了
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Owlstone LtdCambridge University Hospitals NHS Foundation Trust完了
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ModeX Therapeutics, An OPKO Health Company募集
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Duke UniversityNational Institute on Minority Health and Health Disparities (NIMHD)完了
Lightning Processの臨床試験
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Ain Shams University完了