A digital platform with activity tracking for energy management support in long COVID : A randomised controlled trial

Sanal-Hayes, Nilihan and Hayes, Lawrence and Mair, Jacqueline L. and Iacono, Antonio Dello and Ingram, Joanne and Mclaughlin, Marie and Ormerod, Jane and Carless, David and Hilliard, Natalie and Meach, Rachel and Sculthorpe, Nicholas F. (2026) A digital platform with activity tracking for energy management support in long COVID : A randomised controlled trial. Nature Communications, 17: 945. ISSN 2041-1723

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Abstract

In a 6-month pragmatic randomised controlled trial (RCT; ISRCTN16033549), we compared a just-in-time intervention to support energy management in adults with long COVID (LC) to standard care. Participants received either the ‘Pace Me’ app and a wearable activity tracker (intervention) or an app only with data entry screens (control). The intervention group received just-in-time messages on energy management when they reached 50%, 75%, and 100% of their daily ‘activity allowance’. The primary outcome was post-exertional malaise (PEM) measured by the DePaul Symptom Questionnaire-PEM (DSQ-PEM). Of 369 participants assessed for eligibility, 250 participants were randomised 1:1, and 77 controls and 84 intervention participants were included in the final per-protocol analysis. There was no time by group interaction for the DSQ-PEM. The intervention group value was 48 (95% CI 44-53) at baseline and 46 (95% CI 41-51) post-intervention (arbitrary units). The control group value was 47 (95% CI 42-52) at baseline and 44 (95% CI 39-49) at follow-up (interaction effect p=0.614, η²p=0.002; trivial). No individual question exhibited an interaction effect (p>0.05). Although the intervention had minimal effect compared to control, the substantial recovery rates previously reported in LC, coupled with our wide inclusion criteria may have masked intervention effects. Therefore, future studies should consider this energy management framework in conditions without such recovery rates, such as CFS.

Item Type:
Journal Article
Journal or Publication Title:
Nature Communications
Uncontrolled Keywords:
Research Output Funding/yes_externally_funded
Subjects:
?? yes - externally fundedyesmedicine(all)signal processingbiochemistry, genetics and molecular biology(all)chemistry(all)physics and astronomy(all)sdg 3 - good health and well-being ??
ID Code:
235248
Deposited By:
Deposited On:
02 Feb 2026 12:15
Refereed?:
Yes
Published?:
Published
Last Modified:
02 Feb 2026 23:25