Perspectives of Rehabilitation Professionals on Long COVID Interventions to Facilitate Return-to-Work.
MacKinnon, Cassandra, Castro-Barquero, Cassandra, Kontis, Alexandra et al. · Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2025 · DOI
Quick Summary
This study asked rehabilitation professionals in Quebec about their experiences helping people with long COVID return to work. The professionals emphasized that education, gradually increasing activity, and self-management are the most helpful approaches, but they noted that returning to work is very difficult without workplace accommodations and proper support for managing post-exertional malaise (when symptoms worsen after activity).
Why It Matters
This study provides clinician and rehabilitation professional perspectives on what works and what barriers exist in helping ME/CFS patients return to work—a critical outcome measure for functional recovery. Understanding these professional viewpoints can inform better clinical guidelines, workplace policies, and patient support strategies tailored to the unique challenges of post-exertional malaise.
Observed Findings
Rehabilitation professionals identified post-exertional malaise management as a critical and challenging component of intervention
Gradual activity reintegration and education about self-management were consistently emphasized across participants
Return-to-work goals required frequent reassessment rather than fixed planning
Workplace accommodations were identified as necessary but often unavailable
Rehabilitation professionals reported uncertainty and significant challenges when working with the long COVID population
Inferred Conclusions
Education, graded activation, and self-management are central to supporting long COVID recovery
Post-exertional malaise requires specific intervention strategies that differ from traditional rehabilitation approaches
Systemic barriers and lack of workplace accommodations significantly impede successful return-to-work outcomes despite appropriate clinical interventions
Current rehabilitation practices may need modification specifically for long COVID populations
Remaining Questions
Which specific graded activation protocols are most effective for long COVID patients while minimizing PEM exacerbation?
What This Study Does Not Prove
This study does not establish causal relationships between specific interventions and RTW success, nor does it provide patient outcome data or comparative effectiveness evidence. It captures professional opinions and experiences rather than quantified clinical efficacy data, and the small sample size limits generalizability beyond the Quebec rehabilitation context.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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