“Effects of therapeutic interventions on long COVID: a meta-analysis of randomized controlled trials” - evaluation of 7 interventions across 51 trials found exercise the most promising www.thelancet.com/journals/ecl...
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This meta analysis looks very poorly done. Cochrane risk of bias tool should have been used to exclude the trials with poor methodology. The authors then go on to make sweeping claims based on studies that nearly all scored poorly. “Exercise […] in [LC], supported by high-certainty evidence”
aug 16, 2025, 10:53 am • 3 0 • view
This is good "However, it is important to recognize that a subset of Long COVID patients may experience post-exertional malaise (PEM), a condition characterized by the worsening of symptoms following physical or mental exertion. In such cases, exercise interventions may pose a risk of...
aug 15, 2025, 8:03 am • 3 0 • view
...symptom exacerbation rather than improvement. Therefore, clinicians should carefully assess patients' baseline fatigue patterns and tolerance before recommending exercise-based rehabilitation." But it should probably note this may be up to half of patients, pot. a v large subset.
aug 15, 2025, 8:04 am • 4 0 • view
Incredible that this is not noted in the abstract. How many will just read the abstract and form an opinion that exercise is good for all LC patients?
aug 15, 2025, 9:22 am • 3 0 • view
Yes, and plays into the same psychologisation that ME has suffered from for decades. Very dangerous, given the associated harms. I think UK judge Lord Denning said something famous re needing a big red hand to point out any restrictions on consumer liability in T&Cs...this needs the same treatment.
aug 15, 2025, 10:00 am • 3 0 • view
The power imbalance between doctors and patients puts us in an incredibly vulnerable position if those on the frontline don't understand these risks.
aug 15, 2025, 10:02 am • 2 0 • view
Sadly most systematic review abstracts are *very* poorly written - with guidance (PRISMA for Abstracts) mostly ignored (but guided-automation may help) - jamanetwork.com/journals/jam...
aug 16, 2025, 7:51 am • 3 1 • view
Oh, that's very interesting! I have no medical background or training, but I am a scientist so I'm used to scrutinizing papers. My impression is that much of medical literature appears to have a culture ...
aug 16, 2025, 8:20 am • 0 0 • view
of making fairly bombastic statements in the abstract, despite often a high risk of bias inherent in the study. For example, an abstract might conclude that "Treatment X is effective for condition Y." But when you read the paper, you might find a marginal effect, which could be explained by ...
aug 16, 2025, 8:20 am • 1 0 • view
e.g. selection bias in recruitment, response bias and/or a placebo effect. I would expect an abstract to instead say something that matches the uncertainty of the findings, like "Our findings suggest that Treatment X might be effective for condition Y."
aug 16, 2025, 8:20 am • 1 0 • view
A reasonable expectation, but often not done. That’s the reasons for developing PRISMA for Abstracts pmc.ncbi.nlm.nih.gov/articles/PMC...
aug 16, 2025, 9:25 am • 1 0 • view
It's really great to see you've been working on this! Doing science right is really hard (something I am very much still learning myself). I think this kind of "meta work" on how to effectively communicate findings is incredibly important
aug 16, 2025, 9:37 am • 2 0 • view
Yes, training folk to critically read Methods & Results not the Discussion and Conclusions is so important (but hard work!). A problem across most disciplines but might be worse with time-poor clinicians.
aug 16, 2025, 9:28 am • 1 0 • view
People with long COVID can't exercise. The risk of making your illness much worse is way too high. I can't exercise at all. Every time I try, I lower my baseline.
aug 15, 2025, 4:38 am • 9 0 • view
It really does feel like doctors and researchers think we’re sick because we’re stupid or undisciplined. Exercise was THE FIRST thing I tried at a slow, gradual pace, and it’s how I experienced my first crash.
aug 16, 2025, 12:57 am • 1 0 • view
Some doctors & researchers do, but I know many who don’t. So don’t give up on them all, and on finding empathetic professionals.
aug 17, 2025, 3:07 am • 0 0 • view
I'm sorry to hear you're one of the few who can't exercise, but as these multiple randomized trials show, many are helped so please don't deny them that chance.
aug 15, 2025, 4:43 am • 1 0 • view
One of the few? The ones who can't exercise have the neuro immune subtype, similar to ME/CFS. Several studies now showing around HALF of pwLC meet the DX criteria of ME/CFS. And in 2024 there were 400m pwLC. The only one denying people a chance is you with your psych BS bsky.app/profile/dave...
aug 15, 2025, 5:37 am • 11 0 • view
Agree that one should be careful to note that exercise is contra-indicated in a subset of patients when making claims about exercise. But FYI I think the prevalence of ME/CFS is now estimated at 10-20%. But the proportion that don't tolerate exercise could be larger, as not all satisfy criteria
aug 15, 2025, 6:38 am • 3 0 • view
Ok so at least 40m instead of 200m. My point stands. This is not a small group of people. This illness has a worse QoL than stage 4 cancer or renal failure, and most dr's have no clue how to treat it so pretend it is a mental health issue and recommend exercise...
aug 15, 2025, 8:31 am • 3 0 • view
And people with PEM who follow that advice often permanently deteriorate. The real problem here isn't people with neuro immune long covid trying to deny treatment to others. It's that our medical system pushes harmful 'treatments' On millions of us, and when those fail, just neglects us.
aug 15, 2025, 8:33 am • 5 0 • view
Or in fact blames us for their own failures.
aug 15, 2025, 8:34 am • 4 0 • view
Leaving us stuck in blacket out rooms in pain, unable to interact with loved ones. A frequent reality for the 25% of us who are severe or very severe.
aug 15, 2025, 8:35 am • 3 0 • view
I agree with you. I'm sorry, I wasn't trying to refute your point. I agree that trying to pretend that only "a few" of the many patients with LC don't tolerate exercise is dishonest.
aug 15, 2025, 8:53 am • 3 0 • view
I know, sorry if that came across as aimed at you. I was talking to Paul and the others like him (although I know they don't listen and will just dismiss the words of a mere patient).
aug 15, 2025, 9:01 am • 4 0 • view
Thanks for linking this.
aug 14, 2025, 7:30 pm • 0 0 • view
Why did you block David Tuller from engaging with your posts after he pointed out that the trials in the review suffer from serious amounts of bias - to the point that it makes the review useless?
aug 16, 2025, 11:32 am • 1 0 • view
Previous experience in another forum showed that attempts at polite dialogue were unproductive.
aug 17, 2025, 3:08 am • 0 0 • view
Unproductive how?
aug 31, 2025, 4:14 pm • 0 0 • view
Ignoring evidence for post-exertional malaise is not evidence-based medicine.
aug 15, 2025, 8:13 am • 4 1 • view
