Fricke-Comellas et al. (2025)
- Authors: Hermann Fricke-Comellas, Marta Infante-Cano, Alberto Marcos Heredia-Rizo, Ariadna Martín-Fernández, Pablo Escudero-Pérez, Lourdes María Fernández-Seguín.
- Institutes: Universidad de Sevilla; Biomedical Research Institute of Seville (IBiS); University Hospital of Valme.
- Publisher: Healthcare (MDPI)
- Link: DOI
Summary
This study protocol marks a shift in research toward finding safer, home-based ways for ME/CFS and Long COVID patients to manage their symptoms. By testing “conscious movement”—which teaches patients to listen closely to their body’s limits—scientists hope to find a way to maintain physical activity without the high risk of post-exertional malaise often caused by standard exercise. If successful, this research could validate a new, telehealth-accessible treatment model that emphasizes safety and pacing over “pushing through” fatigue. It represents an important step in acknowledging the unique physiological constraints of these conditions while still seeking ways to improve patients’ quality of life.
What was researched?
This protocol outlines a clinical trial designed to compare the safety and effectiveness of a “conscious movement” telerehabilitation program against standard low-intensity exercise and usual care. The research focuses on individuals living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) or Post-COVID Syndrome (PCS), aiming to determine if a mindfulness-based approach can improve fatigue and physical function without triggering symptom worsening.
Why was it researched?
Conventional rehabilitation and exercise programs have frequently led to patient dissatisfaction and adverse events, specifically post-exertional malaise (PEM), in the ME/CFS community. Researchers recognized a critical need for safer clinical approaches that prioritize pacing and body awareness. This study seeks to fill the knowledge gap regarding whether integrating interoception—the ability to sense internal body signals—can help patients engage in movement more sustainably than traditional low-intensity exercise.
How was it researched?
This is a prospective, single-blind, three-arm, parallel randomized controlled trial (RCT) involving 147 participants aged 18 to 70. Participants will be randomly assigned to one of three groups: conscious movement (mind-body exercise), low-intensity exercise, or usual care. The 12-week intervention will be delivered entirely via telehealth, featuring weekly 45-minute sessions and encouraged daily practice. The primary outcome will be measured using the Chalder Fatigue Scale, with secondary outcomes including heart rate variability (HRV), pain intensity, and sleep quality monitored at baseline, 12 weeks, and a 3-month follow-up.
What has been found?
As this paper describes the study protocol, the final results are not yet available; however, the researchers have established a structured methodology focused on “symptom-titrated” movement. They hypothesize that the conscious movement group will show superior improvements in fatigue scores compared to the other groups. The study design specifically prioritizes safety monitoring for adverse events to provide evidence-based data on the feasibility of mindful movement for this patient population.
Discussion
The authors discuss the hypothesis that “conscious movement” may provide greater benefits by modulating the immune system through both autonomic and cognitive activity. They highlight the potential for improved interoception to help patients make real-time adjustments to their activity levels, thereby reducing the risk of “crashing.” Acknowledged limitations include the potential for patient drop-out due to the long duration of the intervention and the subjective nature of self-reported fatigue metrics.
Conclusion & Future Work
The researchers conclude that this trial will provide essential data on whether mindful, interoceptive movement can serve as a safe and effective rehabilitation strategy. Future work will involve analyzing the 3-month follow-up data to see if the benefits of the program are maintained over time. The ultimate goal is to refine personalized rehabilitation strategies that can be integrated into standard clinical care for ME/CFS and Long COVID.