Physical Therapy Outcome Measures Used in Persons With Long Covid: A Systematic Review of Interventional Studies Up to 1-Year Postglobal Health Emergency

Abstract

Purpose: To identify the most frequently used outcome measures in interventional studies for Long Covid in outpatient, home-based, and telerehabilitation physical therapy settings. Methods: Registered in PROSPERO (registration number: CRD42021286714) and conducted according to PRISMA guidelines, this review included interventional studies performed in outpatient, telerehabilitation, or home-based physical therapy settings, assessing adults with persistent Long Covid symptoms in at least 3 months post-COVID-19 infection and published in English, Spanish, or Portuguese. A comprehensive search strategy was executed across PubMed, Embase, Scopus, PEDro, SciELO, Web of Science, and CINAHL. Data were managed via Covidence, with studies independently screened and extracted by multiple authors. The risk of bias was assessed using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool. Outcome measures were mapped to constructs based on core outcome sets (COS) for Long Covid by an international Delphi consensus and American Physical Therapy Association Cross Sections and Academies for COVID-19. The frequency of use of each outcome measure, between-group comparisons, clinical meaningfulness, and reference values from previous studies were reported. Results: Fourteen studies met the inclusion criteria, utilizing 43 distinct outcome measures to assess constructs such as health-related quality of life, functional mobility, endurance, cognition, mental health, strength/power, and fatigue. Notably, 76.4% (33/43) of these measures were used in only one study, with the EQ-5D being the most frequently employed (50%, 7/14). Conclusions: While the outcome measures largely aligned with recommended core domains for Long Covid, significant heterogeneity was observed. Given the variability in outcome measures, the EQ-5D is recommended for assessing health-related quality of life in individuals with Long Covid. (Cardiopulm Phys Ther J. 2025;36:105–123)