Effect of smartphone-based physical training combined with cognitive training on cognitive abilities in individuals with long COVID: A multicenter pilot randomized clinical trial

Background Preliminary studies have suggested that neuropsychological rehabilitation is a potentially useful tool for treating cognitive deficits associated with patients with long COVID. Objective This study aimed to evaluate the effects of physical training (PT) alone or in combination with cognitive training (PCT) on the cognitive abilities of individuals with long COVID. Methods This multicenter, pilot, randomized, single-blind, parallel-group study included 81 individuals with long COVID. The individuals were randomized into two groups: 1) PT: n = 37 and 2) PCT: n = 44. Cognitive abilities (decision time, decision quality, reaction time, reaction quality, attention, and impulsivity control [analyzed through a three-level cognitive test]) were evaluated using the mobile application. In the PCT group, physical exercise was associated with the performance of cognitive tasks (reaction time, Stroop, memory, go/no-go, and Simon tasks) using a mobile application. The PT group was presented with a recorded video of the physical activities streamed on YouTube. Individuals performed seven exercises at home, with tasks involving the most frequent activities of daily living. Fifteen sessions of 50 min, three times a week, for five weeks with a moderate challenge, were performed. Results There was an increase in decision quality in the PCT group compared to the PT group at the end of the intervention (p = 0.008). Participants in both groups showed improved after training in reaction quality, attention, and impulsivity control. Conclusion Smartphone-based physical training combined with cognitive training increase decision quality. Both training (PCT and PT) increased the reaction quality, attention, and impulsivity control.