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Development of a home-based pulmonary rehabilitation program for long COVID in Jordan using an expert consensus survey informed by qualitative item generation

Year: 2026

Type: article

Abstract: Long COVID is associated with persistent symptoms such as fatigue, dyspnea, and reduced functional capacity that impair quality of life. Although pulmonary rehabilitation is recommended, access to center-based programmes remains limited, particularly in low- and middle-income settings. Home-based pulmonary rehabilitation (HBPR) may offer a feasible alternative; however, standardized programmes for Long COVID are lacking. The aim of this study was to develop a consensus-based, evidence-informed HBPR programme for individuals with Long COVID using a modified e-Delphi approach. A modified e-Delphi study was conducted involving 15 multidisciplinary experts in pulmonary rehabilitation and Long COVID management. In Round 1, qualitative data from open-ended questions were analyzed thematically to generate preliminary programme components. In Round 2, experts rated the importance and feasibility of each item using a 5-point Likert scale. Consensus was defined as ≥ 70% agreement and a median score of ≥ 4. A total of 97 statements were evaluated in Round 2. Consensus was achieved for 90 statements (92.8%), while 7 statements were excluded due to lack of consensus. Strong agreement was observed for programme structure, safety, and exercise prescription. The final HBPR programme incorporated pacing strategies, symptom-contingent progression, and screening for post-exertional malaise. Lower feasibility ratings were observed for components requiring intensive supervision or advanced technology. This study developed a consensus-based, evidence-informed HBPR programme for individuals with Long COVID. The findings provide a structured and adaptable framework to support rehabilitation delivery in resource-limited settings. Future studies should evaluate the programme’s feasibility and clinical effectiveness.

Source: Scientific Reports

DOI: 10.1038/s41598-026-70867-x

Authors: Enas Hussien Shaltaf, Sumaiyah Mat, Nor Azura Azmi, Alia Alghwiri, Devinder Kaur Ajit Singh

Institutions: National University of Malaysia, Isra University, University of Jordan, Auburn University

Language: English

Topic: Long-Term Effects of COVID-19

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,690