ORIGINAL RESEARCH article
Front. Rehabil. Sci.
Sec. Interventions for Rehabilitation
Volume 6 - 2025 | doi: 10.3389/fresc.2025.1633466
This article is part of the Research TopicPost-Acute COVID RehabilitationView all 10 articles
Energy diary for Post-Covid Syndrome
Provisionally accepted
Maryam Balke1,2,3*
René Garbsch1,2,4
Jessica Cormann2,3
Pantea Pape3
Frank C. Mooren1,2,4
Boris Schmitz1,2,4- 1Department of Rehabilitation Science, Faculty of Health, Witten/Herdecke University, Witten/Herdecke, Germany
- 2Universitat Witten/Herdecke, Witten, Germany
- 3Cellitinnen Hospital St. Mary, Cologne, Germany
- 4DRV Clinic Koenigsfeld, Ennepetal, Germany
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BackgroundPost-COVID syndrome (PCS) is a frequent condition with an incidence of 7.8 to 10.6 per 100 unvaccinated and 3.5 to 5.3 events per 100 vaccinated persons. Cognitive and motor fatigue are common clinical manifestations, limiting patient’s occupational, educational, and social activities severely.ObjectiveTo develop a diary to keep record of daily changes in energy levels of patients with PCS to adapt their rehabilitation program.Material and MethodsWe conducted a prospective observational study at two German rehabilitation centers in a co-design approach with repeated feedback loops. Daily energy-changes were analyzed and validated using the Multidimensional Fatigue Inventory-20 (MFI-20).ResultsThe final diary revealed that morning and evening energy levels of patients with PCS differed significantly with 49.6±18.6% and 33.4±19.7%, respectively (p≤0.0001, on admission). Energy levels decreased by ~5% with active therapy, and increased by ~5% with passive therapy (p<0.0001). Comparison with MFI-20 at discharge showed good negative correlation (r=-0.5358, p<0.0001), and patient interviews revealed that most patients (N=19; 95%) rated the diary as “useful for self-reflection” and “helpful tool to learn the process of pacing”.Discussion/ConclusionThis diary is a valid and user-friendly tool to detect and control the effects of daily therapy during rehabilitation of patients with PCS. It will facilitate individual planning and adaptation of therapies in PCS and other fatigue-groups and may help to implement an effective relation of exercise load to load capacity (=pacing) for an optimal coping with the disease and an improved handling of daily activities in patients’ lives.
Keywords: Post Covid 19, post COVID syndrome, Chronic fatgue syndrome, diary approach, Neurorehabiliation
Received: 30 May 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Balke, Garbsch, Cormann, Pape, Mooren and Schmitz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Maryam Balke, Department of Rehabilitation Science, Faculty of Health, Witten/Herdecke University, Witten/Herdecke, Germany
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