COVID-19 can have a large impact on people’s participation in work. The purpose of this article is to gain insight in characteristics of persons with COVID-19 at the time of infection, and their work ability and work limitations one year after inclusion in the allied health recovery care study (ParaCov study). A cross-sectional observational study approaching participants in the ParaCov cohort with paid work at cohort inclusion, who completed the 12-month assessment (n = 681). They received additional work-related questionnaires on work characteristics, Work Ability Score (WAS), and Work Limitations Questionnaire (WLQ). Descriptive statistics summarized participant and work characteristics, reporting categorical variables as numbers and percentages and continuous variables as medians with interquartile ranges (IQR) or means with standard deviations (SD). One year after inclusion in the Paracov cohort, 385 out of 681 (57

As health systems shift care from specialised to primary care settings, questions arise about implementing complex interventions such as self‑management programmes. This is especially relevant for the growing population with chronic neurological disorders requiring long‑term support in primary care. ‘Energetic’, an interdisciplinary self‑management group programme delivered by occupational therapists and physiotherapists, was originally developed in specialist rehabilitation to improve participation and functional endurance in people with neurological conditions and fatigue. Although effective in specialist care, little is known about how patients and therapists experience its delivery in primary care, where resources and infrastructure differ substantially. This study examines how patients with chronic neurological conditions and fatigue, and their therapists, experience the implementation and delivery of the Energetic self‑management group programme in primary care. Energetic was implemented in primary care in three regions in the Netherlands. A qualitative study was conducted using semi‑structured interviews with 10 patients and seven therapists (three occupational therapists and four physiotherapists) from three primary care settings. Interviews were audio-recorded and transcribed verbatim. Participants were asked about their experiences with participating in the programme, its implementation and delivery in primary care, and perceived barriers and benefits. Data were analysed using an iterative, inductive thematic approach. Three overarching themes were constructed from the data: 1) The content of the programme is considered comprehensive; 2) The programme is believed to strengthen self-management and particpation; and 3) The implementation is experienced to be challenging within the primary care healthcare system. Patients experienced participating in the programme as meaningful, reporting better self-management and participation. Therapists reported similar developments. Regarding implementation therapists described persistent difficulties related to recruitment, organisation, and financing, and noted that system constraints required administrative improvisation to deliver the programme as intended. Differences in perspectives were also apparent: e.g., patients valued access to sports facilities, whereas all therapists considered such facilities difficult to provide within primary care. Patients and therapists experienced the Energetic programme as meaningful and valuable in primary care practice. However, therapists reported problems in recruitment, reimbursement and administrative barriers that constrained the programme’s implementation. These findings illustrate how promising programmes can struggle to find their way into routine primary care, and therefore to patients living longer at home.

PURPOSE:Interest in the potential significance of the capability approach for healthcare has grown rapidly. In this study, we developed, implemented and evaluated a clinical intervention based on the capability approach. The aim of the process evaluation, described in this article, is to understand how capability care was delivered and how healthcare professionals experienced delivering capability care. MATERIALS AND METHODS:Participants with neuromuscular diseases received usual (n = 29) or capability care (n = 28). We used a mixed methods approach guided by the Medical Research Council framework for process evaluation of complex interventions, collecting and analysing data from electronic health records, audio recordings of consultations with healthcare professionals, and focus groups and interviews with healthcare professionals (n = 13). RESULTS:Healthcare professionals found implementation of capability care challenging and they only partially implemented it. Results showed that especially underlying values were discussed more often in capability care. Although healthcare professionals had different views on the added value of capability care, some healthcare professionals found that using capability care did change the care they provided. CONCLUSIONS:The capability approach seems to have potential in healthcare, although implementation challenges need to be addressed. Practical recommendations for future implementation and evaluation are provided.

Background Shortening of the long finger flexors (FDP) results in extension limitation of both wrist and fingers and can hinder important activities of the upper extremities in Duchenne muscular dystrophy (DMD). Early detection of FDP shortening is important for timely interventions, but reliable measurement of FDP length is difficult.Aim To develop a new instrument to monitor FDP shortening more easily and precisely and to determine its intra -and interrater reliability.Materials and methods The new instrument, called the 'FlexYonio', was clinically developed according to biomechanical standards to be able to monitor FDP length, by measuring range of motion of wrist extension with extended fingers. A prospective reliability study was conducted during annual outpatient visits of people with DMD at the neuromuscular center of the Radboudumc. Repeated measures were conducted and two raters assessed the FDP length with the new instrument using a standardized measurement protocol. Reliability was measured using intra class correlation coefficient (ICC) calculation.Results The 'FlexYonio' was easy to use and became part of the standard daily clinical care in DMD in the Radboudumc. For reliability, 86 arm/hands were assessed; the intra- and interrater reliability were excellent with ICC > 0.99. The within-rater limits of agreement were -6 to 8 degrees and the between-raters -11 to 13 degrees.Conclusion The 'FlexYonio', in combination with the standardized measurement protocol, is a promising, easy to use, and reliable tool to support the monitoring of FDP shortening in people with DMD, who are able to extend their fingers.

BACKGROUND:Rehabilitation of persons with neuromuscular diseases (NMD) requires a personalised approach that focuses on achieving and maintaining a level of functioning that enables them to be in a state of well-being. The capability approach states that well-being should be understood in terms of capabilities, which are the opportunities that people have to be and do things they have reason to value. The aim of this study is to investigate whether providing care inspired by the capability approach (capability care) has an effect on the well-being of persons with NMD. METHODS:In the Rehabilitation and Capability care for persons with NeuroMuscular Diseases (ReCap-NMD) study, 64 adults with facioscapulohumeral muscular dystrophy or myotonic dystrophy type 1 were included in two groups, using a before-after controlled design with 6 months between the measurement moments. The first group received rehabilitation as usual, the second received capability care. This article reports on the primary outcome measure, the Canadian Occupational Performance Measure (COPM) and secondary quantitative outcome measures (questionnaires on participation, capability well-being and health-related quality of life). RESULTS:There was no difference between capability care and usual care on the COPM and the secondary outcome measures. There was a similar improvement for both capability care and usual rehabilitation on the COPM at 6-month follow-up. This means that the effect of capability care is similar to usual rehabilitation. CONCLUSION:This is the first study that explicitly developed, implemented and evaluated a clinical healthcare intervention inspired by the capability approach. We found no difference on the COPM between persons with NMD receiving capability care compared to usual rehabilitation. There is a need for further research on the clinical relevance and added value of the capability approach for rehabilitation and other fields in healthcare. TRIAL REGISTRATION:Trialregister.nl NL8946.

PurposeThe capability approach (CA) is increasingly used in healthcare, but its use in evaluating interventions remains challenging. Therefore, in the Rehabilitation and Capability care for patients with Neuromuscular diseases (ReCap-NMD) study, we conducted a mixed-methods analysis to evaluate how rehabilitation affects capabilities of persons with facioscapulohumeral muscular dystrophy or myotonic dystrophy type 1. We explored whether different operationalizations of the CA yield different results to draw lessons about its use in evaluating rehabilitation.Materials and methodsWe compared semi-structured interviews with the ICEpop CAPability measure for Adults (ICECAP-A) and the Canadian Occupational Performance Measure (COPM) in evaluating changes in capabilities of 26 participants during rehabilitation. Based on interviews, participants were categorized as having worsened, unchanged, or improved capabilities. Quantitative analyses (descriptive statistics, Wilcoxon's signed rank tests, Kruskal-Wallis tests) and qualitative comparisons of interview-based categories with ICECAP-A and COPM scores were conducted to identify differences.ResultsParticipants categorized as having improved capabilities had also higher COPM follow-up scores, while their ICECAP-A scores were unchanged. Changes related to work, energy management, and disease progression anticipation were not captured by the ICECAP-A.ConclusionsBy using a mixed-methods approach, we captured changes in capabilities that occurred during rehabilitation for persons with neuromuscular diseases.

Background: Patients with neuralgic amyotrophy (NA) often experience limitations in daily activities because of pain and fatigue. Visual analogue graphs with a 24-hour x-axis can be used to rate pain and fatigue severity during a typical day. This study aimed to investigate the reliability and validity of the visual analogue graphs in patients with NA. Method: Eight patients completed pain and fatigue graphs on three moments to examine inter-rater and test-retest reliability using Intraclass Correlation Coefficients (ICCs). Concurrent validity (n = 47) was tested by determining correlations between mean pain graph scores and numerical rating scale for pain (NRS-pain) and between mean fatigue graph scores and checklist individual strength-subscale fatigue (CIS-fatigue). Results: ICC for test-retest reliability varied from 0.72– 0.93 for pain and 0.67–0.85 for fatigue scores. ICC for inter-rater reliability varied from 0.76–0.97 for pain and 0.47–0.97 for fatigue scores. Correlation between the mean pain graph score and NRS-pain was strong (rs = 0.75, ps = 0.42, p = 0.003). Conclusion: The visual analogue graph for pain appears reliable and valid in patients with NA. Test-retest reliability and concurrent validity for the fatigue graph warrant further research.

Objectives This study identifies work trajectories of patients with persistent complaints after a COVID-19 infection receiving allied healthcare and predictors of return work. Methods A prospective cohort of 1333 Dutch working-age patients with persistent complaints after a COVID-19 infection receiving allied healthcare between 2021 and 2022 were used. Sequence analysis was conducted to identify work trajectories over time and logistic regression to investigate predictors of return to work. Results Five hundred fifty-two unique work trajectories were identified. The proportion of return to work was 31.4% (n = 419). High health-related quality of life was associated with higher odds of return to work (OR = 1.02; 95% CI = 1.00 to 1.04). Conclusions Only one-third of patients returned to work 9 months after receiving allied healthcare. Return to work was best predicted by health-related quality of life although the model’s accuracy was poor.

Background A Dutch nationwide prospective cohort study was initiated to investigate recovery trajectories of people recovering from coronavirus disease 2019 (COVID-19) and costs of treatment by primary care allied health professionals. Objectives The study described recovery trajectories over a period of 12 months and associated baseline characteristics of participants recovering from COVID-19 who visited a primary care allied health professional. It also aimed to provide insight into the associated healthcare and societal costs. Methods Participants completed participant-reported standardized outcomes on participation, health-related quality of life, fatigue, physical functioning, and costs at baseline (ie, start of the treatment), 3, 6, 9 and 12 months. Results A total of 1451 participants (64 % women, 76 % mild/moderate severity) with a mean (SD) age of 49 (12) years were included. Linear mixed models showed significant and clinically relevant improvements over time in all outcome measures between baseline and 12 months. Between 6 and 12 months, we found significant but not clinically relevant improvements in most outcome measures. Having a worse baseline score was the only baseline factor that was consistently associated with greater improvement over time on that outcome. Total allied healthcare costs (mean €1921; SEM €48) made up about 3% of total societal costs (mean €64,584; SEM €3149) for the average participant in the cohort. Conclusions The health status of participants recovering from COVID-19 who visited an allied health professional improved significantly over a 12-month follow-up period, but nearly the improvement occurred between baseline and 6 months. Most participants still reported severe impairments in their daily lives, and generated substantial societal costs. These issues, combined with the fact that baseline characteristics explained little of the variance in recovery over time, underscore the importance of continued attention for the management of people recovering from COVID-19. Trial registration clinicaltrials.gov (NCT04735744)

PurposeGlycogen Storage Disease type 5 (GSD5 or McArdle disease) is caused by deficient glycogen phosphorylase enzyme activity in skeletal muscles. Individuals with GSD5 experience symptoms like muscle pain, fatigue, and tachycardia during exertion. Our study aimed to explore the lived experiences of individuals with GSD5, focusing on their daily challenges, the process of being diagnosed, and management strategies.MethodsParticipants were invited to share their life experiences through in-depth, semi-structured interviews, and the collected data was analyzed using thematic analysis.ResultsUsing purposeful sampling, 13 individuals with GSD5 were recruited for the study. The analysis identified four key themes: "experiencing incomprehensible difficulties," "diagnosis as an explanation," "finding ways to manage daily challenges," and "listening to your body." These themes reflect diverse experiences of daily functioning, physical challenges faced, the pivotal role of diagnosis in understanding symptoms, and the adoption of management strategies like using the 'second wind' phenomenon. Participants emphasized the importance of support networks and adaptive lifestyle changes in effectively managing their condition.ConclusionsEarly diagnosis and tailored management strategies are critical for improving outcomes and quality of life in individuals with GSD5. Timely diagnosis and comprehensive multidisciplinary care are essential for effectively managing the complexities of this rare metabolic disorder.

BackgroundPersons with COVID‐19 may experience limitations in daily functioning and can be referred to occupational therapy.ObjectivesTo evaluate changes in daily functioning, cognitive complaints, fatigue and self-management of persons with COVID-19 who received occupational therapy in primary care.To get insights in the volume and duration of occupational therapy.DesignA pre-post observational cohort study from October 2020 until April 2021.SettingFifty-eight occupational therapy practices in primary care throughout the Netherlands participated with 68 occupational therapists.Participants228 adults (≥18 years) with COVID-19, referred to occupational therapy, gave informed consent and participated in the pre-post evaluation. The mean age was 49 years (SD 13) and 79% of the patients was female. The most frequently reported complaints included fatigue and cognitive complaints.InterventionsOccupational therapy using Dutch guidelines for occupational therapy in clients with COVID-19.Outcome measuresPerformance and satisfaction with performance using the Canadian Occupational Performance Measure (COPM); the impact of Cognitive Complaints on Participation (CoCo-P); and daily activities, self-management and perceived contribution of occupational therapy using the Patient Reported Outcome Measure for Occupational Therapy (PROM-OT).ResultsCOPM-performance score improved with a mean difference of 2.9 points (95% CI 2.7 to 3.2), and COPM-satisfaction score improved with 3.2 points (95% CI 2.9 to 3.5). CoCo-P score improved with a mean difference of 20.9 points (95% CI from 14.4 to 27.4), and PROM-OT improved with 42.8 points (95% CI from 40.2 to 45.4). Participants received a median of seven sessions of occupational therapy (IQR 5–10) with a median duration of 18 weeks (IQR 12–25). They valued the contribution of occupational therapy to their improved functioning with a mean score of 8 (SD 1.4) and recommended this to others with a mean score of 9 (SD 1.2).ConclusionsPersons with COVID-19 who received occupational therapy in primary care improved significantly in daily functioning and highly valued occupational therapy.

BACKGROUND: Shortening of the long finger flexors (Flexor Digitorum Profundus, FDPs) in Duchenne Muscular Dystrophy (DMD) causes reduced hand function. Until now, longitudinal studies on the natural course of the shortening of the FDPs are lacking, which impedes recommendations on timing and evaluation of preventive measures. OBJECTIVE: To investigate the longitudinal course of the FDP length during different disease stages focusing on symmetry, timing, and decline of the FDP length. METHODS: A retrospective, longitudinal multicenter study was conducted in the Radboud university medical center and the Leiden university medical center. The FDP outcome was measured using goniometry and gross motor function was assessed using the Brooke score. Longitudinal mixed model analyses were used to describe the course of the FDP outcome, and to investigate symmetry in both hands. RESULTS: Data on 534 visits of 197 males (age ranged 4–48 years) showed that in the ambulatory stages the FDP outcome was within a normal range. The mean decline in FDP outcome is 3.5 degrees per year, the biggest decline was seen in Brooke 5 (>15 degrees per year). In Brooke 4, 41% of the FDP outcome was < 40 degrees. No significant differences were found between right and left. CONCLUSIONS: This study supports the consideration of preventive measures to delay shortening of the FDPs in DMD patients transitioning to a Brooke scale of 4 or higher. Besides, natural history of FDP outcome has been established, which provides a base to evaluate (preventive) interventions.

Background: Glycogen storage disease type 5 (GSD) is an autosomal recessive inherited metabolic myopathy caused by a deficiency of the enzyme muscle glycogen phosphorylase. Individuals with GSD5 experience physical activity intolerance. Objective: This patient-led study aimed to capture the daily life experiences of GSD5, with a focus on adapting to and coping with their physical activity intolerance. Methods: An online survey was composed in close collaboration with patient organizations. It consisted of customized and validated questionnaires on demographics, general health and comorbidities, physical activity, psychosocial well-being and functioning, pain, fatigue and adapting to and coping with GSD5. Results: One hundred sixty-two participants (16 countries) participated. The majority, n = 86 (69%) were from the Netherlands, USA or UK. We observed a high rate of misdiagnosis prior to GSD5 diagnosis (49%), surprisingly a relatively high proportion had not been diagnosed by DNA testing which is the gold standard. Being diagnosed had a strong impact on emotional status, daily life activities and important life choices. A large proportion had not received any rehabilitation (41%) nor medical treatment (57%) before diagnosis. Engagement in vigorous and moderate physical activity was reduced. Health related quality of life was low, most likely related to low physical health. The median Fatigue Severity Score was 4.3, indicating moderate to severe fatigue. Participants themselves had found various ways to adapt to and cope with their disability. The adaptations concerned all aspect of their life, including household chores, social and physical activities, and work. In addition to lack of support, participants reported limited availability of information sources. Conclusion: Participants have provided guidance for newly diagnosed people, including the advice to accept one’s limited abilities and maintain an active lifestyle. We conclude that adequate counseling on ways of adapting and coping is expected to increase both health-related quality of life and physical activity.

PURPOSE:To develop a multidisciplinary outpatient rehabilitation intervention for people with neuromuscular diseases (NMD) based on the capability approach: capability care for persons with NMD. MATERIALS AND METHODS:The development process is described using a framework of actions for intervention development. It has been an iterative process consisting of a design phase based on theoretical insights and project group discussions, and a refine phase involving input from relevant stakeholders. RESULTS:Multidisciplinary efforts have resulted in the development of capability care for rehabilitation of persons with NMD. It can focus both on facilitating and achieving functionings (beings and doings), as well as looking for alternative functionings that fulfil the same underlying value, thereby contributing to the persons' well-being. To facilitate a conversation on broader aspects that impact on well-being, persons with NMD receive a preparation letter and healthcare professionals are provided with guiding questions and practical tools to use. CONCLUSIONS:We have shown that it is possible to develop a healthcare intervention based on the capability approach. We hope that rehabilitation professionals will be encouraged to use capability care and that other medical professionals will be inspired to develop capability care in their respective fields. REGISTRATION:Registered at trialregister.nl NL8946.

Background and objectives: Quality of life (QoL) in children with facioscapulohumeral dystrophy (FSHD) seems plausible decreased. Little is known about factors influencing QoL in children with FSHD. Our objective is to explore factors contributing to the QoL of children, adolescents, and young adults with FSHD, to describe how they experience life with FSHD, and to report their support needs. Methods: We performed a mixed-method study with individual age-appropriate semi-structured interviews assessing QoL in children, adolescents, and young adults with FSHD and their parents. To characterize the sample, quantitative data on QoL, pain, fatigue, and participation were collected. Interview data was analyzed using a thematic analysis. Results: Fourteen patients participated (age between 9 and 26 years old, eight males and six females). The degree of FSHD severity, as indicated by the FSHD-score, did not correlate with QoL. Older children had a lower QoL than younger children. Children and adolescents strived for normality regardless of physical discomfort. Phenotypical features of FSHD led to insecurity aggravated by hurtful comments of others. The unpredictability of disease progression and its implications for career and parenthood choices led to a generalized feeling of uncertainty about the future. Support was found within family and friends. Participants expressed a need for peer support and psychological support as well as recommending it to others. Discussion: Quality of life in childhood FSHD is diminished caused by their physical limitations, altered appearance, fear of social rejection, and uncertainty of the disease progression in the future. A fear of social rejection most likely contributes to striving for normality regardless of physical discomfort. Support should be focused on acceptance and coping with hurtful comments. It should preferably be individualized, easily accessible and not offered as therapy but rather as tutoring for children.

Glycogen storage disease type 5 (GSD5; McArdle disease) is an autosomal recessive inherited metabolic myopathy caused by a deficiency of the enzyme muscle glycogen phosphorylase. Characteristic symptoms include muscle pain, fatigue and cramping which can progress to rhabdomyolysis. Individuals with GSD5 experience physical activity intolerance. This patient-led study aimed to capture the daily life experiences of individuals with GSD5, with a focus on adapting to and coping with their physical activity intolerance. An online survey was composed in close collaboration with patient organizations. It consisted of customized and validated questionnaires on demographics, general health and comorbidities, physical activity, psychosocial well-being and functioning, pain, fatigue and adapting to and coping with GSD5. One hundred sixty-two participants from 16 countries participated. The majority, n=86 (69%) was from the Netherlands, USA or UK. We observed a high rate of misdiagnosis prior to a definitive GSD5 diagnosis (49%). Being diagnosed had a strong impact on emotional status, daily life activities and important life choices. A large proportion had not received any rehabilitation (41%) nor medical treatment (57%) before diagnosis. Engagement in vigorous and moderate physical activity was reduced. Health related quality of life (HRQOL) was low, most likely related to low physical health. The median FSS score was 4.3, indicating moderate to severe fatigue. Patients themselves had found various ways to adapt to and cope with their disability. The adaptations concerned all aspect of their life, including household chores, social and physical activities, and work. In addition to lack of support, patients reported limited availability of information sources. Participants have provided guidance for newly diagnosed people, including the advice to accept one's limited abilities and maintain an active lifestyle. We conclude that adequate counseling on ways of adapting and coping is expected to increase both health related quality of life and physical activity. Glycogen storage disease type 5 (GSD5; McArdle disease) is an autosomal recessive inherited metabolic myopathy caused by a deficiency of the enzyme muscle glycogen phosphorylase. Characteristic symptoms include muscle pain, fatigue and cramping which can progress to rhabdomyolysis. Individuals with GSD5 experience physical activity intolerance. This patient-led study aimed to capture the daily life experiences of individuals with GSD5, with a focus on adapting to and coping with their physical activity intolerance. An online survey was composed in close collaboration with patient organizations. It consisted of customized and validated questionnaires on demographics, general health and comorbidities, physical activity, psychosocial well-being and functioning, pain, fatigue and adapting to and coping with GSD5. One hundred sixty-two participants from 16 countries participated. The majority, n=86 (69%) was from the Netherlands, USA or UK. We observed a high rate of misdiagnosis prior to a definitive GSD5 diagnosis (49%). Being diagnosed had a strong impact on emotional status, daily life activities and important life choices. A large proportion had not received any rehabilitation (41%) nor medical treatment (57%) before diagnosis. Engagement in vigorous and moderate physical activity was reduced. Health related quality of life (HRQOL) was low, most likely related to low physical health. The median FSS score was 4.3, indicating moderate to severe fatigue. Patients themselves had found various ways to adapt to and cope with their disability. The adaptations concerned all aspect of their life, including household chores, social and physical activities, and work. In addition to lack of support, patients reported limited availability of information sources. Participants have provided guidance for newly diagnosed people, including the advice to accept one's limited abilities and maintain an active lifestyle. We conclude that adequate counseling on ways of adapting and coping is expected to increase both health related quality of life and physical activity.

BackgroundPatients recovering from COVID-19 often experience persistent problems in their daily activities related to limitations in physical, nutritional, cognitive, and mental functioning. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19. ObjectiveThis study aimed to evaluate the primary allied health care of patients recovering from COVID-19 at 6-month follow-up and to explore which baseline characteristics are associated with changes in the scores of outcomes between baseline and 6-month follow-up. MethodsThis Dutch nationwide prospective cohort study evaluated the recovery of patients receiving primary allied health care (ie, dietitians, exercise therapists, occupational therapists, physical therapists, and speech and language therapists) after COVID-19. All treatments offered by primary allied health professionals in daily practice were part of usual care. Patient-reported outcome measures on participation, health-related quality of life, fatigue, physical functioning, and psychological well-being were assessed at baseline and at 3- and 6-month follow-up. Linear mixed model analyses were used to evaluate recovery over time, and uni- and multivariable linear regression analyses were used to examine the association between baseline characteristics and recovery. ResultsA total of 1451 adult patients recovering from COVID-19 and receiving treatment from 1 or more primary allied health professionals were included. For participation (Utrecht Scale for Evaluation of Rehabilitation—Participation range 0-100), estimated mean differences of at least 2.3 points were observed at all time points. For the health-related quality of life (EuroQol Visual Analog Scale, range 0-100), the mean increase was 12.3 (95% CI 11.1-13.6) points at 6 months. Significant improvements were found for fatigue (Fatigue Severity Scale, range 1-7): the mean decrease was –0.7 (95% CI –0.8 to –0.6) points at 6 months. However, severe fatigue was reported by 742/929 (79.9%) patients after 6 months. For physical functioning (Patient-Reported Outcomes Measurement Information System—Physical Function Short Form 10b, range 13.8-61.3), the mean increase was 5.9 (95% CI 5.9-6.4) points at 6 months. Mean differences of –0.8 (95% CI –1.0 to –0.5) points for anxiety (Hospital Anxiety and Depression Scale range 0-21) and –1.6 (95% CI –1.8 to –1.3) points for depression were found after 6 months. A worse baseline score, hospital admission, and male sex were associated with greater improvement between baseline and 6-month follow-up, whereas age, the BMI, comorbidities, and smoking status were not associated with mean changes in any outcome measures. ConclusionsPatients recovering from COVID-19 who receive primary allied health care make progress in recovery but still experience many limitations in their daily activities after 6 months. Our findings provide reference values to health care providers and health care policy makers regarding what to expect from the recovery of patients who receive health care from 1 or more primary allied health professionals. Trial RegistrationClinicalTrials.gov NCT04735744; https://tinyurl.com/3vf337pn International Registered Report Identifier (IRRID)RR2-10.2340/jrm.v54.2506