Experiences of individually tailored physical exercise in COVID-19-induced postural orthostatic tachycardia syndrome: A qualitative content analysis.

Qualitative content analysis of interviews with 23 participants with COVID-19-induced POTS produced five main categories describing their experiences of individually tailored exercise.

• Twenty-three participants who had completed a feasibility study of semi-supervised tailored exercise were interviewed individually.
• Data were collected with a semi-structured interview guide.
• An inductive qualitative content analysis approach was applied.

Participants emphasised the importance of an individualised exercise program design with flexible modalities.

• The five main categories underscored individualised program design and flexible modalities.
• The authors conclude that rehabilitation for COVID-19-induced POTS needs to be flexible and individualised.

Participants valued continuous support from physiotherapists with expertise in PCC and POTS.

• Continuous support from condition-specific physiotherapists was highlighted as important.
• The authors recommend that exercise be closely monitored by a physiotherapist with condition-specific expertise who adapts exercise to symptom fluctuations.

Participants reported improvements in physical, mental, and social functioning, but setbacks and symptom fluctuations were common.

• Improvements were experienced across the physical, mental and social domains.
• Setbacks and fluctuating symptoms were commonly reported during the intervention.

Energy management strategies and informal and formal support were identified as facilitators that reduced barriers to exercise as a treatment.

• Both informal support (e.g., from the personal environment) and formal support were described as facilitators.
• These factors were perceived as lowering barriers to engaging in exercise.

Psychological dimensions were central to participants' experiences of exercise.

• These included hope, motivation, goal setting, emotional adaptation, acceptance, and coping strategies.
• The authors state that therapists should address diverse psychosocial needs and individual resources.

The combination of intervention structure, therapeutic support, and effective strategies was perceived as contributing to the intervention's effectiveness, and many participants viewed exercise as a key pathway to recovery.

• Participants linked perceived effectiveness to a combination of structure, support and strategies rather than to exercise alone.
• Many saw exercise as a key pathway to recovery.

The authors conclude that a holistic, multidisciplinary, person-centred rehabilitation model may support recovery and long-term wellbeing in PCC and POTS.

• This conclusion is drawn from participants' experiences.
• The wording is tentative ('may support recovery').