Addressing persistent symptoms in post-COVID condition: Through a multimodal intervention delivered in two technology-based formats
Principal Investigators
Led by Mar Ariza and Maite Garolera, alongside a team including Neus Cano, Anna Carnes-Vendrell, Olga Gelonch, Yemila Plana, Bruno Porras-Garcia, Elisabeth López-Soley, Silvia Moron, and Gerard Piñol-Ripoll (on behalf of the REHAB Project Collaborative Group).
Involved Institutions
Consorci Sanitari de Terrassa – Hospital Universitari (CST), University of Barcelona (UB), International University of Catalonia (UIC), Hospital Universitari Santa Maria (Lleida), University of Girona, and the Polytechnic University of Catalonia (UPC).
Location and Timeline
The interventions and evaluations were conducted at the facilities of the Consorci Sanitari de Terrassa and the Hospital Universitari Santa Maria in Lleida (Spain). Recruitment and follow-up took place between May 2023 and December 2024.
Participants
The study initially enrolled 172 participants (adults with post-COVID syndrome or Long COVID). Participants were assigned to three different groups. During the 12-week program, some dropouts occurred due to lack of adherence or other reasons. After accounting for attrition, the final sample that completed the study and was included in the analysis consisted of 129 participants (75% retention rate), distributed as follows:
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- Online Group: 59 participants.
- Control Group: 37 participants.
- IVR Group: 33 participants.
Publication
Published in the scientific journal Digital Health (Volume 12) in April 2026.
Technology Used
The study evaluated and compared two distinct technological formats for rehabilitation:
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- Immersive Virtual Reality (IVR): A 360º audiovisual projection system using the Broomx MK360UHD projector.
- Self-Guided Online Program: A remote and autonomous intervention using specific web platforms (iCF platform and Cerebral Training).
Context and Intervention
Individuals with Long COVID suffer from prolonged debilitating symptoms, most notably cognitive impairment (“brain fog”) and fatigue. To address this, this study evaluated a 12-week multimodal rehabilitation program combining cognitive training, physical exercise, and mindfulness. Three groups were compared: a control group, an online format, and Immersive Virtual Reality (IVR). The IVR format utilized an immersive room with Broomx technology to conduct supervised group sessions, integrating tasks with high ecological validity that simulated everyday situations—without the need for VR goggles—to enhance cognitive stimulation.
Context and Intervention
Individuals with Long COVID suffer from prolonged debilitating symptoms, most notably cognitive impairment (“brain fog”) and fatigue. To address this, this study evaluated a 12-week multimodal rehabilitation program combining cognitive training, physical exercise, and mindfulness. Three groups were compared: a control group, an online format, and Immersive Virtual Reality (IVR). The IVR format utilized an immersive room with Broomx technology to conduct supervised group sessions, integrating tasks with high ecological validity that simulated everyday situations—without the need for VR goggles—to enhance cognitive stimulation.
Key Results
- Broader cognitive improvements for the IVR group: While both the IVR and Online groups improved verbal recognition memory compared to the control group, only the immersive group (IVR) achieved deeper significant improvements in global cognition, immediate recall, and response inhibition (the ability to avoid impulsive responses).
- Boost to executive functions: Interactive training in the virtual environment improved response inhibition capacity and notably reduced patients’ commission errors (i.e., avoiding impulsive or incorrect responses).
- Physical and behavioral benefits: The IVR group showed a significantly more favorable recovery trajectory in increasing moderate physical activity and improving psychological flexibility. In these same areas, the online group remained stable, while the control group worsened. The online format excelled in achieving significant increases in mindfulness levels, improving perceived health-related quality of life, and reducing functional disability. In these general health perception spheres, the IVR group maintained stable levels.
- Prevention of functional decline: While patients in the control group experienced a decline in their abilities over time, participants using the immersive room managed to maintain and even improve them, effectively preventing cognitive decline.
- Complementary, not mutually exclusive formats: The study demonstrates that both technologies prevent functional decline but act in a complementary manner. The IVR format is superior for stimulating executive functions and memory because it immerses the patient in dynamic 360º environments that require sustained attention, while the Online format is ideal for promoting patient autonomy and integrating private wellness routines into daily life.
Conclusions and discussion
Although both technologies yielded benefits, the IVR format stood out for its profound improvements in executive and memory functions. Researchers conclude that the immersive, interactive, and group-based nature of the sessions facilitates sustained attention and greater patient engagement. Furthermore, replicating realistic dynamic environments requires brain processes very similar to those used in the real world, which strengthens neural connections and facilitates the direct transfer of these improvements to daily life. Ultimately, the shared immersive projection format is confirmed as a superior therapeutic tool for addressing complex rehabilitation and preventing functional decline in patients.