Balance-ACT may improve health-related quality of life in adults with post-COVID syndrome compared to treatment as usual, but efficacy is not yet established as this is a study protocol.
This protocol describes a randomised controlled trial evaluating Balance-ACT, a novel ACT-based intervention, for post-COVID syndrome (PCS). The trial will recruit 196 adults with PCS from NHS long COVID services and randomise them to Balance-ACT (10 sessions over 13 weeks) or treatment as usual (educational videos and self-help leaflet). The primary outcome is health-related quality of life measured by SF-36 Physical Component Score at 14 weeks post-randomisation, with secondary outcomes including sleep disturbance, fatigue, and cognitive function.
This article is automatically generated from the structured evidence profile behind the claim above. Scores reflect the quality and quantity of available research, not clinical advice.
Balance-ACT may improve health-related quality of life in adults with post-COVID syndrome compared to treatment as usual, but efficacy is not yet established as this is a study protocol. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Balance-ACT may improve health-related quality of life in adults with post-COVID syndrome compared to treatment as usual, but efficacy is not yet established as this is a study protocol.
This conclusion is most relevant to: Adults with post-COVID syndrome (symptoms persisting >12 weeks after SARS-CoV-2 infection) recruited from specialist long COVID services in NHS secondary care in England.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Randomised controlled trial assessing the efficacy of balance acceptance and commitment therapy (ACT) for post-COVID syndrome: a study protocol. (BMJ open, 2026) —
How It Works
The proposed biological pathway:
- ▸Balance-ACT enhances psychological flexibility
- ▸Reduces fear-avoidance and damage beliefs
- ▸Encourages values-based behaviour change
- ▸Improves physical health-related quality of life
Who Might Benefit
Evidence fit by population:
- ▸Adults with post-COVID syndrome (symptoms persisting >12 weeks after SARS-CoV-2 infection) recruited from specialist long COVID services in NHS secondary care in England
Recommended Dose
10 sessions over 13 weeks
Limitations & Caveats
Important context when interpreting this evidence:
- ▸No results yet; efficacy not established
- ▸Potential for high dropout due to 13-week intervention and follow-up
- ▸Generalisability limited to NHS secondary care patients in England
Frequently Asked Questions
What is Balance-ACT?▼
Balance-ACT is a novel adaptation of acceptance and commitment therapy designed for people with post-COVID syndrome, consisting of 10 therapist-delivered sessions over 13 weeks.
What is the primary outcome of the Balance-ACT trial?▼
The primary outcome is health-related quality of life measured using the SF-36 Physical Component Score at 14 weeks post-randomisation.
Who can participate in this trial?▼
Adults with post-COVID syndrome (symptoms persisting beyond 12 weeks) recruited from specialist long COVID services within NHS secondary care in England.
Does Balance-ACT improve sleep disturbance?▼
Sleep disturbance is a secondary outcome, but the protocol does not report results yet; efficacy for sleep is not established.
References
- 1.Carvalho N, Kalfas M, Jolley C, Rafferty GF, Pearson O, Emsley R, Metcalfe AJ, Barrett B, Brewin D, Felton L, Khan T, Hart N, Duncan EL, Nicholson T, Witard OC, Evans RA, Beckwith C, Chalder T. “Randomised controlled trial assessing the efficacy of balance acceptance and commitment therapy (ACT) for post-COVID syndrome: a study protocol..” BMJ open, 2026. PMID: 42547235 DOI: 10.1136/bmjopen-2026-122602