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.
Evidence Score
Study Evidence
Study 1. Randomised controlled trial assessing the efficacy of balance acceptance and commitment therapy (ACT) for post-COVID syndrome: a study protocol.
observationalCarvalho 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 · BMJ open (2026)
Result:
Mechanism Graph
Limitations
- ⚠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.
Products
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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