Digital Interventions
neurocognitive symptoms, fatigue
After enrollment and the first contact with their personal pilots, patients received access to the digital platform. Initially, patients from the IG and ACG familiarized themselves with the platform using unspecific interventions, such as general information about hygiene, nutrition, and exercise. In the ACG, the personal pilots decided together with the patients which symptom-specific plan would be the most fitting. They could choose between digital interventions focusing on fatigue, neurocognitive symptoms, or cardiorespiratory symptoms. Patients in the IG received digital interventions based on their physiological and cognitive capacity that was determined during the assessment in the clinic. Digital intervention plans were developed specifically targeted for low, medium, and high capacity. Capacity was assessed both subjectively and objectively and finally summarized by a physician. In the online screening, patients subjectively reported how strongly their condition affected their resilience and capacity to cope with everyday life demands. This information was explored in the admission interview for the diagnostic assessment by medical staff. To include more objective methods, typical parameters for echocardiography (performance of the heart at rest), ergometry, and spirometry (lung function) were assessed to determine the cardiopulmonary exercise capacity. Impairments regarding patients’ neuropsychological capacity were assessed with comprehensive testing of cognitive abilities (attention, thinking, and memory). In a physiotherapeutic and occupational therapy assessment, individual tests were performed and the accuracy as well as the stamina in this assessment were evaluated. In the final medical interview and the overall medical assessment, an assessment of exercise capacity was thus made in the areas of cardiology and pulmonology, neurology, psychosomatics, and neuropsychology. If reduced resilience was determined in one area, then remedial therapy was recommended in the treatment plan for this target. There were no cutoff values for the integration of capacity measures, as the aim was to use the patients’ own subjective assessments and the more objective diagnostic assessments as a basis to categorize the patients’ capacity as low, medium, or high for the digital interventions.Contents of the digital interventions included breathing and relaxation exercises, mindfulness training, meditation, physical strength tasks, and sensory as well as functional training. All patients in the IG and ACG received personal guidance from their personal pilots and were encouraged to adapt the exercises individually, when needed. For this purpose, based on physiotherapeutic expertise, an exercise manual with different variants of the physical exercises was provided. The focus of the digital training was to strengthen the patients’ self-management. Patients took part individually in the asynchronous offers and were expected to adhere to the daily intervention plan. The time spent on the daily activities on average was 50.4 minutes (range 44.6-58.7, depending on the level of intensity) in the IG and 41.9 minutes (range 32.5-48.7) in the ACG.