Objectives: Fatigue syndromes have been widely observed following post-viral infection and are being recognised because of Covid19. Interventions used to treat and manage fatigue have been widely researched and this study aims to synthesise the literature associated with fatigue interventions to investigate the outcomes that may be applicable to ‘long Covid’.Method: The study was registered with PROSPERO (CRD42020214209) in October 2020 and five electronic databases were searched. Papers were screened, critically appraised and data extracted from studies that reported outcomes of fatigue interventions for post-viral syndromes. The narrative synthesis includes statistical analysis associated with effectiveness and then identifies the characteristics of the interventions, including identification of transferable learning for the treatment of fatigue in long Covid. An expert panel supported critical appraisal and data synthesis.Results: Over 7,000 research papers revealed a diverse range of interventions and fatigue outcome measures. Forty papers were selected for data extraction after final screening. The effectiveness of all interventions was assessed according to mean differences (MD) in measured fatigue severity between each experimental group and a control following the intervention, as well as standardised mean differences as an overall measure of effect size. Analyses identified a range of effects–from most effective MD -39.0 [95% CI -51.8 to -26.2] to least effective MD 42.28 [95% CI 33.23 to 51.34]–across a range of interventions implemented with people suffering varying levels of fatigue severity. Interventions were multimodal with a range of supportive therapeutic methods and varied in intensity and requirements of the participants. Those in western medical systems tended to be based on self- management and education principles (i.e., group cognitive behavioural therapy (CBT).Conclusion: Findings suggest that the research is highly focussed on a narrow participant demographic and relatively few methods are effective in managing fatigue symptoms. Selected literature reported complex interventions using self-rating fatigue scales that report effect. Synthesis suggests that long Covid fatigue management may be beneficial when a) physical and psychological support, is delivered in groups where people can plan their functional response to fatigue; and b) where strengthening rather than endurance is used to prevent deconditioning; and c) where fatigue is regarded in the context of an individual’s lifestyle and home-based activities are used.

Background: People with Long Covid (Post Covid-19 Condition) describe multiple symptoms which vary between and within individuals over relatively short time intervals. We aimed to describe the real-time associations between different symptoms and between symptoms and physical activity at the individual patient level. Methods and findings: Intensive longitudinal study of 82 adults with self-reported Long Covid (median duration 12–18 months). Data collection involved a smartphone app with 5 daily entries over 14 days and continuous wearing of a wrist accelerometer. Data items included 7 symptoms (Visual Analog Scales) and perceived demands in the preceding period (Likert scales). Activity was measured using mean acceleration in the 3-hour periods preceding and following app data entry. Analysis used within-person correlations of symptoms pairs and both pooled and individual symptom networks derived from graphical vector autoregression. App data was suitable for analysis from 74 participants (90%) comprising 4022 entries representing 77.6% of possible entries. Symptoms varied substantially within individuals and were only weakly autocorrelated. The strongest between-subject symptom correlations were of fatigue with pain (partial coefficient 0.5) and cognitive difficulty with light-headedness (0.41). Pooled within-subject correlations showed fatigue correlated with cognitive difficulty (partial coefficient 0.2) pain (0.19) breathlessness (0.15) and light-headedness (0.12) but not anxiety. Cognitive difficulty was correlated with anxiety and light-headedness (partial coefficients 0.16 and 0.17). Individual participant correlation heatmaps and symptom networks showed no clear patterns indicative of distinct phenotypes. Symptoms, including fatigue, were inconsistently correlated with prior or subsequent physical activity: this may reflect adjustment of activity in response to symptoms. Delayed worsening of symptoms after the highest activity peak was observed in 7 participants. Conclusion: Symptoms of Long Covid vary within individuals over short time scales, with heterogenous patterns of symptom correlation. The findings are compatible with altered central symptom processing as an additional factor in Long Covid.

KinectFusion is a typical three-dimensional reconstruction technique which enables generation of individual three-dimensional human models from consumer depth cameras for understanding body shapes. The aim of this study was to compare three-dimensional reconstruction results obtained using KinectFusion from data collected with two different types of depth camera (time-of-flight and stereoscopic cameras) and compare these results with those of a commercial three-dimensional scanning system to determine which type of depth camera gives improved reconstruction. Torso mannequins and machined aluminium cylinders were used as the test objects for this study. Two depth cameras, Microsoft Kinect V2 and Intel Realsense D435, were selected as the representatives of time-of-flight and stereoscopic cameras, respectively, to capture scan data for the reconstruction of three-dimensional point clouds by KinectFusion techniques. The results showed that both time-of-flight and stereoscopic cameras, using the developed rotating camera rig, provided repeatable body scanning data with minimal operator-induced error. However, the time-of-flight camera generated more accurate three-dimensional point clouds than the stereoscopic sensor. Thus, this suggests that applications requiring the generation of accurate three-dimensional human models by KinectFusion techniques should consider using a time-of-flight camera, such as the Microsoft Kinect V2, as the image capturing sensor.

Manual anthropometrics are used extensively in medical practice and epidemiological studies to assess an individual's health. However, traditional techniques reduce the complicated shape of human bodies to a series of simple size measurements and derived health indices, such as the body mass index (BMI), the waist-hip-ratio (WHR) and waist-by-height^0.5 ratio (WHT.5R). Three-dimensional (3D) imaging systems capture detailed and accurate measures of external human form and have the potential to surpass traditional measures in health applications. The aim of this study was to investigate how shape measurement can complement existing anthropometric techniques in the assessment of human form. Geometric morphometric methods and principal components analysis were used to extract independent, scale-invariant features of torso shape from 3D scans of 43 male participants. Linear regression analyses were conducted to determine whether novel shape measures can complement anthropometric indices when estimating waist skinfold thickness measures. Anthropometric indices currently used in practice explained up to 52.2% of variance in waist skinfold thickness, while a combined regression model using WHT.5R and shape measures explained 76.5% of variation. Measures of body shape provide additional information regarding external human form and can complement traditional measures currently used in anthropometric practice to estimate central adiposity.

Traditional body measurement techniques are commonly used to assess physical health; however, these approaches do not fully represent the complex shape of the human body. Three-dimensional (3D) imaging systems capture rich point cloud data that provides a representation of the surface of 3D objects and have been shown to be a potential anthropometric tool for use within health applications. Previous studies utilising 3D imaging have only assessed body shape based on combinations and relative proportions of traditional body measures, such as lengths, widths and girths. Geometric morphometrics (GM) is an established framework used for the statistical analysis of biological shape variation. These methods quantify biological shape variation after the effects of non-shape variation–location, rotation and scale–have been mathematically held constant, otherwise known as the Procrustes paradigm. The aim of this study was to determine whether shape measures, identified using geometric morphometrics, can provide additional information about the complexity of human morphology and underlying mass distribution compared to traditional body measures. Scale-invariant features of torso shape were extracted from 3D imaging data of 9,209 participants form the LIFE-Adult study. Partial least squares regression (PLSR) models were created to determine the extent to which variations in human torso shape are explained by existing techniques. The results of this investigation suggest that linear combinations of body measures can explain 49.92% and 47.46% of the total variation in male and female body shape features, respectively. However, there are also significant amounts of variation in human morphology which cannot be identified by current methods. These results indicate that Geometric morphometric methods can identify measures of human body shape which provide complementary information about the human body. The aim of future studies will be to investigate the utility of these measures in clinical epidemiology and the assessment of health risk.

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve the clinical and quality-of-life outcomes of cancer patients by using lifestyle behaviour-change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients.