Reconceptualizing rehabilitation research via an enactive framework and a radically interdisciplinary cross-analysis: a study protocol on fatigue in post COVID-19 condition (PCC)

Abstract

Objective: To present a radically interdisciplinary research approach to ill-defined symptoms, with a focus on fatigue as a major symptom of post COVID-19 condition, where multiple and, to date, rarely combined approaches may yield a fuller understanding of these symptoms.

Design: Protocol for a mixed-methods study comprising an interdisciplinary cross-analysis.

Patients: 35 persons with post COVID-19 condition and severe fatigue were included, and 35 age-, sex-, and educationally matched controls who recovered from COVID-19 without post COVID-19 condition.

Methods: Participants were assessed by a multidisciplinary research team as follows: physician assessment; blood and urinalysis; spirometry and physical performance tests; neuropsychological tests; structural and functional magnetic resonance imaging; extended immunological tests (cytokines); and qualitative phenomenological analysis of interviews. Data will be analysed in accordance with established methods in each of these research fields and by a cross-analysis methodology developed from within an enactive framework. This framework encompasses a focus on neuroscientific, physiological, and experiential aspects of the person as a living being in their sociocultural world.

Conclusion: The biopsychosocial model needs to be implemented in research according to methods that allow radically different research paradigms, typically seen as incommensurable, to inform each other in a non-reductionist manner. One application of such an approach is therefore described.

Fig. 1

Visualization of the framework and the methods brought together in the project. The dotted lines are intended to visualize (i) that the lived body is not neatly set apart from the living body, and (ii) the embeddedness of the living being, acknowledging the dynamic interplay between the living being and its world. Further, the figure is intended to visualize and acknowledge that while a certain perspective and method may predominantly focus on the production of knowledge concerning the lived body as subjectively lived or the production of knowledge concerning the living body from a third-person perspective, these kinds of knowledges are also brought together and cross-analysed with the overarching aim of gaining a deeper understanding of the experience, characteristics, and pathophysiology of the object of study, that is, fatigue in PCC. The figure is adapted from Fuchs (16, p.3), with his permission. Fuchs' figure (16) is published in Frontiers of Psychology, and Frontiers articles are published under the CC-BY licence, https://creativecommons.org/licenses/by/4.0/