Background <p>Many COVID-19 survivors have been shown to experience at least one persistent symptom or deficit following infection, impacting their functioning and quality of life. However, knowledge about the appropriate care and rehabilitation needs of individuals with Long COVID remains fragmented. More research is needed to understand the impact of rehabilitation or telerehabilitation programs on Long COVID symptoms, quality of life, and work ability.</p> <p>This is a pilot randomized controlled trial to evaluate the feasibility of the study procedures and to compare the preliminary effects of a rehabilitation program delivered remotely (experimental group) or in-person (control group) for an adult (≥ 18&#xa0;years) with confirmed COVID-19 and persistent dyspnea at least eight weeks post-infection.</p> Methods <p>Participants were randomly assigned to either the telerehabilitation or in-person group using a computer-generated allocation sequence. An 8-week rehabilitation program, including cardiovascular, muscular, balance training, and respiratory exercises, was provided to both groups. Outcomes assessed included feasibility (recruitment rate, dropout rate, adherence rate, occurrence of adverse events, and patient satisfaction). Secondary outcomes comprised preliminary effect measures including exercise capacity, functional capacity, functional independence in daily life, quality of life, and clinical frailty.</p> Results <p>Twenty-one participants aged between 29 and 75 (median age 52) were recruited to the study. Thirty-nine (39) eligible individuals were approached, and 22 participants consented to participate in the study (56.4% consent rate). One participant withdrew before the start of the program due to scheduling issues, resulting in 21 participants included in the analysis. Eight participants in the in-person group and ten participants in the telerehabilitation group attended at least 75% of the sessions. No adverse events related to the intervention were reported during the study period. Participants’ satisfaction levels were high, with 90% strongly agreeing to the quality of services received in the telerehabilitation group. For the exercise capacity (pedaling time), there was a Group*Time interaction (<i>F</i>_{(1, 16)} = 6.1, ηp² = .28) and a main effect of time (<i>F</i>_{(1, 16)} = 20.9, ηp² = .57). A main effect of time was also detected for the One-Minute Sit-to-Stand Test (<i>F</i>(1, 16) = 8.1, ηp² = .34) in both groups.</p> Conclusions <p>This pilot randomized controlled study demonstrated the feasibility and safety of delivering a supervised group-based rehabilitation intervention remotely compared with in-person delivery to individuals with Long COVID characterized by persistent dyspnea eight weeks post-infection. These findings apply to a relatively young, non-hospitalized population and may not be generalizable to all Long COVID phenotypes. The protocol proved feasible in our clinic, showing favorable recruitment, dropout, and adherence rates, as well as a low occurrence of adverse events and high satisfaction. Preliminary observations on clinical outcomes suggest potential benefits of telerehabilitation compared to in-person delivery; these findings are exploratory and intended to inform future research rather than provide definitive conclusions. Further studies, including larger multicenter RCTs across Québec regions, are needed to evaluate the effects, safety and generalizability of supervised group-based telerehabilitation interventions for individuals with Long COVID.</p> Trial registration <p>ClinicalTrial.gov,&#xa0;NCT06952127. Registered on 28 April 2025—retrospectively registered. <a href="https://clinicaltrials.gov/study/NCT06952127">https://clinicaltrials.gov/study/NCT06952127</a></p>