Practicalities for Exercise Prescription in Long-COVID-19 Rehabilitation. A Narrative Review
Main Article Content
Abstract
Many COVID-19 survivors worldwide suffer from persistent symptoms, impaired functional capacity and quality of life. Rehabilitation exercise interventions for the long-term physical consequences of coronavirus disease 2019 (COVID-19) are currently being reported. As a result, the clinical practice and research focus on interventions that support recovery from ongoing symptomatology, independently to hospitalization. To date, the outpatient rehabilitation programs offer various exercise modes and training intensities for people recovering from long-term symptomatology of COVID-19.
This narrative review summarizes previous studies that used exercise training protocols at the outpatient rehabilitation setting, presents the effectiveness of training on the functional outcomes and provides practical issues of the application of exercise training which overcome possible respiratory and peripheral muscle limiting factors of exercise and functional capacity for patients with Long-COVID-19. To this end we make recommendations on how better to implement exercise training in future studies so as to maximize training effects.
Due to lack of randomized trials, more research is needed in the field of the exercise training modalities that are more effective and in parallel more tolerable for patients with persistent post-COVID-19 symptoms. In this context, interval training mode with short exercise periods can prevent high lactate accumulation and allow more intense exercise stimuli to the deconditioned peripheral muscles with minimal cardiac strain and exercise-induced hyperventilation, thus improving exercise capacity in this patients’ population.
Keywords:
Covid-19, post-COVID-19, exercise training, rehabilitation, physiotherapy
Article Details
How to Cite
KORTIANOU, Eleni A.; MAVRONASOU, Aspasia S.; SAPOUNA, Vaia.
Practicalities for Exercise Prescription in Long-COVID-19 Rehabilitation. A Narrative Review.
Medical Research Archives, [S.l.], v. 10, n. 5, june 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2801>. Date accessed: 27 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i5.2801.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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11. Paneroni M, Simonelli C, Saleri M, et al. Muscle strength and physical performance in patients without previous disabilities recovering from COVID-19 pneumonia. Am J Phys Med Rehabil. 2021;100(2):105-109. doi: 10.1097/PHM.0000000000001641
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13. Dalbosco-Salas M, Torres-Castro R, Rojas Leyton A, et al. Effectiveness of a Primary Care Telerehabilitation Program for Post-COVID-19 Patients: A Feasibility Study. J Clin Med. 2021;10(19):4428. doi: 10.3390/jcm10194428
14. Daynes E, Gerlis C, Chaplin E, Gardiner N, Singh SJ. Early experiences of rehabilitation for individuals post-COVID to improve fatigue, breathlessness exercise capacity and cognition - A cohort study. Chron Respir Dis. 2021;18:14799731211015691. doi: 10.1177/14799731211015691
15. do Amaral VT, Viana AA, Heubel AD, et al. Cardiovascular, respiratory and functional effects of tele-supervised home-based exercise training in individuals recovering from COVID-19 hospitalization: A randomized clinical trial. doi: 10.1101/2022.01.24.22269745
16. Everaerts S, Heyns A, Langer D, et al. COVID-19 recovery: benefits of multidisciplinary respiratory rehabilitation. BMJ Open Respir Res. 2021;8(1):e000837. doi: 10.1136/bmjresp-2020-000837
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18. Kortianou EA, Tsimouris D, Mavronasou A, et al. Pilot application of a home-based exercise program combined with tele-rehabilitation in previously hospitalized patients with COVID-19. A prospective observational study. Pneumon. 2022;35(2). doi: 10.18332/pne/146521.
19. Li J, Xia W, Zhan C, et al. A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomized controlled trial. Thorax. 2021;thorax jnl-2021-217382. doi: 10.1136/thoraxjnl-2021-217382
20. Martin I, Braem F, Baudet L, et al. Follow-up of functional exercise capacity in patients with COVID-19: It is improved by telerehabilitation. Respir Med. 2021;183:106438. doi: 10.1016/j.rmed.2021.106438
21. Mayer KP, Parry SM, Kalema AG, et al. Safety and Feasibility of an Interdisciplinary Treatment Approach to Optimize Recovery From Critical Coronavirus Disease 2019. Crit Care Explor. 2021;3(8):e0516. doi: 10.1097/CCE.0000000000000516
22. Nambi G, Abdelbasset WK, Alrawaili SM, et al. Comparative effectiveness study of low versus high-intensity aerobic training with resistance training in community-dwelling older men with post-COVID 19 sarcopenia: A randomized controlled trial. Clin Rehabil. 2022;36(1):59-68. doi: 10.1177/02692155211036956
23. Spielmanns M, Pekacka-Egli AM, Schoendorf S, Windisch W, Hermann M. Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients. Int J Environ Res Public Health. 2021;18(5):2695. doi: 10.3390/ijerph18052695
24. Stavrou VT, Tourlakopoulos KN, Vavougios GD, et al. Eight Weeks Unsupervised Pulmonary Rehabilitation in Previously Hospitalized of SARS-CoV-2 Infection. J Pers Med. 2021;11(8):806. doi: 10.3390/jpm11080806
25. Thomas P, Baldwin C, Beach L, et al. Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations. J Physiother. 2022;68(1):8-25. doi: 10.1016/j.jphys.2021.12.012
26. Postigo-Martin P, Cantarero-Villanueva I, Lista-Paz A, Castro-Martín E, Arroyo-Morales M, Seco-Calvo J. A COVID-19 Rehabilitation Prospective Surveillance Model for Use by Physiotherapists. J Clin Med. 2021;10(8):1691. doi: 10.3390/jcm10081691
27. Negrini F, de Sire A, Andrenelli E, Lazzarini SG, Patrini M, Ceravolo MG. Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field. Update as of October 31st, 2020. Eur J Phys Rehabil Med. 2021;57(1):166–170. doi: 10.23736/S1973-9087.20.06723-4
28. Randal JT, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association and the American College of Cardiology. Circulation 2019; 140(1):e69-e89. doi: 10.1161/CIR.0000000000000663
29. Rochester CL, Vogiatzis I, Holland AE, et al. An official American Thoracic Society/European Respiratory Society Statement: Enhancing Implementation, Use and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med 2015;192(11):1373-1386. doi: 10.1164/rccm.201309-1634ST
30. Cortés-Telles A, López-Romero S, Figueroa-Hurtado E, et al. Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea. Respir Physiol Neurobiol. 2021;288:103644. doi: 10.1016/j.resp.2021.103644
31. Goërtz YM, Van Herck M, Delbressine JM, et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome? ERJ Open Res. 2020;6(4):00542–2020. doi: 10.1183/23120541.00542-2020
32. Raman B, Cassar MP, Tunnicliffe EM, et al. Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine. 2021;31:100683. doi: 10.1016/j.eclinm.2020.100683
33. Aparisi A, Ybarra-Falcón C, García-Gómez M, et al. Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation. J Clin Med. 2021;10(12):2591. doi: 10.3390/jcm10122591
34. Rinaldo RF, Mondoni M, Parazzini EM, et al. Deconditioning as main mechanism of impaired exercise response in COVID-19 survivors. Eur Respir J. 2021;58(2):2100870. doi: 10.1183/13993003.00870-2021
35. Baratto C, Caravita S, Faini A, et al. Impact of COVID-19 on exercise pathophysiology: a combined cardiopulmonary and echocardiographic exercise study. J Appl Physiol (1985). 2021;130(5):1470-1478. doi: 10.1152/japplphysiol.00710.2020
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