The Role of Physical Activity in COVID-19 Recovery

COVID-19 continues to have a worldwide impact on many facets of daily life. While COVID-19 can impact our ability to exercise, there is also emerging evidence about the benefits of exercise for those recovering from the disease. For those with a COVID-19 diagnosis, symptom intensity and duration can vary significantly.

Common symptoms include:

  • Fever
  • Sore throat
  • Headaches
  • Fatigue
  • Shortness of Breath
  • Body Aches
  • Coughing

Most of these symptoms will last 1-2 weeks, with some people being asymptomatic, and some individuals still experiencing symptoms beyond their infectious period. ‘Post-COVID Syndrome’ is loosely defined as experiencing ongoing COVID-19 symptoms for more than 12 weeks post infection. Further to this, ‘Long-COVID’ is the term given to people who continue to experience symptoms beyond 6 months post infection.

Based on interviews with those experiencing Post-COVID Syndrome, the most common reported symptom is fatigue. For those experiencing only short-term effects and symptoms lasting 1-2 weeks, the two main limiting factors are often shortness of breath and fatigue. Additionally, emerging evidence suggests increased risk of cardiac damage, including Myocarditis and in rare cases, Cardiac Failure.

The guidelines for those who are asymptomatic indicate exercise can be completed at normal levels, and those with mild symptoms may be required to reduce their exercise intensity; however, should limit sedentary periods where possible. In cases of more severe symptoms, it is recommended to reduce exercise levels for a 2–3-week period and return in a graduated fashion. Those with cardiac symptoms associated with infection are recommended to complete ECG testing and cardiopulmonary exercise testing prior to a return to exercise; however, current recommendations note a return to high-level sport and physically demanding activity is possible, should relevant testing be completed and arrythmias ruled out.

Regardless of the severity, when returning to exercise there are some key principles to abide by:

  1. Start slow. Even those with very mild symptoms may experience ongoing fatigue and shortness of breath. Depending on the duration of isolation, mild to significant de-conditioning can occur. Going ‘too hard, too soon’ can lead to ‘Boom Bust’ outcomes, meaning exacerbation of fatigue can occur and necessitate longer recovery duration.
  2. Pace your activity. Once starting slow, gradual increases in intensity, duration and frequency of exercise or physical activity can be made. Gradually building these over time will allow sustainable increases in physical capacity.
  3. Stepped Goals. Plan gradual increases in activity week-to-week based on your current activity levels and what is reasonably achievable. An Accredited Exercise Physiologist is perfectly placed to assist you with this.
  4. Be realistic. For mild to moderate symptoms with a fast recovery, exercise may be reasonable to return to in a matter of weeks. For those experiencing ‘Long COVID’ starting slow might mean completing 1-2 minutes of walking, or completing activities of daily living such as showering, light dusting, or preparing a meal. Some/low levels of physical activity is better than none.
  5. Never Miss Leg Day. Although COVID-19 effects the respiratory system, muscle loss and deconditioning can occur to varying extents depending on the duration of illness and time spent being physically inactive. Lower body strengthening helps not only to improve cardio-respiratory fitness by raising our heart rate momentarily, but also helps with increasing our strength to walk or run.

Those with more severe symptoms, including cardiac complications such as Myocarditis and those experiencing Post-COVID Syndrome requiring further medical intervention with a rehabilitation team, should undergo functional assessments to determine their current functional status and consulting with an Accredited Exercise Physiologist is a great way to ensure a safe and progressive return to activity.

References

Gochicoa-Rangel, L Hernandez-Morales, P Salles-Rojas, A Madrid-Mejia, W Guzman-Valderrabano, C Gonzalez-Molina, A Salas-Escamilla, I Duran-Cuellar, A Silva-Ceron, M Hernandez-Morales, V Reyes-Garcia, A Alvarado-Amador, I Lozano-Martinez, L Enright, P Pensado-Piedra, E Torre-Bouscoulet, L, 2021, Gas Exchange Impairment During COVID-19 Recovery, Respiratory Care, No, 66, pp. 1610-1617, accessed 1 February 2022, ISSN; 0020-1324

Shelley, J Hudon, J Mackintosh, KA Saynor, ZL Duckers, J Lewis, KE Davies, GA Berg, RMG McNarry, MA 2021, ‘I Live a Kind of Shadow Life’; Individual Experiences of COVID-19 Recovery and the Impact on Physical Activity Levels, International journal of environmental research and public health, Vol. 18, No. 21, accessed January 30 2022

Fernandez-de-las-Penas, C Palacios-Cena, D Gomez-Mayodomo, V Cuadrado, ML Florencio, LL 2021, Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Intergrative Classification, International journal of environmental research and public health, vol. 18, no. 5, accessed 30 January 2022

Barker-Davies, RM O’Sullivan, O Senaratne, KRP et.al, 2020, The Stanford Hall consensus statement for post-COVID-19 rehabilitation, British journal of sports medicine, vol. 54, pp, 949-949, accessed 1 February 2022

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