Exercise for COVID-19
There are many unknown specifics in relation to COVID-19, but evidence from previous coronavirus outbreaks suggests it may cause pulmonary and physical dysfunction, increased emotional anguish, and reduced quality of life. Furthermore, a number of individuals with COVID-19 would have spent time in ICU, and may have symptoms that are common within this setting such as dyspnoea, anxiety, depression, persistent pain and impaired physical function. As such, The British Journal of Sports Medicine (BJSM) has published evidence-based guidelines to assist with the rehabilitation of those who have been diagnosed with COVID-19: reducing secondary effects and recurrence.
These include;
Cardiac Rehabilitation Recommendations
All patients that have suffered with COVID-19 should have an assessment of their cardiac function, recovery, and potential impairments.
Depending on the patient’s initial assessment and symptoms, specialist advice should be sought
A period of rest post-infection, depending on symptoms and complications, will reduce risk of post-infection cardiac failure
If cardiac pathology is present, specific cardiac rehabilitation programmes should be provided tailored to the individual based on their cardiac complications, impairments and rehabilitation needs assessment
Musculoskeletal Rehabilitation Recommendations
All patients requiring rehabilitation following COVID-19 should have a comprehensive functional assessment to determine residual musculoskeletal impairments in order to determine appropriate rehabilitation
Patients that have had an ICU admission should have a multidisciplinary team approach for rehabilitation
Exercise Rehabilitation Recommendations
Those who required oxygen therapy or had acute lymphopenia should be identified and have a pulmonary function test
Those who experience severe sore throat, body aches, shortness of breath, general fatigue, chest pain, cough or fever should avoid exercise (>3METs) for between 2-3 weeks after the cessation of those symptoms
With very mild symptoms, consider limiting activity to light activity (≤3METs) but limit sedentary periods, with an increase in rest periods if symptoms deteriorate and prolonged exhaustive or high intensity training should be avoided.
On return from mild COVID-19 illness to exercise, 1 week of low level stretching and light muscle strengthening activity should be trialled prior to targeted cardiovascular sessions
References: Barker-Davies, R. M et al. (2020). The Stanford Hall consensus statement for post-COVID-19 rehabilitation. British Journal of Sports Medicine