SOME BELIEVE THAT EXERCISE FOR LONG COVID could cause harm. But is that true?

Does even light physical activity hurt people with post-exertional malaise (with symptoms such as fatigue, cognitive dysfunction, and challenges with body temperature regulation)?

I was lucky; my COVID-19 infection was virtually asymptomatic. I slept ten hours, something I never do. So I tested.

Others are less fortunate.

In 2022, seven percent of adults had Long COVID. Women (8.5 percent) were more likely than men (5.2 percent) to ever have Long COVID-19, and women (4.4 percent) were also more likely than men (2.3 percent) to currently have Long COVID.

Long COVID-19

Long COVID, a perplexing phenomenon characterized by the persistence of symptoms for weeks, months, or even years after recovering from COVID-19, continues to baffle medical professionals and researchers.

Those who suffer from it experience a wide range of symptoms, including fatigue, cognitive dysfunction, and challenges with body temperature regulation.

Many people believe that exercise could worsen long COVID and cause harm.

Today’s goals

However, a recent study published in the British Medical Journal has shown that exercise may be a key player in long COVID recovery.

In this article, I will explore the findings of this study and provide insight into how exercise can improve the health-related quality of life for individuals experiencing long-term effects of COVID.

Post-exertional malaise (PEM)

Post-exertional malaise refers to worsening symptoms after even minor physical or mental exertion.

This phenomenon typically intensifies 12 to 48 hours post-activity, lingering for days or weeks.

Would exercise worsen COVID-19-related fatigue?

Chronic fatigue syndrome

Unlike many fatiguing diseases, where patients often find relief after exercise, those with Chronic Fatigue Syndrome face a different reality.

Even the slightest exertion can trigger Post-exertional Malaise (PEM), exacerbating their symptoms instead of providing relief.

Managing PEM involves adopting activity management strategies, commonly known as pacing.

The objective is to prevent flare-ups and avoid relapses by maintaining a delicate balance between rest and activity.

New study

A recent study published in the British Medical Journal has provided the first evidence-based recommendation for self-reported long COVID: exercise.

The research, titled “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial,” focused on individuals recently discharged from the hospital after experiencing COVID-19.

Study objectives

The goal of the REGAIN trial (Rehabilitation Exercise and psycholoGical support after COVID-19 InfectioN) was to assess the effectiveness of an eight-week, organized online supervised group program focused on physical and mental health rehabilitation.

The objective was to determine whether this structured intervention could enhance the health-related quality of life in adults experiencing long Covid-19 compared to standard care.

Exercise intervention

These participants reported ongoing damage from COVID-19, commonly known as self-reported long COVID-19.

Researchers randomly assigned study subjects to an 8-week group exercise program or a single check-in session, with the main measure being their quality of life.

Exercise details

The REGAIN internet-based exercise and behavioral support intervention comprised an initial individual consultation with a skilled practitioner.

Eight online group exercise sessions and six group support sessions were conducted over eight weeks.

Additionally, participants could avail themselves of an online repository containing on-demand exercises and support videos.

Results

Despite failing to achieve full participation from everyone, the study showed significant improvements.

In the intervention group, 47% of participants (141 individuals) fully adhered to the program, 39 percent (117 individuals) partially adhered, and 13 percent (40 individuals) did not receive the intervention.

Even with varying levels of engagement, positive outcomes were still evident.

Compared to standard care, the exercise intervention improved health-related quality of life, particularly in areas such as depression, fatigue, and pain interference.

My take

These positive effects were sustained at the 12-month mark, suggesting that exercise can play a crucial role in the recovery of individuals experiencing long-term effects of COVID.

Researchers are testing the exercise and counseling intervention in a randomized controlled trial.

Got long-COVID-19? Please check in with a valued healthcare provider before embarking on physical activity.