Post-Acute Sequelae of COVID-19: The Potential Role of Exercise Therapy in Treating Patients and Athletes Returning to Play 2022 Cavigli et al

[Andy]

Abstract

Post-acute sequelae of coronavirus disease 19 (COVID-19) (PASC) describe a wide range of symptoms and signs involving multiple organ systems occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, representing a growing health problem also in the world of sport and the athletic population. Patients with PASC have new, returning, or persisting symptoms four or more weeks after the infection. Among the most frequent symptoms, patients complain of fatigue, dyspnea, exercise intolerance, and reduced functional capacity that interfere with everyday life activity. The role of exercise programs in PASC patients will be identified, and upcoming studies will establish the magnitude of their benefits. However, the benefits of exercise to counteract these symptoms are well known, and an improvement in cardiopulmonary fitness, functional status, deconditioning, and quality of life can be obtained in these patients, as demonstrated in similar settings.

Based on this background, this review aims to summarise the current evidence about the PASC syndrome and the benefit of exercise in these patients and to provide a practical guide for the exercise prescription in PASC patients to help them to resume their functional status, exercise tolerance, prior activity levels, and quality of life, also considering the athletic population and their return to play and sports competitions.

Open access, https://www.mdpi.com/2077-0383/12/1/288

 

[Trish]

From the introduction

Among the most frequently reported symptoms in PASC, patients complain of fatigue, dyspnea, and exercise intolerance that interfere with everyday life or worsen after even minor physical or mental efforts

The then go on to attribute exercise intolerance to deconditioning and POTS/OI to too much bedrest. For both they say exercise is the solution.

Moreover, it seems necessary for early intervention during the ongoing symptomatic COVID-19 phase to prevent PASC syndrome and avoid the chronicity of fatigue

Endurance training can include running, cycling, swimming, walking, etc. PACS patients with tachycardia, exercise/orthostatic intolerance, and/or deconditioning could be unable to tolerate upright exercise (i.e., power walking, jogging), which may worsen fatigue [2]. Therefore, recumbent or semi-recumbent exercise (e.g., rowing, swimming, or cycling) is preferable in these patients with transition to upright exercise over time as orthostatic intolerance resolves [2].

Once an exercise program is prescribed, strict compliance must be stressed to verify the correct performance of the training. After a few months, a new evaluation is required to adjust the exercise prescription, reassess intensity and VTs, and assess improvement of functional capacity and symptoms [45,50].

Post-acute sequelae of coronavirus disease 19 (PASC) are characterised by a wide range of symptoms and signs involving multiple organ systems representing a growing health problem. Among the most frequent symptoms, patients complain of fatigue, dyspnea, exercise intolerance, and reduced functional capacity that interfere with everyday life activity. The current review demonstrated that multidisciplinary rehabilitation programs can lead to an improvement in cardiopulmonary and musculoskeletal fitness, functional status, deconditioning, fatigue, and quality of life in post-COVID-19 patients. Upcoming studies will implement the knowledge regarding the modalities and the short/long-term effects of exercise in this setting. To date, these results highlight the importance of multidisciplinary rehabilitation programs, based on individualised and tailored exercise prescriptions, to be added to the continuum of care in PASC patients.

This is not just a bit of walking GET, this is hard core fitness training with the confident assumptions that exercise will cure exercise intolerance and OI.

 

[rvallee]

When you completely skip the first step of the scientific method. And the 3rd. It's a 3-step process and they skip 2, smh.

Hard to make it anymore clear that they have their conclusions decided in advance. This not serious at all.

One thing that's clear is that medicine's understanding of exercise is comically inept. And of causality, frankly. And words, I guess. Still unable to grasp that it's exertion intolerance. Or not caring, either is terrible.

 

[SNT Gatchaman]

Moreover, it seems necessary for early intervention during the ongoing symptomatic COVID-19 phase to prevent PASC syndrome and avoid the chronicity of fatigue.

Once again for those not paying attention at the back. I did not have symptomatic COVID, I did not become deconditioned. I was fit, active, sporting etc - I simply developed "de novo" orthostatic intolerance and pathological fatigue etc.

 

[Sean]

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