The effectiveness of exercise in alleviating long COVID symptoms: A systematic review and meta-analysis, 2024, Xueyan Cheng PhD candidate

[Mij]

Abstract
Background
Long COVID is prevalent in the general population. Exercise is a promising component of rehabilitation for long COVID patients.

Aim
This study examined the effects of exercise interventions on managing long COVID symptoms.

Methods
In this systematic review and meta-analysis, a systematic search was conducted through June 2023 using keywords such as “long COVID” and “post-acute COVID-19 syndrome” among major electronic databases. Randomized controlled trials that examined the effect of exercise on patients suffering from long COVID were included. Nine studies involving 672 individuals were included in this study.

Results
The main outcomes for exercise interventions in patients with long COVID were fatigue, dyspnea, anxiety, depression, and cognitive impairment. The exercise interventions comprised aerobic exercise, multimodal exercise, breathing exercise, and Taichi. Most of the included studies (6/9) were at high risk of bias. According to the meta-analyses, exercise significantly improved long COVID fatigue (ES = 0.89, 95% CI: 0.27 to 1.50) and dyspnea (ES = 1.21, 95% CI [0.33, 2.09]), whereas no significant effect was identified on long COVID anxiety, depression, and cognitive impairment. According to subgroup analyses, multimodal exercise had the broadest spectrum of benefits on long COVID symptoms (including fatigue, dyspnea, and depression), and supervised exercise, intervention frequency ≤4 times a week, the passive control group also showed a positive effect on some long COVID symptoms.

LINK

 

[Eleanor]

Most of the included studies (6/9) were at high risk of bias. Almost all the included trials reported[...] deviation from the intended intervention, missing outcome data, and selections of the reported result[...] Six studies had a high risk of bias as they used participant-reported scales in the measurement of the outcome.

ho hum

 

[SNT Gatchaman]

Long COVID and cancer share a number of overlapping symptoms, and exercise has played an important role in managing cancer- and cancer treatment-related symptoms. The detected pooled effect of exercise on cancer fatigue, dyspnea, anxiety, and depression ranged from 0.03 to 0.36, which appears to be lower than the effect size of exercise for improving long COVID symptoms as identified by our study (ranging from 0.46 to 1.21). A plausible interpretation of the lower overall exercise ES detected in cancer patients is that the cancer-related symptoms may be affected by ongoing treatment and its side effects, as well as the prognosis of the disease

However, exercise has shown positive effects on mental health and cognitive functions for various patients, including cancer patients and chronic obstructive pulmonary disease patients. The absence of significant effects among patients with long COVID in this meta-analysis may be attributed to the limited number of trials (all less than six). In particular, only two trials aimed at improving cognitive impairment.

Exercise must work, surely?

At least the limitation sections was somewhat realistic.

This review had some limitations. First, most of the included studies used subjective measurements, which may have left the findings prone to recall bias and response bias. Second, only articles published in English or Chinese were searched. Studies in other languages were omitted. Third, the majority of included studies were at high risk of bias, which may jeopardize the evidence strength. Fourth, the present study only explored the effect of exercise at the timepoint of exercise completion, so the long-term effects remain unknown.

 

[bobbler]

ho hum

it's pretty bad isn't it when it is a review - something doesn't have a high risk of bias for no reason ie you have to assume there is a likelihood that the bias is operating in the direction of the preferred agenda of the writer. Because sure as heck if something was wrecking the result they were hoping for you see how quickly - in any context - people tend to suddenly be able to see things again and do something about it.

So yes to the 'ho hum' let's include it as if it didn't isn't really the right attitude.

SO it just shouldn't be allowed that writing something with that high risk gets your message 'heard' in these reviews.

Otherwise it is more advantageous not to risk removing the bias, lest you not get the result because you are leaving it to the whims of real science and 'whether it actually works as a treatment', rather than using a design that you know will provide a sealed deal. In fact all that should get written about them is the name of the author and an 'unfortunately weren't able to do decent methods'.

Where's the penalty?

 

[bobbler]

Exercise must work, surely?

At least the limitation sections was somewhat realistic.

Long COVID and cancer share a number of overlapping symptoms, and exercise has played an important role in managing cancer- and cancer treatment-related symptoms.

is that really where the cancer literature is now? where the big charities would all be OK with suggestions that - what all cancer, given nothing specific has been excluded here, has a component of exercise tied to outcome? Because that would be as flawed as you get!!?

Oh what a surprise those whose treatment 'works' because they are lucky enough that area had a good 'match' for yours and you and didn't damage you in other ways so you could finish it were more likely to be able to complete the exercises than the people having to think about their plan B, C, D. I mean it is the same thing really as ME/CFS - they really would be testing the cancer treatment working through whether someone could complete their exercise NOT 'using it to treat'? SO Krypton factor filter cheating again?

Or is it that they get cancer treatment, and I don't think I'm wrong in saying that there are other things for common side-effects like steroids, anti-nausea and so on.

I have no idea how hugely dodgy the claims of what I assume is coming from the same 'fatigue' as if it is a feeling school are, but it isn't 'cancer' but the after-effects?

Measured more than likely by the people who complete the programme said it was helpful. Hmmm how do they not realise what that 'question' is actually testing as a Research Question?


Are these people genuinely actually trying to use cancer as the straw man to distract with claims 'well it works for cancer and whilst we are using a fop to try and pretend we respect LC to say it has similarities there is also the insinuations of ... well if people with cancer 'said it was good''?

I mean that is pretty naughty and sicko usage of the 'hierarchy of illnesses' mentioned in another thread here currently.

 

[rvallee]

In particular, only two trials aimed at improving cognitive impairment.

WTH kind of BS is an exercise trial aimed at improving cognitive impairment anyway? The whole point of exercise is that it has broad physiological, mostly non-specific, benefits. For most known benefits exercise is exercise, it doesn't have any particular aim and that's precisely what makes it useful, that it can be as non-specific as "just exercise according to your abilities and preferences". There are some differences between doing cardio vs weights but for the most part most analyses and reviews show little to no differences. Hence why no such advice can actually be given. Plus how generally biased and uninterpretable most studies are, making comparisons pretty much pointless.

But the whole thing has been turned into a ritual practice. As if there is some specific kind of exercise that someone can make that will target some bodily process more than others, outside of building muscle mass (through weights) vs cardiovascular fitness (through aerobic training).

And even then, it's not even clear if for the most part improvements in most ill cohorts are a simple reflection of those less ill being able to do more. This causal relationship is almost always the most likely explanation, but having turned this into a belief system makes it almost impossible to argue the obvious point.

Who even thinks of doing a systematic review with 6 studies anyway? Besides being an easy PhD? Even though there have been far more than 6, because 'systematic' reviews are usually not really reviews and even less systematic.