Effect of Physical Exercise-Based Rehabilitation on Long COVID: A Systematic Review and Meta-analysis

Abstract

Purpose The number of persons living with post-coronavirus disease 2019 (COVID-19) conditions or long COVID continues to rise worldwide; however, the etiology and treatment of long COVID remain nebulous. Therefore, efficient, feasible, and cost-effective therapeutic strategies for a large population with long COVID remain warranted. Physical exercise-based rehabilitation is a promising strategy for long COVID, although its therapeutic effects remain to be determined. This systematic review and meta-analysis aimed to examine the effects of physical exercise-based rehabilitation on long COVID. Methods The electronic databases Medline, Embase, Global Health (Ovid), CINAHL (EBSCO), Web of Science, WHO Global Research Database on COVID-19, LitCovid, and Google Scholar were searched from their inception to November 2022. The identified articles were independently screened by three reviewers, and a random-effects model was utilized to determine the mean differences in the meta-analysis. Results Twenty-three studies involving 1,579 individuals who had COVID-19 (752 women) were included. Physical exercise-based rehabilitation showed beneficial effects on long COVID-related symptoms characterized by dyspnea, fatigue, and depression, as well as on the 6-minute walk test, forced expiratory volume in 1 second/forced vital capacity, and quality of life in people who had COVID-19. Conclusions Physical exercise-based rehabilitation is a potential therapeutic strategy against long COVID and can be applied as a routine clinical practice in people who have recovered from COVID-19. However, customized physical exercise-based rehabilitation programs and their effects on specific types of long COVID require future large-scale studies.

Long COVID Symptoms vs. Back Pain and Physical Activity among Students in Poland—Cross-Sectional Study

“…Rehabilitation with physical activity is a promising strategy used in routine clinical practice, although its therapeutic effects are not yet clearly defined. The literature shows that it has a positive effect on the symptoms of dyspnoea, fatigue, depression, and quality of life [59].…”

Physical Activity, Long-COVID, and Inactivity: A Detrimental Endless Loop

“…In keeping with these findings, a recent meta-analysis including 23 studies totaling 1579 subjects with documented SARS-CoV-2 infection revealed that a program of PAbased rehabilitation may be an effective therapeutic option in patients with long-COVID, showing substantial benefits on most symptoms, particularly dyspnea, fatigue, depression, and capacity of performing physical exercise. 11 The Second Side of the Coin: Long-COVID and Risk of Physical Inactivity…”

Long COVID management: a mini review of current recommendations and underutilized modalities

“…Physical exercise rehabilitation has also been shown to provide improvement of fatigue but it is essential to rule out conditions such as post-exertional malaise (PEM) and POTS as exercise may exacerbate symptoms and be harmful ( 41 , 48 , 51 ). A randomized controlled trial (RCT) examined functional versus aerobic exercise telerehabilitation programs in combination with breathing techniques to improve long COVID symptoms and demonstrated both improved quality of life and stress symptoms ( 54 ).…”

“…However, functional exercise exhibited more significant results improving fatigue and functional performance ( 54 ). Physical exercise rehabilitation should be performed in a clinical setting with direct supervision to ensure patient safety ( 51 , 55 ).…”