Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial

Abstract

The aim of this study was to determine the effectiveness of physical exercise, respiratory muscle training and the self-management WHO recommendations leaflet on the recovery of physical fitness, quality of life and symptom status in people with post COVID-19 conditions. Eighty non-hospitalized adults with a post-COVID-19 condition were randomly assigned to one of four 8-week parallel intervention groups: multicomponent exercise program based on concurrent training- CT (n= 20; 3 resistance and endurance supervised sessions per week at low-moderate intensity); b) inspiratory muscle training- RM (n= 17; 2 standardized daily sessions); c) a combination of both of the above- CTRM (n= 23); d) control group- CON (n= 20; following the WHO guidelines for post-COVID-19 related illness rehabilitation). No significant differences between groups were detected at baseline. While no significant differences between interventions were detected in the VO2max, significant individual improvements were identified in the CT (7.5%; ES=0.38) and CTRM (7.8%; ES=0.28) groups. Lower body muscle strength significantly improved in the CT and CTRM (14.5-32.6%; ES=0.27-1.13) groups compared to RM and CON (-0.3-11.3%; ES=0.19-0.00). The CT and CTRM groups improved significantly for dyspnea and fatigue, as did the health status. In addition, significant differences between interventions were described in fatigue and depression scales favouring CT and CTRM interventions. An individualized and supervised concurrent training with or without respiratory muscle training was safer and more effective than self-care recommendations and inspiratory muscle training alone, to regain cardiovascular and muscular fitness, improve symptom severity and health status in outpatients with post-COVID-19 conditions.

Reduced exercise capacity, chronotropic incompetence, and early systemic inflammation in cardiopulmonary phenotype Long COVID

“…Reports of post-exertional malaise or symptom exacerbation (PEM/PESE) in PASC overlapping with ME/CFS [65–67] mean exercise-based interventions should be considered with caution. A study of a six-week structured pacing intervention improved physical activity levels and reduced PESE [68], and another study found that supervised exercise may be helpful rather than harmful in PASC [69].…”

“…Exercise is an effective treatment for postural orthostatic tachycardia syndrome, which may also be related to post-viral alterations in autonomic responses to stress and occurs in PASC [63,64]. Reports of post-exertional malaise or [68], and another study found that supervised exercise may be helpful rather than harmful in PASC [69].…”

Fortaleciendo la respiración: La rehabilitación como pilar en la recuperación del paciente post-COVID

“…Por su parte el estudio RECOVE [12] es un ensayo controlado aleatorizado donde se valoró la eficacia de un programa de RP basado en entrenamiento de ejercicio con o sin entrenamiento muscular inspiratorio, comparado con las recomendaciones de autocontrol recomendadas por la Organización Mundial de la Salud y un grupo control adicional [13] para pacientes con síntomas posteriores a COVID-19. Este estudio encontró que un programa multicomponente supervisado y personalizado es más efectivo que las recomendaciones de autocontrol para recuperar la condición física y los síntomas en pacientes con PCS.…”

Physical activity levels respiratory and peripheral muscle strength and pulmonary function in young post-COVID-19 patients

“…Various strategies to increase physical activity should be applied to improve general health and reduce the effects on pulmonary function, musculoskeletal system, cardiovascular, and psychological factors in individuals after COVID-19 [ 44 ]. Recent studies have shown that enduring physical activity and exercise training improve cardiovascular fitness, respiratory parameters, and general health in post-COVID-19 [ 45 – 47 ].…”