Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review

Abstract

Millions of people worldwide are infected with COVID-19, and COVID-19 survivors have been found to suffer from functional disabilities and mental disorders such as depression and anxiety. This is a matter of concern because COVID-19 is still not over. Because reinfection is still possible in COVID-19 survivors, decreased physical function and increased stress and anxiety can lower immune function. However, the optimal exercise intensity and volume appear to remain unknown. Therefore, the current systematic review aimed to evaluate the effect of resistance or aerobic exercises in post-COVID-19 patients after hospital discharge. We conducted searches in the Scopus, SciELO, PubMed, Web of Science, Science Direct, and Google Scholar databases. Studies that met the following criteria were included: (i) English language, (ii) patients with COVID-19 involved with resistance or aerobic exercise programs after hospital discharge. Out of 381 studies reviewed, seven studies met the inclusion criteria. Evidence shows that exercise programs composed of resistance exercise (e.g., 1–2 sets of 8–10 repetitions at 30–80% of 1RM) along with aerobic exercise (e.g., 5 to 30 min at moderate intensity) may improve the functional capacity and quality of life (reduce stress and mental disorders) in post-COVID-19 patients. In addition, only one study reported reinfection of three subjects involved with the exercise program, suggesting that exercise programs may be feasible for the rehabilitation of the patients. A meta-analysis was not conducted because the included studies have methodological heterogeneities, and they did not examine a control group. Consequently, the results should be generalized with caution.

Sleep Quality Mediates the Effect of Sensitization-Associated Symptoms, Anxiety, and Depression on Quality of Life in Individuals with Post-COVID-19 Pain

“…First, management of sensitization-associated symptomatology and depression may induce an improvement in HRQoL (due to their direct effects). In fact, evidence supports the use of resistance (e.g., 1–2 sets of 8–10 repetitions at 30–80% of 1RM) and aerobic (e.g., 5 to 30 min at moderate intensity) exercise programs for the management of HRQoL and emotional stress in patients with the post-COVID-19 condition [ 57 ]. A rationale for this improvement would be that exercise effects are mainly mediated by the central nervous system, and, accordingly, an effect in the nervous system of a patient with the post-COVID-19 condition would be expected [ 58 ].…”

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

“…For instance, exercise is a therapeutic strategy recommended for chronic pain and is being proposed as beneficial for individuals with long COVID [ 64 ]. In fact, evidence supports that programs combining resistance and aerobic exercises may improve the functional capacity and quality of life (reduce stress or mental disorders) in patients with post-COVID-19 symptoms [ 65 ]. However, underlying pain mechanisms must be considered in order to optimize the exercise prescription, especially in people with a nociplastic pain phenotype [ 66 ].…”

Effects of Aerobic Training on Brain Plasticity in Patients with Mild Cognitive Impairment: A Systematic Review of Randomized Controlled Trials

“…BDNF plays an essential role in maintaining synaptic plasticity in learning and memory. BDNF plays a vital role in facilitating nerve growth and maturation through the developmental stages and the regulation of synaptic transmission and flexibility in adulthood [ 37 , 38 ]. BDNF is mainly synthesized in neurons and glial cells and is then transported to presynaptic terminals and postsynaptic dendrites in the brain.…”