Intermittent versus equivalent constant-load cycle training in COVID-19 patients

Vitacca, Michele; Vogiatzis, Ioannis; Salvi, Beatrice; Bertacchini, Laura; Venturelli, Massimo; Paneroni, Mara

doi:10.1016/j.pulmoe.2022.02.005

Cited by 4 publications

(7 citation statements)

References 8 publications

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“…Taking into account the possible risks associated with intense exercise for individuals suffering from post-viral chronic fatigue syndrome, we employed intermittent exercise training on a cycle ergometer. After being released from the hospital, intermittent exercise has been demonstrated to be safe and well-tolerated by COVID-19 survivors [53,54]. For patients with respiratory disorders characterized by exertional dyspnea, intermittent exercisewhich alternates brief intervals of exercise with periods of rest-has been shown to be beneficial [55].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Michalas,

Katsaras,

Spetsioti

et al. 2024

JPM

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Background: Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome. Methods: The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups. Results: No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02). Conclusions: Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Michalas,

Katsaras,

Spetsioti

et al. 2024

JPM

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“…However, several individual components of our practical recommendations have already been investigated in specific clinical trials and were found to be beneficial and safe in many people with long COVID (e.g. interval endurance training [ 38 ] or inspiratory muscle training [ 30 ]).…”

Section: Discussionmentioning

confidence: 99%

Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal

Gloeckl,

Zwick,

Fürlinger

et al. 2024

Sports Med - Open

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People with long COVID may suffer from a wide range of ongoing symptoms including fatigue, exertional dyspnea, reduced exercise performance, and others. In particular, impaired exercise performance is a condition that can be recovered in many people through an individualized physical exercise training program. However, clinical experience has shown that the presence of post-exertional malaise (PEM) is a significant barrier to physical exercise training in people with long COVID. Currently, there is no guideline or consensus available on how to apply exercise training in this cohort. Therefore, we conducted a literature review in the PubMed library using the following search terms: “COVID”, “post-COVID”, “long COVID” and “exercise” searching for studies from January 2020 to January 2024. Data from 46 trials were included. Exercise training regimes were very heterogeneous and none of these studies reported on the management of PEM in the context of an exercise training program. Based on the feedback from an additional survey that was answered by 14 international experts in the field of exercise training in long COVID, combined with the authors´ own extensive practical experience, a best practice proposal for exercise training recommendations has been developed. This proposal differentiates exercise procedures according to the presence of no, mild/moderate or severe PEM in people with long COVID. These recommendations may guide allied healthcare professionals worldwide in initiating and adjusting exercise training programs for people with long COVID, stratified according to the presence and severity of PEM.

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“…In line with this official guidance and considering that exercise programmes at relatively high intensity could be harmful in patients with postviral ‘chronic fatigue syndrome’, we implemented intermittent exercise training on the cycle ergometer starting at 50% of peak work rate. Intermittent exercise has been shown to be safe and well tolerated by COVID-19 survivors post-hospital discharge 16 56. Intermittent exercise, consisting of repeated bouts of exercise that are alternated with short periods of rest, has shown to be effective in respiratory patients with profound symptoms of exertional breathlessness and leg discomfort 57.…”

Section: Discussionmentioning

confidence: 99%

“…Early in the course of the pandemic, medical associations worldwide issued guidance emphasising the necessity for rehabilitation programmes tailored to the needs of the growing number of post-COVID-19 patients with persistent symptoms and disabilities 14 15. Since then, an increasing number of prospective, single cohort studies have shown that rehabilitation is a feasible, safe and effective therapeutic intervention in post-COVID-19 patients with a range of severity and symptoms 16 17. Studies have shown clinically meaningful benefits in improving symptoms (including fatigue), exercise capacity, respiratory function and measures of HRQoL in these patients 8 17–19.…”

Section: Introductionmentioning

confidence: 99%

Additive benefit of rehabilitation on physical status, symptoms and mental health after hospitalisation for severe COVID-19 pneumonia

et al. 2023

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IntroductionThe potential additive benefits of rehabilitation beyond spontaneous recovery post-COVID-19 currently remain unknown.MethodsIn this prospective, interventional, non-randomised parallel assignment two-arm study, we investigated the effects of an 8-week rehabilitation programme (Rehab, n=25) added to usual care (UC) versus UC (n=27) on respiratory symptoms, fatigue, functional capacity, mental health and health-related quality of life in patients with COVID-19 pneumonia, 6–8 weeks post-hospital discharge. The rehabilitation programme included exercise, education, dietary and psychological support. Patients with chronic obstructive pulmonary disease, respiratory and heart failure were excluded from the study.ResultsAt baseline, groups were not different in mean age (56 years), gender (53% female), intensive care unit admission (61%), intubation (39%), days of hospitalisation (25), number of symptoms (9) and number of comorbidities (1.4). Baseline evaluation was conducted at median (IQR) 76 (27) days after symptoms onset. Groups were not different regarding baseline evaluation outcomes. At 8 weeks, Rehab showed significantly greater improvement in COPD Assessment Test by a mean±SEM (95% CI) 7.07±1.36 (4.29–9.84), p <0.001andall three fatigue questionnaires: Chalder-Likert: 5.65±1.27 (3.04–8.25), p <0.001; bimodal: 3.04±0.86 (1.28–4.79), p=0.001; Functional Assessment of Chronic Illness Therapy: 6.37±2.09 (2.08–10.65), p=0.005 and Fatigue Severity Scale: 1.36±0.433 (0.47–2.25), p=0.004. At 8 weeks rehab also showed significantly greater improvment in Short Physical Performance Battery: 1.13±0.33 (0.46–1.79), p=0.002; Hospital Anxiety and Depression Scale (HADS)Anxiety: 2.93±1.01 (0.67–5.18), p=0.013; Beck Depression Inventory: 7.81±3.07 (1.52–14.09), p=0.017; Montreal Cognitive Assessment: 2.83±0.63 (1.5–4.14), p <0.001; EuroQol (EQ-5D-5L) Utility Index: 0.21±0.05 (0.1–0.32), p=0.001 and Visual Analogue Scale: 6.57±3.21 (0.2–13.16), p=0.043. Both groups significantly improved 6-min walking distance by approximately 60 m and pulmonary function measures, whereas post-traumatic stress disorder measurement IES-R (Impact of Event Scale, Revised) and HADS-Depression score were not different between groups at 8 weeks. A 16% attrition rate was observed in the rehabilitation group exhibiting a threefold increase in training workload. There were no adverse effects reported during exercise training.DiscussionThese findings highlight the added value of rehabilitation post-COVID-19 to amplify the natural course of physical and mental recovery that otherwise would remain incomplete with UC.

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Intermittent versus equivalent constant-load cycle training in COVID-19 patients

Cited by 4 publications

References 8 publications

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome

Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal

Additive benefit of rehabilitation on physical status, symptoms and mental health after hospitalisation for severe COVID-19 pneumonia

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