People battling long COVID tend to be able to walk further and further when they do individualized exercises, a new review suggests.
When symptoms such as fatigue, headache and shortness of breath last at least two months, without another explanation, they meet part of the definition of what the World Health Organization now calls a post-COVID-19 condition.
Part of the challenge is that symptoms can fluctuate unpredictably. Previous research suggests that the wide range of symptoms and their severity, as well as different time periods, make it difficult to study long COVID systematically to guide treatment.
This new research helps fill out the picture on how exercise helps people walk farther and faster, as those with long COVID commonly say they find it difficult to endure long or strenuous walks, which in turn hinders their quality. of life.
To that end, the researchers combined findings from 14 randomized clinical trials, the gold standard for evaluating medical studies and reducing bias. That way, doctors will have more information when choosing treatments such as exercise for adults with long COVID.
“We found evidence to suggest that rehabilitation programs may be beneficial in improving walking ability and quality of life,” said Pavlos Bobos, lead author of the study and an assistant professor at Western University’s school of physiotherapy in London, Ontario.
The meta-analysis and systematic review were published in this week’s issue of Open JAMA Network.
Respiratory strengthening part of the treatment.
Dr. Mark Bayley, medical director of the Toronto Rehabilitation Institute, leads the University Health Network program to help patients with long COVID-19 recover from fatigue.
Exercise is a primary treatment or rehabilitation for patients with long COVID, Bayley said. Treatment includes respiratory strengthening to retrain the chest muscles and facilitate deeper breathing.
People with long COVID may have adopted a breathing pattern that doesn’t work as well as normal, and that’s where breathing exercises come in.
Katie Kitchen first tested positive for COVID-19 in December 2020. More than two years later, she is still living with long COVID symptoms.
“Part of this is really allowing the person to recognize that, yes, they are short of breath, but yes, they can maintain their comfort level even though they may be straining,” Bayley said.
People then feel less nervous and less short of breath, allowing them to engage in more vigorous activities, such as jogging or walking for longer periods of time.
Aerobic and strength training are also offered in rehabilitation medicine.
Bobos warned that there is still some uncertainty about the possibility of problems such as post-exertional malaise. This happens when a person exercises and then, that same day or the next day, they feel unwell and the symptoms reappear. The problem can also occur with myalgic encephalomyelitis, formerly chronic fatigue syndrome.
“We were very concerned that exercise might not be indicated or help them overall,” Bayley said. “However, this study brings together a large number of people and it is really exciting to see that it is a positive result.”
The long COVID is not over
Bayley said that while the number of Canadians with a post-COVID-19 condition is leveling off after vaccines and immunity to infection, some are developing the long-term condition for the first time.
People with other medical conditions such as cancer or those who have received a transplant remain vulnerable to both COVID-19 and long COVID, he said.
Researchers across Canada are looking at all angles of the problem, such as why long COVID occurs, what happens to the immune system and how to recognize and treat people who contract it.
Its goal is to help those who continue to suffer the effects of COVID for long months or years after infection.
Bayley said he’s interested in what improves other aspects of long COVID, such as whether dietary changes decrease intestinal symptoms. Improving concentration and memory problems, also known as “brain fog,” is another area where patients and their doctors are looking for progress.
Bobos, first author and Western doctoral student Dimitra Pouliopoulou and her team focused on studies using a measure, called the six-minute time-point walk test.
Since both hospitalized and non-hospitalized patients were included, it is not clear who benefits most from breathing exercise, or whether it will work as well if patients do the exercises themselves at home without a doctor monitoring their progress.
Elsewhere, research on educating people with chronic obstructive pulmonary disease, or COPD, sometimes called emphysema, without a doctor’s guidance tends to be less effective, in part because people may not use the equipment correctly or not at all. follow the exercises, the reviewers said.
