A recent study found long COVID can adversely affect your ability to exercise. And not just because of chronic fatigue.
However, Dr. Salman Bhai, director of the neuromuscular center at the Institute for Exercise and Environmental Medicine at Texas Health Dallas, told KERA’s Sam Baker that with help, an exercise routine is still possible with long COVID.
You know, activity and exercise are so central to our lives, but the fatigue itself is not the most worrisome component.
It's this report of post-exertional malaise, which means that when people exercise, they feel even worse. They get knocked out for several days. It's somewhat unique to long Covid. It's also seen in other conditions.
But that's what has researchers and clinicians like me worry for patients. What is the best strategy to improve that? And we're still learning more and more about that.
Does it make a difference how much you exercised before developing long COVID?
No, it doesn't seem to be a clear correlation, but it does help the mindset when patients know that they've exercised at a previous high level. They can set that goal again to get to that new baseline to improve. And I think that's a tact that patients and clinicians work together to achieve the best outcomes.
So how do you approach exercise then if you have long COVID?
The goal isn't to get back to your old baseline. We're not trying to catch up. We're starting with the new baseline and we're going to get improvement.
We make new patient-specific exercises and goals related to their physical activity. And as a mutual decision between the patient and the multidisciplinary team, we come up with an incremental, gradual plan of increase in time and intensity that's tailored to individual patients. The goal is 6 to 12 months out, not a few weeks.
So, if someone is feeling particularly good one day, you know, we don't say, go out and sprint, right? Just stick to the plan. Gently push yourself, but don't overdo it.
With that, we hope to avoid some of the post-exertional symptoms that patients would feel.
Give me an idea of what the beginning of this looks like.
If it's just simple walking for a few minutes and that's what starts to cause fatigue, that's good to know. So we cut that back some and we say, well walk a little less. Take a break. Walk again. Take a break.
The goal is mixing low-intensity cardio and resistance training to help patients improve over the long term.
Water aerobics can be helpful. That's in the cardio bucket. You can also do yoga, like stretching. I think those can be quite helpful too.
But it is so individually based, so it's hard to say exactly what's best for certain individuals. You know, they might have other medical issues that might prevent them from doing a certain activity.
Ultimately, though, the goal is to stay moving at a measured, gradual pace that increases over time. But more research needs to be done about what that exactly is. We're still learning answers to the question is exercise useful? If so, what kind of exercise would be most useful for patients?
Can you do this on your own, or should you do this under a doctor's care?
I think it's important initially to start in the health care setting, with a team. We don't want to miss a condition that might be mimicking what long COVID looks like. The symptoms are quite nonspecific.
Once you get started with a gradual training program, that's something that people can do on their own. But it really depends on how comfortable people are. So I think it's a case-by-case basis.
You can do it with a health care team or by yourself in a self-supervised way. But research needs to catch up to that point where it's more broadly applicable.
RESOURCES:
Muscle abnormalities worsen after post-exertional malaise in long COVID
Long COVID or Post-COVID Conditions
Study helps explain post-COVID exercise intolerance
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