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"Post-Acute Covid", "Long Covid", "Covid Long-Haulers" and Exercise.

The name given to the long term health consequences of Covid-19 does not appear to be decided on amongst experts. Symptoms such as shortness of breath and fatigue can linger after respiratory illness (as with many severe illnesses) with some cases showing cardiac, pulmonary and neurologic involvement after testing and imaging reports.

I was initially concerned by an article written advising against graded exercise post Covid infection. This alarmed me because:

  1. Each person should be assessed properly on a case by case basis with a person centred approach.

  2. Once safe to participate in physical activity, already compromised cardiac, pulmonary, musculoskeletal and neurologic systems will not improve to pre-existing levels (if this is possible) without a GRADUAL physical activity increase towards those levels.

  3. Many properly qualified Physiotherapists and Clinical Exercise Specialists are able to use training and technology to assess and monitor patients/clients to ensure they start and progress at the at the right level and intensity of physical activity.

  4. Pre-Lockdown, 70% of the population didn't usually do enough physical activity to benefit their health. Should we really be scaring people off physical activity if a graded approach from a low level would actually help improve their health post Covid?

Is doing no physical activity an option? Only a full assessment can give that answer. What we do know about physical activity from years of research is:

  1. Low and moderate intensity physical activity/exercise can maintain and increase fitness and lead to health benefits such as lowering blood pressure, improving health in people with some chronic diseases and reducing the risk of developing those diseases.

  2. High intensity exercise can increase fitness but may also reduce the effectiveness of the immune system for some time post exercise potentially increasing risk of developing Covid if exposed.

In my opinion it is clear that far from discouraging a proper graded approach to physical activity post Covid, we should be encouraging this under the care of qualified Physiotherapists and Clinical Exercise Specialists in an interdisciplinary manner with other health and care professionals.

Suzanne McCollum BSc Exercise Science BSc Physiotherapy

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