Annabel investigates….

 

Should we return to our usual exercise regime after Covid-19? What does the evidence say about individuals returning to physical activity after they have been infected with Covid-19? There are mixed opinions across all platforms of media and from experts about the specific steps that an individual should undertake when returning to physical activity. Today Annabel and the Longevity Exercise Physiology team at Drummoyne, EdgecliffMarrickvilleBella VistaRandwick, PymbleBalmain and Neutral Bay are going to delve into the various details around the current research for returning to physical activity in those individuals who have been infected with Covid-19.

 

Background

With over one million Australians being diagnosed with Covid-19 since the pandemic begun, the results have led to a broad range of clinical manifestations in the general adult population. There has been a large range from having asymptomatic/mild symptoms to severe symptoms requiring hospitalisation and intensive medical care. Although we do not entirely understand the long-term consequences of Covid-19, we understand that there could be concerns to an individual’s heart, brain, lungs, and kidneys. Patients could also experience long-term symptoms including shortness of breath, muscle aches, loss of stamina and exhaustion (Turner, 2021). With this understanding we need to be aware of the potential side effects that returning to physical activity can pose to individuals returning with a deconditioned immune system.

 

The Covid-19 pandemic has impacted physical activity immensely, which has affected all population groups, including professional, elite, occupational and recreational athletes. The need for evidence-based recommendations is high in the current climate on safely returning to exercise after Covid-19 infection. More information is becoming available on the potential longer term cardiopulmonary consequences of Covid-19 (also known as “long’ Covid). Individuals may experience persistent symptoms such as cough, elevated heart rate and high levels of fatigue which can last for weeks or months after infection (Salman, 2021). When returning to exercise, these adverse effects should be monitored throughout.

 

“The Covid-19 pandemic has impacted physical activity immensely, which has affected all population groups, including professional, elite, occupational and recreational athletes.”

 

Returning to Exercise

When we talk about returning to physical activity after a period of being infectious with Covid-19, it is essential that you take the time coming back into your usual health and exercise routine. As discussed above, everyone’s outcome of Covid-19 will be vastly different, therefore before commencing exercise, it is imperative to determine the levels of risk to provide precise recommendations on how each specific group can return to exercise in a safe manner.

 

The American College of Sports Medicine (ACSM) break down these groups. They state that those individuals who are under the age of 50 and have been asymptomatic during their infection period or have mild respiratory symptoms which resolved within seven days are considered lower risk. This group can follow a gradual return to exercise without further assessment. Those considered intermediate risk, are those who had symptoms or fatigue lasting longer than seven days, or prolonged shortness of breath or chest pain that did not require hospitalisation. Higher risk clients are those who were hospitalised or who experienced extensive bouts of shortness of breath or chest pain completing activities of daily living.

These individuals in both the intermediate or higher risk categories should be more cautious of their return to exercise regime and talk to a trained health professional in order to write up an individualised plan to ensure monitoring of adverse effects is present. (Turner, 2021)

 

When determining when an individual should return to physical activity it is important to consider several factors including the safety of the athlete, potential risks to the safety of other participants, functional capabilities of the athlete (i.e., baseline and current fitness) and functional demands of the sport or occupation (e.g. military, first responder).

 

Considering the above information, experts have agreed on some principles that need to be implemented in terms of gradual return to exercise. For all individuals coming back from infection, they should return to their normal daily routine including work/school and sleep patterns first and ensure that they are able to perform activities of daily living. In addition to these basic tasks, individuals should be able to perform 500m on a flat surface without experiencing extreme fatigue or shortness of breath. To begin with, 15 minutes of light exercise should be completed to ensure that no adverse effects occur. Once energy and fatigue levels have been achieved, activity and intensity of training can be increased, starting with body weight resistance exercise.

 

“During the first couple of months of returning to physical activity, if there is an incidence of any red-flag symptoms, such as chest pain, severe shortness of breath or rapid/irregular heartbeat, the individual should be referred to a health professional.”

 

Pre-illness capacity should dictate progressing to more physically demanding activity. As previously discussed, these are only recommendations, and everyone’s return to exercise will be different.

 

If you have tested positive to Covid-19 and want an individualised program to get you back to your previous level of fitness while monitoring for adverse effects,

Call Longevity Exercise Physiology Edgecliff, Pymble, Marrickville, Randwick, Drummoyne, Balmain, Bella Vista, and Neutral Bay on 1300 964 002 to enquire today.

 

Written by Annabel Bergman

 

References:

Salman, D., Vishnubala, D., Le Feuvre, P., Beaney, T., Korgaonkar, J., Majeed, A. and McGregor, A., 2021. Returning to physical activity after covid-19. BMJ, p.m4721.

Turner, M., 2022. ACSM Blog. [online] ACSM_CMS. Available at: <https://www.acsm.org/blog-detail/acsm-certified-blog/2021/12/20/safe-return-to-physical-activity-after-covid-19> [Accessed 13 January 2022].

Fallon, K., 2020. Exercise in the time of COVID-19. Australian Journal of General Practice, 49.

Hull, J., Wootten, M., Moghal, M., Heron, N., Martin, R., Walsted, E., Biswas, A., Loosemore, M.,

Elliott, N. and Ranson, C., 2021. Clinical patterns, recovery time and prolonged impact of COVID-19 illness in international athletes: the UK experience. British Journal of Sports Medicine, 56(1), pp.4-11.

G O’Connor, F. and Franzos, A., 2019. COVID-19: Return to play or strenuous activity following infection