Question & Answer

• According to the WHO, Post-COVID Condition (Long COVID) starts around 3 months after the first COVID-19 symptoms and lasts for at least 2 more months. It causes feelings of tiredness, trouble breathing, problems thinking, and more, which can make daily life hard. However, some studies have shown that people with other kinds of viruses that affect breathing can have symptoms like these, even up to three months after being sick and that there are problems with how Long COVID is defined.
• Claims have been made that exercising might help reduce the symptoms of Long COVID.
• Two systematic reviews evaluated the effect of digital exercise programmes. In these studies, people were given exercise programmes over video, and they were compared with people who were not doing the exercises. One study found improvements in breathing and overall symptoms in the group doing the exercise programme, but, many people dropped out of doing the exercise in this study. The other study showed improvements in general physical health and breathing.
• Another systematic review included 6 randomised controlled trials and compared online physiotherapy with face-to-face physiotherapy. The review found that some studies reported an improvement in symptoms in people doing the physiotherapy online but some did not. So we can’t be sure if online or face-to-face physiotherapy is better. Also, the research study didn’t compare doing physiotherapy with not doing physiotherapy, so we can’t be sure that physiotherapy improves symptoms of Long COVID.
• In addition, one systematic review looked at whether exercises help breathing or exercises in general improve symptoms of Long COVID. There were mixed findings. One Randomised Controlled Trial reported an improvement in fitness. One study found that those doing the exercises reported improvements in breathing at 6 weeks (but not at 28 weeks), while another study found no difference.
• One recent systematic review found that physical exercises as part of rehabilitation helped to improve breathing problems and movement issues caused by long COVID. However, the rehabilitation processes were not limited to physical rehabilitation on their own, so they were not fully able to distinguish the sole effects of physical exercise on long COVID.
• Furthermore, another recent systematic review looked at 14 different clinical trials where people with long COVID went through various rehabilitation programs. They found that those who did physical rehabilitation saw more improvements in their ability to exercise, less trouble breathing and a better overall quality of life compared to those who just received normal care. This research showed a moderate level of confidence that rehabilitation programs can improve exercise abilities and life quality for long COVID patients. However, the evidence is less clear for other benefits. Also, there’s some uncertainty about how safe these programs are, so more studies are needed, especially ones that pay close attention to any possible negative side effects.
• Overall, we can’t be sure if exercise improves symptoms of Long COVID, because not many studies have been done on long COVID. Of those that are done, many of them are badly designed, use only a few participants or test many different treatments and results on a diverse group of people.

Guidelines and recommendations

• World Health Organization recommends using exercise to help manage issues like difficulty breathing, fatigue, anxiety, depression, and trouble standing up. However, the evidence for these recommendations isn’t very strong.
• Health Service Executive suggests gentle stretches and strength exercises like yoga can be used to manage joint pain or muscle pain in Long COVID.
• According to a systematic review published by the Health Information and Quality Authority (HIQA), some Long COVID patients may find that customised exercise helps reduce their symptoms in the short term. But exercise can also make some people’s problems worse, so it’s important that exercise is formed with each person’s unique needs and takes an individual approach.