3 Steps For Returning To Physical Activity After COVID-19

The following tips are designed to help people return to fitness after a typical case of COVID-19. Around 10% of people infected with COVID-19 will have problems that linger for months after the infection is gone. These individuals are called long-haulers, and the condition is known as "long COVID" or PASC, which stands for Post-Acute Sequelae of SARS-CoV-2. If you have symptoms of long COVID, contact your primary care doctor before starting an exercise program. Long COVID may include other health complications that require labs, tests, or imaging, before being referred to a physical therapist for an evaluation and treatment specific to your condition. Note: Exercise may not be appropriate for everyone living with long COVID.

A mild to moderate bout with COVID-19 can leave you feeling weak, with a loss of balance and coordination, a lack of endurance, and sometimes problems with memory. Physical activity can help you recover.

Exercise may be the last thing on your mind, but it is key to regaining your fitness. Regular physical activity benefits your physical, mental, and social health. It's important for COVID-19 survivors (after their initial recovery) to get moving. Physical activity helps to improve:

• Strength.

• Endurance.

• Breathing capacity.

According to an article in BMJ, it's important to return to exercise after at least seven days free of COVID-19 symptoms, and to begin with at least two weeks of minimal exertion.

Listen to your body (and your doctor or physical therapist) for when it's safe to return to exercise. Then, take things slowly and follow this advice for returning to physical activity after a typical case of COVID-19.

1. Just Move, Even a Little

Your body has been through a lot. Take things slowly. For some, a trip from the bed or couch to the bathroom may be as much as you can handle in the early days. A flight of stairs may make you want to plop on the nearest easy chair. Get up and move as many times throughout the day as you can, even if it's just to stand from sitting several times in a row. Stretch for the sky with both arms and take several deep breaths each time you rise. Doing this light movement several times a day will help you start to build back strength. 

2. Take a Walk

If a little movement is not too challenging, try taking a brief walk. Begin at first by walking down the hall several times or around your house or apartment building. If that feels good, try a five-, 10-, or 15-minute walk around your neighborhood.

At this stage in your recovery, your intensity should be very light to light. At a light intensity, you should be able to easily carry on a conversation. If your intensity causes you to gasp for breath, you are pushing yourself too hard. The CDC provides a helpful description of Borg's Rating of Perceived Exertion to help you measure your intensity.

If you're a regular fitness fanatic and light intensity sounds too easy, be careful not to overdo it. It is important to allow your body time to get back to doing activities at your pre-COVID-19 pace. Gradually increase the intensity and length of your walks. With each day and each week, you'll be preparing your body to return to the full demands of a vigorous workout.

3. Ready To Run

If you tolerate walking, you may be ready to begin jogging, swimming, biking, or other activities. First, start your chosen activity at a slow pace for 10 minutes. Then, increase your pace for one minute before returning to the slower pace for another five to 10 minutes. Then repeat. When you're able to do these intervals for 30 minutes or more, you're ready to progress. Safely ease back into physical activity by slowly increasing the amount of intense exercise each day or week.

At this phase of recovery you may be ready for a higher intensity level. Aim for moderate intensity in which the exercise is somewhat hard, but not too hard. You should be breathing faster and deeper, but still be able to speak a full sentence and not be gasping for breath.

Everyone, regardless of age, condition, or ability should try to get the amount of daily physical activity recommended by the Department of Health and Human Services.

If you struggle with lingering side effects from COVID-19 and have trouble doing even minor physical activity, contact your doctor or a physical therapist experienced in treating COVID long-haulers. They can work with you on pacing, conserving energy, and addressing breathing pattern disorders to help you reach your goals.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement.

Avoid Chronic Disease With Regular Physical Activity→

Most Americans don’t move enough despite proven benefits, such as reduced risk of cancer and chronic diseases, and improved bone health, cognitive function, weight control, and overall quality of life.

The second edition of the Physical Activity Guidelines for Americans, reports that approximately 80% of US adults and adolescents are insufficiently active. As a result, many Americans currently have or are likely to experience chronic diseases, including heart disease, diabetes, obesity, and depression.

The good news is that regular physical activity can prevent and improve many chronic conditions. America, it's time to get moving!

How Much Physical Activity Should I Do?

According to the guidelines, the following is recommended:

1. Preschool-aged children (ages 3 through 5 years) should be physically active at least for 3 hours, if not more. Adult caregivers should encourage active play that includes a variety of activity types and limits sitting-around time, such as screen time.

1. Children and adolescents (ages 6 through 17 years) need at least 60 minutes or more of activity a day. This includes activities to strengthen bones, build muscles, and get the heart beating faster.

1. Adults should do at least 150 minutes of moderate-intensity aerobic activity a week, and at least 2 days for muscle-strengthening activities. Adding more time provides further benefits.

1. Older adults (ages 65 and older) should do at least 150 minutes of aerobic activity a week and include muscle-strengthening activities 2 days a week. You should also add components, such as balance training as well. If you have limitations due to preexisting conditions, consult with a health care provider and be as physically active as your abilities allow.

1. Pregnant and postpartum women who were physically active before pregnancy can continue these activities during pregnancy and in the postpartum period, but they should consult their health care provider about any necessary adjustments.

1. Adults with chronic health conditions and disabilities, who are able, should do at least 150 minutes of moderate-intensity activity a week. You should consult with a health care provider about the types and amounts that are appropriate for you.

How a Physical Therapist Can Help

Physical therapists are movement experts who optimize quality of life through prescribed exercise, hands-on care, and patient education.

After making a diagnosis, physical therapists create personalized treatment plans that help their patients improve mobility, manage pain and other chronic conditions, recover from injury, and prevent future injury and chronic disease.

Physical therapists empower people to be active participants in their own treatment, and they work collaboratively with other health professionals to ensure patients receive comprehensive care.

Resources

US Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. Washington, DC: US Dept of Health and Human Services; 2018. Accessed November 14, 2018.

US Department of Health and Human Services. Are My Kids Getting Enough Physical Activity. Move Your Way. Washington, DC: US Dept of Health and Human Services. Accessed November 14, 2018

US Department of Health and Human Services. 60 A Day! Move Your Way. Washington, DC: Dept of Health and Human Services. Accessed November 14, 2018.

US Department of Health and Human Services. What’s your move? Move Your Way. Washington, DC: Dept of Health and Human Services. Accessed November 14, 2018.

4 Tips to Stay Active and Independent As You Age→

 

Aging can have a bad reputation; however, there is no reason that growing older can’t be a journey full of adventure and opportunities to live life to the fullest. All you need is proper guidance, proactive steps, and a positive attitude.

And there is proof. Research suggests that improvements in physical function are possible well into older adulthood, and supports that continued activity as you age helps fight cognitive decline.

With the guidance of a physical therapist, you can improve mobility, maintain your independence, and continue participating in your favorite daily activities. As a movement expert, a physical therapist can provide an evaluation and design a treatment program to address any of your ailments and deficiencies, make modifications based on other preexisting conditions, and help you achieve your goals.

The following tips can keep you active and independent as you age:

1. Staying fit. Whether you are participate in regular exercise or just want to stay fit for daily activities, exercise is necessary. Exercise is proven to help improve balance, strengthen bones, and prevent heart and brain conditions. A prescribed strength training and aerobic exercise program will help you maintain and strengthen critical muscle groups needed for your life.
2. Staying balanced. Maintaining balance and avoiding falls are imperative to maintaining a quality of life and living independently. A physical therapist can prescribe a customized program of static and dynamic balance activities and exercises to improve your balance and prevent dangerous falls.
3. Assessing the terrain. A physical therapist can make recommendations that make your home and other environments safe by eliminating dangerous barriers. Typically this means removing throw rugs, loose carpets, clutter, and modifying entry thresholds with ramps.
4. Staying engaged. Successful aging is not only impacted by one’s environment, but also how one interacts with their environment. Fear and social isolation are substantial factors that increase fall risk and jeopardize independence. To ensure active and successful aging, continue to engage with friends, family, and the community. Social experiences with friends and family help diminish fear and improve physical and mental capabilities.

References

Stephens C, Breheny M, Mansvelt J. Healthy ageing from the perspective of older people: a capability approach to resilience. Psychol Health. 2015;30(6):715–731. Article Summary in PubMed.

Avin KG, Hanke TA, Kirk-Sanchez N, et al. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–834. Free Article.

Young WR, Mark Williams A. How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait Posture. 2015;41(1):7–12. Free Article.

Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLOS Med. 2010;7(7):e1000316. Free Article.

Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–2243. Article Summary in PubMed.

Moreland J, Richardson J, Chan DH, et al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49(2):93–116. Article Summary in PubMed.

House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241(4865):540–545. Article Summary in PubMed.

 Authored by Joseph V Libera, PT, DPT, MBA, MPH, GCS

Article Source:  Move Forward PT