Can Rehabilitation Help People with Long COVID?
Yes. In this study, 30 people with Long COVID who completed a 6-week rehabilitation program showed significant improvements in exercise capacity, fatigue, breathing symptoms, and cognition. Walking distance improved by 112 meters, and there were no serious adverse events.
This UK study tested whether an adapted pulmonary rehabilitation program could safely help people struggling with lasting COVID-19 symptoms. The results showed clear benefits across multiple measures of function and quality of life.
What the Data Show
The rehabilitation program produced statistically significant improvements:
- Walking distance (ISWT): Improved by 112 meters (p<0.01)
- Walking endurance (ESWT): Improved by 544 seconds (p<0.01)
- Fatigue score (FACIT): Improved by 5 points (p<0.01)
- Cognition (MoCA): Improved by 2 points (p<0.01)
- Respiratory symptoms (CAT): Improved by 3 points (p<0.05)
- Quality of life (EQ5D): Improved by 8 points (p=0.05)
Study Snapshot
- Participants: 30 individuals (52% male)
- Average age: 58 years
- Hospital admission: 87% had been hospitalized (average stay 10 days)
- ICU care: 14% required mechanical ventilation
- Time since infection: Average 125 days before starting the program
- Session attendance: Average 11 out of 12 sessions completed
- Dropouts: Only 2, both due to social circumstances (not symptom worsening)
Dr. Kumar’s Take
This study addresses a critical concern about Long COVID rehabilitation: could exercise make symptoms worse? The answer here is reassuring. Not only did participants improve, but there were no serious adverse events and no one dropped out because their symptoms got worse.
The fact that fatigue improved alongside exercise capacity is particularly important. There was concern that exercise might trigger post-viral fatigue, but when properly supervised and paced, rehabilitation helped both measures improve together.
The 125-day average between infection and enrollment suggests these weren’t people still in early recovery. Natural improvement had likely slowed, making the rehabilitation-related gains more meaningful.
The Rehabilitation Program
The 6-week program included:
- Frequency: Twice-weekly supervised sessions
- Aerobic exercise: Walking and treadmill-based activities
- Strength training: Upper and lower limb exercises
- Education sessions: Breathlessness management, fatigue, pacing, anxiety, memory and concentration, sleep, eating well, returning to work
Staff experienced in pulmonary and cardiac rehabilitation supervised the program. They used breathlessness scales and perceived exertion ratings along with patient-reported symptoms to guide exercise progression.
Who Was in the Study
- Most participants (87%) had been hospitalized with COVID-19
- 13% had pre-existing respiratory conditions (3 with asthma, 1 with COPD)
- Baseline oxygen saturation was normal (96.3%)
- Anxiety and depression scores were relatively low at baseline
- Exercise capacity and quality of life were reduced compared to healthy controls
Safety Findings
The safety profile was encouraging:
- No serious adverse events during the program
- No dropouts due to worsening symptoms
- Only one participant did not improve both fatigue and exercise capacity (due to a previous stroke)
- Four participants who reported increased fatigue still showed meaningful improvements in exercise capacity
Important Limitations
- Small sample size (30 participants)
- No control group for comparison
- Some natural recovery may have occurred during the program
- Participants were those who identified rehabilitation needs themselves
Practical Takeaways
- Supervised rehabilitation appears safe for Long COVID patients
- Exercise capacity and symptoms can improve together
- Proper pacing and progression are important
- A comprehensive approach (exercise plus education) addresses multiple symptoms
- Programs should be individualized and symptoms monitored
Related Studies and Research
- Athletic performance study
- Long-Term Oxygen Treatment Trial (LOTT)
- Oxygen Multistep Therapy: Physiological and Technical Foundations (Book)
- Oxygen multistep therapy pilot study (46 patients)
FAQs
Will exercise make Long COVID fatigue worse?
In this study, properly supervised and paced exercise improved both fatigue and exercise capacity in most participants. The key is gradual progression based on individual symptoms.
How long does the rehabilitation program take?
This program was 6 weeks long with two supervised sessions per week. Participants attended an average of 11 out of 12 scheduled sessions.
How long after COVID infection can rehabilitation help?
Participants in this study started rehabilitation an average of 125 days (about 4 months) after infection. The significant improvements suggest rehabilitation can help even when symptoms have been present for months.
Bottom Line
A 6-week supervised rehabilitation program significantly improved exercise capacity, fatigue, breathing symptoms, and cognition in 30 people with Long COVID. Walking distance improved by 112 meters, and there were no serious adverse events or dropouts due to symptom worsening. This early evidence suggests that properly supervised rehabilitation combining exercise and education is both safe and effective for people struggling with lasting COVID-19 symptoms.
