Study: Exercise Improves Long COVID Fatigue

For about 10% of people who get infected with COVID-19, symptoms like fatigue don't subside after three months or even a year post-infection. New research finds that exercising may help reduce fatigue for those in recovery.

Researchers from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre—a partnership between Leicester's Hospitals, the University of Leicester, and Loughborough University—hoped to discover a means to support individuals experiencing long COVID. 

The small study followed 30 patients, all of whom completed a six-week rehabilitation program with two supervised sessions per week. “The group of people that we recruited were a mixed group of post-ICU hospitalized patients and a couple of community patients,” senior study author Sally Singh, PhD, head of cardiac and pulmonary rehabilitation at Leicester’s Hospitals, tells Verywell. 

Singh says that, based on the existing research, exercise is thought to be rehabilitating and helps reduce fatigue among people with long COVID. This is especially true for those who were bedridden and lost muscle tone as a result. ”People that have had particularly prolonged stays in the hospital have been confined to bed," Singh says. "So everybody becomes deconditioned if we don’t do anything."

The program consisted of aerobic exercises such as treadmill walking, strength training of upper and lower limbs, and some educational courses. These courses touched on a variety of topics including:

• Breathlessness
• Cough
• Fatigue
• Fear
• Anxiety
• Memory and concentration
• Eating well
• Sleep hygiene
• Returning to the workforce.

The May study was published in the Chronic Respiratory Disease journal.

Exercise Improved Long COVID Symptoms

Researchers found that exercise helped COVID-19 long-haulers improve on:

• Exercise capacity
• Respiratory symptoms
• Fatigue
• Cognition

They saw an improvement in fatigue by five points on the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale over a six-week period.

“It [FACIT] is a questionnaire we use to measure fatigue,” Enya Daynes, PhD, MCSP, pulmonary rehabilitation and research physiotherapist at the NIHR Leicester Biomedical Research Centre, tells Verywell. Daynes explains that the questionnaire rates fatigue-related concerns on a scale from 0 to 52 points.

Before the rehabilitation program, patients with long-term COVID had over 30 points. After the study, participants no longer experienced severe fatigue. “So when we say we improved by five points, what we mean is that it came down five points," Daynes says. "The higher the score, the worse their fatigue. Anything above 30 would be severe."

In addition, the study used a test known as the incremental shuttle walking test and found that participants improved by 112 meters. People increased their endurance by 544 seconds.

However, she adds that exercise is not a one-size-fits-all solution and might not be a solution for everyone. “If they want to try exercise, they should speak to their doctor or their physical therapist, or whoever is in charge of their care because there is going to be a small amount of readers that won’t benefit,” Daynes explains. 

What's Next?

The data is still preliminary and more research will need to be conducted in the months ahead. “The next step for us and as a community would be a randomized control trial so that we have a control group so we can compare the changes we’re seeing are due to the intervention,” Daynes shares. 

Daynes believes it’s important to share the early data in an effort to inform pulmonary rehabilitation programs. “I think it’s important to show this data as early as we can so that other programs can be like, okay, we know it does this, so we should try and do that too,” Daynes says. “Being able to share that what we did actually helped people will then help services develop.”

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