Benefits of exercise:
People recovering from a COVID-19 infection in the community setting often present with a wide range of medical, physical and psychological needs due to the virus and also related to other underlying health conditions. Your EXi rehabilitation program will take all of this into account when developing your personalised plan.
Starting rehabilitation as soon as you are able (and once the initial fever has settled) can help to improve physical, psychological and emotional recovery and prevent a process called deconditioning which is a loss of strength, fitness, and functional capacity which can lead to a loss of independence (CSP COVID-19 Community Rehabilitation Standards September 2020).
Advice:
Minimising risk of infection should be an important consideration in the early stages of your rehabilitation.
We recommend a graduated aerobic program at a low to moderate intensity. A walking program is ideal, home-based aerobic exercise (e.g. a home workout video or exercise bike) is also recommended if you would prefer to stay indoors. Your EXi plan will gradually increase in exercise time, intensity and frequency over 12 weeks (you will be offered high intensity exercise as an option after the first 12 weeks if your health profile allows this).
Post-acute COVID-19 symptoms vary widely and most commonly include fatigue and persistent coughing. Other symptoms include shortness of breath, chest pain and muscle aches and pains. You should take this into account when planning your daily exercise and you may prefer to carry out your daily exercise in multiple short sessions with rest periods in between (the EXi app will record any activity that has been completed during the day of 1 minute in duration or longer). This may help you to recover from an exacerbation of breathlessness, coughing or fatigue and may allow you to increase the amount of exercise you are able to do.
e.g. if your goal is to complete 10 minutes of aerobic exercise in one day, you could walk for 5 minutes in the morning, rest for a few hours, then complete a home workout for 5 minutes in the afternoon (you can also use the pause function on the EXi app during your activity if you need to).
If you have been critically ill or hospitalized on the intensive care unit and feel like you would benefit from one to one care, please contact your local healthcare team. Likewise, if you experienced a significant cardiac issue during your COVID-19 infection such as myocarditis, pericarditis, dysrhythmia or pulmonary embolus, please speak to your doctor before starting an exercise program (BMJ 2020; 307:m3026).
If you have persistent breathlessness you may benefit from supported breathing control exercises: Sitting in a high backed chair with arms and shoulders relaxed, practice slower breathing into your tummy at an inspiration/expiration ratio of 1:2. Aim to do this for 5 minutes if you can, and you can repeat 2 to 3 times daily.
A strengthening program (light to moderate intensity) may help to improve general muscle strength and function. This can be done at home and should be function based to improve performance of everyday tasks (e.g. climbing stairs/step ups or getting up from a chair). You can also use everyday items such as small bottles of water to use as weights – there are a number of home workouts on the EXi app that will help with this.
The app will monitor your exertion level after each exercise session, that is how hard you found the exercise (measured on a scale of 1 to 10). Your heart rate will be monitored throughout your exercise session if you have a connected wearable (i.e. Apple Watch), or we will ask you to check your heart rate using your mobile phone’s camera flash immediately after exercise. The app will use your heart rate to check that you are working at the correct exercise intensity level. You will be given the option to record your resting heart rate and your blood pressure (if known) on a weekly basis to monitor the effect that your exercise program is having on your fitness levels. Your weight, abdominal circumference and BMI can also be recorded on a weekly basis if you would like to keep track of this.
Another optional test, the timed 6-minute walk, has been shown to provide good information about your current level of function and helps to measure your progress. This will be offered at the start of the program and then every 6 weeks throughout the course of the program and is recorded using the GPS function on your smartphone.
Precautions:
If you experience any of these symptoms stop exercising. You may be working at a level that is too high for you and may need to reduce the intensity or duration of the exercise. If symptoms persist or worsen please seek medical advice.
Contraindications:
If you experience any of these symptoms exercise is not allowed (contraindicated). Please seek medical advice before continuing with this program.