Personalized Exercise Prescription in Long COVID: A Practical Toolbox for a Multidisciplinary Approach.

Area of Science:

• Rehabilitation Medicine
• Exercise Physiology
• Infectious Disease Epidemiology

Background:

• Limited evidence-based guidance exists for Long COVID rehabilitation, particularly concerning precise exercise dosage.
• Existing rehabilitation strategies often lack specificity for managing post-exertional symptom exacerbation.

Purpose of the Study:

• To describe a methodology for operationalizing a multidisciplinary Long COVID clinic.
• To present practical tools for personalized, progressive exercise prescription in Long COVID management.

Main Methods:

• A multidisciplinary team screens referrals for individuals aged 16+ with Long COVID.
• A three-tier triage model is employed based on presenting problems.
• Personalized exercise includes submaximal resistance training, titrated endurance exercise (RPE 4-6/10), and inspiratory muscle training for dyspnea.

Main Results:

• Over two years, 250 patients were treated with no serious adverse events.
• Promising patient feedback was received.
• The implemented exercise prescription was less conservative than international guidelines, showing potential value.

Conclusions:

• A multidisciplinary, clinic-based approach to progressive exercise in Long COVID is feasible and safe.
• Individualized titration of peripheral and inspiratory muscle exercise is effective.
• Close monitoring for post-exertional symptom exacerbation is critical for successful rehabilitation.