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Exercise-Based Rehabilitation in Severe COVID-19 Survivors with Long COVID: A Randomized Controlled Pilot Study
Edson Fonseca Pinto1,2,3, Nailton José Brandão Albuquerque Filho4, Jéssica Costa Leite5
1Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil.
Medical Sciences (Basel, Switzerland)
|May 27, 2026
Summary
Structured physical rehabilitation programs significantly improved physical activity, functional capacity, and quality of life in severe COVID-19 survivors. Both multicomponent exercise and added inspiratory muscle training were effective post-hospitalization interventions.
Area of Science:
- Rehabilitation Medicine
- Pulmonology
- Infectious Diseases
Background:
- Severe COVID-19 survivors often experience prolonged immobility, leading to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function.
- Post-hospital rehabilitation is crucial for mitigating these effects and supporting functional recovery in patients recovering from severe COVID-19.
- Physical exercise interventions during and after hospitalization are being investigated for their efficacy in COVID-19 recovery.
Purpose of the Study:
- To evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19.
- To compare a multicomponent exercise program with one combined with inspiratory muscle training.
Main Methods:
- A randomized clinical trial involving 30 severe COVID-19 survivors.
- Participants were allocated to either a multicomponent exercise group (GEm) or a combined group (GEmTMI).
- Interventions were conducted three times weekly for six weeks, with assessments of quality of life, physical activity, functional status, and physical capacity.
Main Results:
- Significant improvements were observed across all assessed outcomes in the total sample after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), and physical activity (IPAQ).
- Both groups showed gains in respiratory muscle strength and performance in functional tests like the 6-minute walk test (6MWT), sit-to-stand tests (STS), and timed up and go (TUG).
- The GEmTMI group showed a significant difference in the Physical Activity Index (IPAQ) post-intervention compared to the GEm group (p = 0.002).
Conclusions:
- Multicomponent physical rehabilitation, with or without inspiratory muscle training, significantly enhances physical activity, functional capacity, balance, neuromuscular fitness, respiratory strength, and quality of life in severe COVID-19 survivors.
- Structured post-intensive care unit (ICU) rehabilitation is vital for comprehensive physical and psychosocial recovery.
- Inspiratory muscle training may offer additional benefits for physical activity levels in this patient population.