Review Developing effective strategies to optimize physical activity and cardiorespiratory fitness in [LC] need for caution […], 2024, Faghy, Dalton+

Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment
Faghy; Duncan; Hume; Gough; Roscoe; Laddu; Arena; Asthon; Dalton

The Post Covid-19 Condition (commonly known as Long Covid) has been defined by the World Health Organisation as occurring in individuals with a history of probable or confirmed SARS CoV 2 infection, usually within 3 months from the onset of acute Covid -19 infection with symptoms that last for at least two months which cannot be explained by an alternative diagnosis. Long Covid is associated with over two hundred recognised symptoms and affects tens of millions of people worldwide.

Widely reported reductions in quality of life(QoL) and functional status are caused by extremely sensitive and cyclical symptom profiles that are augmented following exposure to physical, emotional, orthostatic, and cognitive stimuli. This manifestation prevents millions of people from engaging in routine activities of daily living (ADLs) and has important health and well-being, social and economic impacts. Post-exertional symptom exacerbation (PESE) (also known as post exertional malaise) is an exacerbation in the severity of fatigue and other symptoms following physical, emotional, orthostatic and cognitive tasks. Typically, this will occur 24-72 hours after “over-exertion” and can persist for several days and even weeks. It is a hallmark symptom of Long Covid with a reported prevalence of 86%. The debilitating nature of PESE prevents patients from engaging in physical activity which impacts functional status and QoL.

In this review, the authors present an update to the literature relating to PESE in Long Covid and make the case for evidence-based guidelines that support the design and implementation of safe rehabilitation approaches for people with Long Covid. This review also considers the role of objective monitoring to quantify a patient’s response to external stimuli which can be used to support the safe management of Long Covid and inform decisions relating to engagement with any stimuli that could prompt an exacerbation of symptoms.

Link | PDF (Progress in Cardiovascular Diseases)

 

(Pre-proof with a current 12:4 ME/CFS:ME/CSF ratio!)

 

We can't cure ME/CFS...but can we at least cure ME/CSF? Haha

 

They seem to understand a great deal, which is good. I've still got concerns about talk of rehabilitation, though, at whatever pace and with however much caution.

Rehabilitation's understood as supporting people to regain as much function as possible after an accident, illness or surgery, and it isn't usually started until recovery is underway. But few pwME ever get to that stage, and it looks likely to be the same for some with ME-like LC.

I suppose technically, learning how not to do some of the things you used to do—or do them differently and less often—is a form of rehabilitation, but for the avoidance of confusion among non-specialists it feels as if we need a different word.

It's more like a complete reframing of possibility.