Method
Exercise Training Rehabilitation: a prescription was made by a pulmonologist for “exercise training rehabilitation following severe COVID” following an
AMK28 rating (60-90 minutes, 20 sessions)
An initial 6 minutes walking test should be made upon first mandatory assessment (
AMK10.7) to determine target heart rate (HR), and at the end of care to evaluate progression
Endurance training will be carried using a cycle ergometer device, with a continuous monitoring of heart rate and oxygen saturation to check the tolerance of the exercises
Continuous endurance training will start at 60-70% of the participant’s maximal peak power. For participants unable to maintain continuous training, interval training sequences (30 seconds of effort followed by 30 seconds of rest) may be proposed. A target dyspnoea of 4-6 on the modified BORG scale should be achieved (
10.1378/chest.109.5.1169 )
Initially, the effort will last for 15 minutes, then will be gradually increased to reach an exercise duration of 40 minutes or 45-60 minutes for continuous endurance training or interval training respectively
The power should be adjusted according to the participant's progress, to reach the target heart rate and dyspnoea at 4-6 on the BORG scale
All participants will be offered muscle strengthening exercises. Strengthening of the lower limbs is to be prioritised, but additional exercises for the upper limbs and core can be included. Each exercise will consist of 3-4 sets of 6-12 repetitions. Devices can be used to implement those exercises, including but not limited to leg press, leg curl, leg extension, stepper, rower, treadmill, weights etc
The exercises are up to the discretion of the physiotherapist BUT muscle fatigue should be felt at the end of each set
Standard Physiotherapy: a prescription was made by an intensive care physician for “4 limbs physical therapy and respiratory disorders following severe COVID” following an
AMK20 rating (at least 30 minutes, 20 sessions)
Course of the physiotherapy sessions will be left to the discretion of the physiotherapist according to his/her mandatory initial assessment (
AMK10.7).
Sessions should consist of
Strength training of limbs and trunk muscles (weight bench with guided loads, weights, elastics...)
Aerobic training (cycle ergometer, treadmill…)
Active and passive mobilisation by the physiotherapist for articular range of motion gain
Balance exercices
Respiratory muscle training (pressure-resistant valves)
Respiratory therapy
Return to the previous sport, reintegration of the sport gesture
Electrostimulation
Education on perpetuating physical activity
Autonomous rehabilitation exercises