Exploring the perceived impact of physical activity on physical and mental health among individuals with long COVID:... 2026 Sirotiak et al

[Andy]

Abstract​

Objectives​

Long COVID presents a significant health burden with limited treatment options. Physical activity (PA) has been suggested for self-management, yet symptom worsening has been reported in similar patient populations. This study aims to identify PA’s perceived impact on physical and mental health in adults with long COVID.

Methods​

Semi-structured interviews were conducted with 34 adults (mean age 52 years, 62% women) based in the United States (U.S.) self-reporting long COVID. PA-related content was analyzed using deductive thematic analysis, assessing worsened and improved health experiences attributed to PA.

Results​

Participants’ perceived health scores were one standard deviation worse than the general U.S. population. Most participants (64.7%) reported worsening long COVID symptoms with PA, while 14.7% noted improvement. Themes for worsened physical health included post-exertional malaise, specific symptom worsening (e.g., fatigue), limited PA abilities, external control perceptions, forced inactivity, and loss of previous PA abilities. Improved health themes involved beliefs in health benefits, symptom improvement, increased energy, accomplishment, enhanced PA abilities, and hope.

Discussion​

PA’s impact on health varied among individuals with long COVID, highlighting the need to tailor PA recommendations to individual needs and limits.

Open access

 

[Utsikt]

Themes for worsened physical health included post-exertional malaise, specific symptom worsening (e.g., fatigue), limited PA abilities, external control perceptions, forced inactivity, and loss of previous PA abilities.

This is what I’ve been trying to tell all my HCPs. If you want me to be as physically active as possible, you can’t make me do more than I can do because that will make me do much less the next days.

There are some good bits that essentially describe people living with PEM and how this is consistent with the literature, but then there is this interpretation:

Other participants, however, noted improvements in physical health with PA. Nearly a third (32.4%) of participants reported that they knew PA was good for their health, motivating them to attempt it. These participants reported believing that increasing PA is likely to help their symptoms as they have been educated that PA has positive impacts on health.

This finding is consistent with other literature demonstrating that knowledge of positive effects of PA is associated with higher PA levels [46]. Some participants endorsing this belief noted that they believed that their symptoms were temporary, and that PA would assist in recovery from long COVID.

46 isn’t about sick people, it’s a cross-sectional population survey with ~600 participants where they found a correlation between «belief in positive effects of PA» and «self-reported PA». Many of the people actually had inaccurate knowledge about the effects of PA, e.g. over-estimating the negative impact of inactivity.

So the myth about exercise as a treatment lives on.

And of course there is no need for recommendations about physical activity specifically for people with LC. All they need is advice on pacing if they have PEM. Not that this is going to stop the rehabbers and BPSers from psycoeducating us about the benefits of PA..