Resistance Exercise Therapy After COVID-19 Infection: A Randomized Clinical Trial

1. Resistance exercise for three months improved physical function and psychological well-being among adults after COVID-19 infection.

Evidence Rating Level: 1 (Excellent)

Long COVID includes symptoms such as breathlessness and fatigue persisting for more than 3 months after COVID-19 infection and can impair physical function. Skeletal muscle mass and function decline from physical inactivity can be increased with resistance exercise. However, the relationship between resistance exercise and physical function in long COVID is unclear. This study thus examined the effect of a resistance exercise intervention on exercise capacity, health status, and safety among adults after COVID-19 infection. This multicenter, randomized clinical trial conducted between June 1, 2021, to April 26, 2026, in Scotland included adults with COVID-19 infection with persisting symptoms for at least 4 weeks. Participants were randomized 1:1 to either the intervention or control group. The intervention group included daily performance of personalized resistance exercises for 3 months, while the control group included treatment as usual according to the guidelines of the National Institute for Healthcare Excellence. The primary outcome was the distance achieved in the Incremental Shuttle Walk Test. In total, 233 adults (median age, 53.6 years [IQR, 43.8-60.8 years]); 146 women [62.7%]) were randomized, but 195 were included in the analysis. Of these, 95 were in the intervention group and 100 in the control group. The mean (SD) change in Incremental Shuttle Walk Test distance at 3 months compared with baseline was larger in the intervention group than the control group (83 [118] m vs 47 [95] m; adjusted mean difference, 36.5 m [95% CI, 6.6-66.3 m]). Compared with the control group at 3 months, the intervention group also showed greater improvements in in the health-related quality of life utility score (European Quality of Life 5-Dimension 5-Level Instrument) (0.06 [95% CI, 0.01-0.11]), in anxiety and depression (Patient Health Questionnaire) (0.5 [95% CI, 0.2-0.8]), and handgrip strength (2.6 kg [95% CI, 0.9-4.2 kg]). No serious adverse reactions were reported. Overall, this study found that a 3-month personalized resistance training intervention improved physical function and psychological well-being among adults after COVID-19 infection. These findings suggest that resistance training may be a promising therapy for individuals with persisting physical symptoms after COVID-19 infection. Future studies are needed to confirm these findings.

Click here to read this study in JAMA Network Open

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