Physical activity is different to exercise. Activity is any muscle movement that uses energy. Exercise is planned, structured and intentional movement, aiming to improve strength or cardiovascular fitness. Graded exercise is often prescribed by exercise professionals following a period of illness which may have led to deconditioning or muscle weakness. The aim of graded exercise is to improve muscle strength and fitness. It can also help with improving well-being and quality of life.
Some patients with muscle weakness 12 weeks after COVID-19 infection require this kind of exercise programme, particularly those who have been hospitalised with the infection.
Importantly, the majority of patients with long COVID exhibit symptoms similar to Chronic Fatigue Syndrome. For some patients, symptoms worsen both during and in the days following increased physical activity or exercise. This is referred to as post exertional fatigue. In this instance, graded exercise is not recommended. Instead, pacing of activity is crucial to avoid what is known as the ‘boom and bust cycle’. This is when you might ‘do too much’ on one day and feel unable to do anything the next, due to your levels of fatigue.
Screening by a suitably qualified health professional is therefore recommended for patients with Long COVID to ensure any intended exercise prescription is safe.
Pacing is a strategy used to manage symptoms of post-exertional fatigue and avoid worsening of your symptoms. Avoidance of over-activity can help you to conserve your energy to participate in meaningful activities.
The following resources may help you to learn to effectively pace your activities: