Rehabilitation and long COVID

Researchers at the regional Centre for Exercise and Rehabilitation in Leicester, England, have reported promising results in a pilot study with people who have long COVID.

Study details

Researchers reported on the first 32 people who completed a six-week rehabilitation program.

Participants were referred by their family doctors and the researchers stated that they excluded people if they had “acute symptoms or were not medically stable or had only symptoms that were not modifiable from a rehabilitation program (such as loss of sense of taste only).”

All participants were screened for cardiovascular disease.

The program consisted of two supervised sessions each week that had the following elements:

  • aerobic exercise – walking on a treadmill
  • strength training of upper and lower limbs
  • educational discussions – addressing long COVID symptoms

Researchers noted that participants were cautioned to pace themselves so as not to become exhausted.

Additionally, validated surveys were used to assess changes in endurance, functional ability, fatigue, mental health, brain issues and quality of life.

The average profile of participants upon study entry was as follows:

  • age – 58 years
  • 52% men, 48% women
  • 26 participants had previously been hospitalized (because of acute COVID-19) for 10 days. Five of these people required mechanical ventilation during their hospitalization.

Overall, 30 people completed the program. Two participants left due to what the researchers called unspecified “social circumstances.”


No one had to stop or leave the program because of worsening symptoms. Researchers found significant improvements with the following issues:

  • walking capacity
  • fatigue
  • cognition
  • breathing

Concern about exercise

Some rehabilitation specialists and people with long COVID have raised concerns that exercise therapy may inadvertently make fatigue worse. However, the exercise component of the program was supervised by staff who were experienced with lung and heart rehabilitation. The intensity of exercise was gradual and tailored to each person’s capacity. The researchers did not report any relapse or serious side effects due to exercise.

Most participants reported decreased symptoms of fatigue and improved exercise capacity as a result of the intervention. However, five people did not improve or had mixed results, as follows:

  • one person had no improvement in exercise capacity or fatigue due to a previous stroke
  • four people had improvement in their exercise capacity but also experienced fatigue

For the future

The research team concluded by stating:

“Rehabilitation programmes should aim to provide a holistic and multi-faceted approach to managing post-COVID symptoms. Clinicians should aim to individualise programmes and to monitor adverse events and symptoms, given the limited evidence in the field.”

—Sean R. Hosein


  1. Daynes E, Gerlis C, Chaplin E, et al. Early experiences of rehabilitation for individuals post-COVID to improve fatigue, breathlessness, exercise capacity and cognition – a cohort study. Chronic Respiratory Disease. 2021 Jan-Dec;18:14799731211015691.
  2. Décary S, Gaboury I, Poirier S, et al. Humility and acceptance: Working within our limits with long COVID and myalgic encephalomyelitis/chronic fatigue syndrome. Journal of Orthopaedic and Sports Physical Therapy. 2021 May;51(5):197-200.