Physical and psychological reconditioning in long COVID syndrome: Results of an out-of-hospital exercise and psychological - based rehabilitation program.

Background: Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatment of this syndrome are still poorly understood, even if evidences suggest the potential role of physical rehabilitation in improving symptoms in these patients. Aim of the study: The aim of the present study was to evaluate effectiveness, safety and feasibility of an out-of-hospital multidisciplinary rehabilitation (MDR) program, based both on physical and psychological reconditioning, in reducing symptoms and improving physical fitness and psychological parameters in patients with LCS. Methods: Thirty consecutive patients with LCS (18 males, mean age 58 years) underwent an accurate medical screening process including anthropometric and muscular strength evaluation, cardiopulmonary exercise test, quality of life (QoL) and psychological appraisal before and after a MDR program. Results: At baseline, all LCS patients were strongly symptomatic and showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during the exercise training sessions. After the MDR program, COVID-19 residual symptoms significantly decreased, and significant improvements in upper and lower limb muscular strength, cardiopulmonary parameters, perceived physical and mental health, depression and anxiety were observed. Conclusions: The present study confirms the severe physical and psychological impairment of patients with LCS and suggests that a MDR program is effective, safe and feasible in these patients and could promote their physical and psychological recovery.

Comprehensive therapeutic program for cardiovascular patients: role of a sports medicine unit in collaboration with local gymnasiums.

Although there is mounting evidence stressing the therapeutic role of physical activity, the reality of the situation is very different with only a small minority of patients directed toward a comprehensive rehabilitation program after hospital discharge, and some categories of patients who could benefit from such programs are often excluded from them. Therefore, within our Sports Medicine Service, we have created a unit for the prescription of physical exercise initially directed at patients suffering from chronic heart failure, patients who have undergone coronary angioplasty for at least two-vessel disease or have diabetes or have suffered restenosis or have an overall stent length of at least 6 cm or all, patients suffering from obliterating artery disease of the legs and claudication and patients who have undergone heart transplantation. After the initial clinical evaluation and functional assessment, which comprises a Mader Test and strength tests, patients undergo a supervised combined aerobic and resistance training with training titration based on a metabolic parameter. At the end of the in-hospital phase, patients are given a realistic opportunity to continue their training through a collaboration we have established with selected gymnasiums in our area and are periodically reassessed for adjustment of their training loads.