• Aust J Gen Pract Nov 2020

    Life after COVID-19: The importance of a safe return to physical activity.

    Jewson, McNamara & Fitzpatrick describe a roadmap for return to activity after COVID infection, developed by the Australasian College of Sport and Exercise Physicians.

    They consider three risk categories:

    • Low: Under 50 years with mild illness resolving within 7 days.

    • Intermediate: prolonged symptoms (>7d); persistent SOB or chest pain; pre-existing comorbidities; elite/endurance athletes.

      • Consider ECG & baseline pathology, including troponin.
    • High: hospitalised with COVID; SOB or chest pain at rest; cardiac abnormalities.

      • Multi-disciplinary team to advise & monitor return to exercise.

    Graded return to physical activity

    • Begin after 10 days of rest and when 7 days symptom-free.
    • Begin with 15 minutes of light activity, with gradual increase guided by lack of fatigue with activity.
    • 馃毄Red flag symptoms: chest pain, palpitations, severe dyspnoea. STOP & medical review.

    Return to exercise flowchart:

    summary
    • Jacob Jewson, Alice McNamara, and Jane Fitzpatrick.
    • MBBS, BMedSc, Sport and Exercise Medicine Registrar, Olympic Park Sports Medicine Centre, Vic.
    • Aust J Gen Pract. 2020 Nov 25; 49.

    AbstractThe Australasian College of Sport and Exercise Physicians has developed a guideline for primary care practitioners to assist with safe return of patients to physical activity after COVID-19.

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    Notes

    summary
    1

    Jewson, McNamara & Fitzpatrick describe a roadmap for return to activity after COVID infection, developed by the Australasian College of Sport and Exercise Physicians.

    They consider three risk categories:

    • Low: Under 50 years with mild illness resolving within 7 days.

    • Intermediate: prolonged symptoms (>7d); persistent SOB or chest pain; pre-existing comorbidities; elite/endurance athletes.

      • Consider ECG & baseline pathology, including troponin.
    • High: hospitalised with COVID; SOB or chest pain at rest; cardiac abnormalities.

      • Multi-disciplinary team to advise & monitor return to exercise.

    Graded return to physical activity

    • Begin after 10 days of rest and when 7 days symptom-free.
    • Begin with 15 minutes of light activity, with gradual increase guided by lack of fatigue with activity.
    • 馃毄Red flag symptoms: chest pain, palpitations, severe dyspnoea. STOP & medical review.

    Return to exercise flowchart:

    Daniel Jolley  Daniel Jolley
    pearl
    1

    Return to exercise after recovery from COVID infection should be gradual & graded, beginning after 10-days of rest and when 7-days symptom free.

    Daniel Jolley  Daniel Jolley
    comment
    1

    See the more recent 2022 article, Return to exercise post-COVID-19 infection: A pragmatic approach in mid-2022, which also sets out a graduated return to exercise, though is perhaps even more pragmatic.

    Daniel Jolley  Daniel Jolley

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