Recovering from Covid-19 has proven to be unpredictable. As we now know, some people diagnosed with the virus experience no symptoms at all, others can feel as if they’ve had a mild flu with a timely recovery, and some people experience severe symptoms that require hospitalization. Although most of them recover, unfortunately there’s a growing number of patients who, months after diagnosis, still are reporting trouble getting back to feeling 100% like their “old selves.”
As doctors study these mysteriously persistent symptoms, they do know how to relieve one troublesome aspect: the effects of long periods of being sedentary. Patients who have been on ventilators or for other reasons confined to hospital beds for days or weeks face challenges in getting back to their previous levels of activity.
The cost of being sedentary
To help physical therapists address these challenges, the American Physical Therapy Association (APTA) has issued guidelines to measure progress in five areas: function—speed and ease in performing everyday actions like standing from a sitting position; strength; endurance; cognition; and quality of life.
During this time of social distancing, even if you have not contracted the virus, you could be experiencing the price of a sedentary lifestyle. Because of quarantine directives, voluntary sheltering and changing work patterns, you may have stopped going to the gym, walking to work, moving around an office, strolling through a mall, participating in group sports and pursuing other ordinary ways to stay active.
According to GEROS Health, another guiding organization for physical therapists, “Subjects requested to stay at home during this time of social distancing and isolation reduce their daily activity-induced energy expenditure up to 35-40%.”
GEROS identifies multiple areas of impact that being sedentary can have on the body:
- Loss of muscle mass detectable after only 2 days. Some is due to suppression of muscle protein synthesis. “It will take several months to restore muscle mass loss completely following prolonged periods of inactivity or immobilization in the absence of structured exercise,” the GEROS statement says.
- Some loss of nerve function after 3 days.
- Damage to the neuromuscular junction (where a nerve meets a muscle) after 10 days.
- Insulin resistance after a few days of step reduction.
- Decreased VO2max, which is rate of oxygen consumption during exercise of increasing intensity. Decreased VO2max is associated with increased mortality. The rate of loss after a period of profound inactivity is similar to the rate after total bed rest and may be even more significant than that for middle-aged and older adults.
Recommendations from physical therapists
Increasing the number of daily steps is a good way to begin reversing the harm from inactivity. According to GEROS, you should strive to achieve at least 5,000 steps per day. Monitoring this is easier when you have a smartphone or wearables that measure steps.
Aerobic exercise will help to counteract the VO2max decrease due to inactivity, although GEROS says how much you need is not clear. In addition, low- to medium-intensity resistance exercise is recommended to prevent neuromuscular degeneration, maximize protein synthesis and fight muscle atrophy.
Not sure where or when to start? Dr. Patrick Donovan at Heather Lane PT is experienced in reconditioning the body after a diagnosis such as COVID-19 or pneumonia. Under his guidance, you are in safe hands to measure your starting point and, from there, creating a plan to get you back to your strength and activity levels prior to your infection.