Return to Physical Activity (Post-COVID Service)

• Maintaining and improving strength in your muscles and bone
• Maintaining and improving heart strength, circulation, and blood pressure
• Maintaining of energy levels
• Good for your mental health - anxiety and depression
• Helps to manage stress levels
• Helps to prevent other problems associated with prolonger bed rest such as infections, blood clots and reduced strength and balance
• Improves wellbeing, independence, and confidence

Phase One: Preparation for return to exercise

Types of exercise advised: gentle walking, stretching and flexibility exercises, yoga nidra. Borg: zero – one. 

Phase Two: Low intensity exercise

Types of exercise advised: Walking, light household/garden tasks, gentle yoga/Pilates, recumbent cycling. Borg: two – three

Phase Three: Moderate intensity aerobic and resistance exercise

Types of exercise advised: Walking – including inclines, resistance exercise, gentle swimming or cycling, yoga and pilates. Borg: four – six. 

Phase Four: Moderate intensity aerobic and strength exercises with co-ordination and functioning skills

Types of exercise advised: Fast paced walking, jogging, swimming, cycling, Zumba or dance classes. Borg: seven – eight

Phase Five: Return to baseline exercises

To be able to complete your regular activity or exercise programme without exacerbation of your symptoms. Borg: Aiming up to a Borg of 10.

• It is important to use symptom titrated activity or pacing up: this means using small increments of up to 10% to increase one activity at a time. Then monitor your symptoms for 24 – 48 hours.
• If no change in symptoms, then complete the same level of exercise and repeat the monitoring phase. If your symptoms remain stable, this then becomes your new level of stability.
• If you do have a ‘relapse’ in symptoms, then step down a phase of the Borg score, you may need to stay at the new reduced level for two – four weeks before considering any increase in physical activity.
• It is important after any increase in activity, you stay at that level for two-four weeks before adding in another small increment in activity.
• This could be up to a 10% increment of time, distance, step count, weight resistance or reps.
• Choose activities that you enjoy, you are more likely to continue with these and they will have a positive impact on your wellbeing.
• The type of physical activity you chose may have to be different from the physical activity you completed pre your COVID illness especially at the initial phases.
• The above advice should be adapted to your individual symptoms and phase of your recovery. This may fluctuate over time, and you can step up or down phases on the Borg scale as needed.
• If you have any concerns or further questions about increasing your activity levels, then please speak to your healthcare professional.