Home-Based Exercise for Post-COVID Fatigue

Overseen By Jared M Gollie, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Psychiatric disorders, Cardiovascular, Musculoskeletal, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 8 weeks

52 Participants Needed

Trial Summary

What is the purpose of this trial?

The overall goal of this project is to advance the understanding of underlying mechanisms impacting performance fatigability and perceived fatigability in Veterans with post-COVID-19 fatigue and explore the safety and feasibility of a home-based "minimal-dose" resistance exercise program in this population. The central hypothesis is that declines in force capacity, skeletal muscle oxygen extraction, and affective responses to physical activity offer potential mechanisms through which fatigability is increased in Veterans with post-COVID-19 fatigue. Moreover, home-based resistance exercise delivered remotely may provide a safe and feasibility treatment option for targeting neuromuscular and neurobehavioral factors influencing fatigability severity in this population.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Minimal-Dose Home-Based Resistance Exercise, Home-Based Resistance Exercise, Minimal-Dose Resistance Exercise for post-COVID fatigue?

Research shows that home-based exercise programs, including resistance exercises, can improve physical fitness, reduce fatigue, and enhance overall health in people recovering from COVID-19. Studies have demonstrated significant improvements in muscle strength, cardiorespiratory fitness, and reduction in symptoms like fatigue and shortness of breath, suggesting these exercises can be effective for post-COVID recovery. ^{1 2 3 4 5}

Is home-based exercise safe for people recovering from COVID-19?

Research suggests that home-based exercise programs, including resistance and pulmonary exercises, are generally safe for people recovering from COVID-19. Studies have shown improvements in physical function and symptoms without significant safety concerns, but more controlled studies are needed to confirm these findings. ^{1 2 3 6 7}

How does Minimal-Dose Home-Based Resistance Exercise differ from other treatments for post-COVID fatigue?

Minimal-Dose Home-Based Resistance Exercise is unique because it allows patients to perform resistance exercises at home with minimal equipment, focusing on improving muscle strength and physical function. Unlike other treatments that may require supervised sessions or specialized equipment, this approach is more accessible and can be done independently, making it a practical option for those recovering from post-COVID fatigue. ^{1 2 5 8 9}

Research Team

Jared M. Gollie, PhD

Principal Investigator

Washington DC VA Medical Center, Washington, DC

Eligibility Criteria

This trial is for Veterans aged 50 or older who had COVID-19 and are experiencing fatigue lasting more than 12 weeks post-infection. They must be able to walk (with or without aid), receive care at the DC VAMC, speak English, and be oriented to person, place, and time. Those with a BMI over 40, psychiatric disorders, uncontrolled diseases that make exercise unsafe, or plans to move away within a year cannot join.

Inclusion Criteria

I am 50 or older, can walk (with or without help), have had COVID-19, and feel tired for more than 12 weeks after.

The ability to speak and read English, and orientation to person, place, and time

I am over 50, can walk (with or without help), have had COVID-19, and don't feel tired for more than 12 weeks after.

Exclusion Criteria

I do not have joint pain that would stop me from safely following the study's requirements.

Veterans who do not primarily receive care at the DC VAMC.

I do not have any severe health issues that could make joining the study unsafe.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in an 8-week home-based resistance exercise program performed one day per week

8 weeks

Remote monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Minimal-Dose Home-Based Resistance Exercise

Trial Overview The study tests if a home-based 'minimal-dose' resistance exercise program can safely improve muscle strength and reduce fatigue in Veterans with long-term COVID-19 effects. It aims to understand how physical activity affects those with post-COVID fatigue by monitoring changes in muscle function and mood.

Participant Groups

Group I: Minimal-Dose Home-Based Resistance Exercise Experimental Treatment 1 Intervention

8-week home-based resistance exercise performed one day per week.

Group II: Standard of Care Active Control 1 Intervention

Subjects will be asked to follow standard of care recommendations as prescribed by the physician.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A 10-week home-based exercise training (HBET) program significantly improved the cardiorespiratory and physical functionality of a 67-year-old woman who had critical COVID-19, with VO2peak increasing by 45.9% and handgrip strength improving by 22.7%.

The HBET program was safe and led to reductions in fatigue and self-reported persistent symptoms, indicating its potential as an effective rehabilitation strategy for COVID-19 survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of Home-Based Exercise Training Following Critical SARS-CoV-2 Infection: A Case Report. Longobardi, I., do Prado, DML., Goessler, KF., et al.[2022]

An 8-week supervised exercise program, either through concurrent training alone or combined with inspiratory muscle training, significantly improved physical fitness, muscle strength, and reduced symptoms like dyspnea and fatigue in 80 nonhospitalized adults with post-COVID-19 conditions.

Compared to self-management recommendations from the WHO, the exercise interventions were found to be safer and more effective in enhancing cardiovascular and muscular fitness, as well as overall health status.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial. Jimeno-Almazán, A., Buendía-Romero, Á., Martínez-Cava, A., et al.[2023]

A 12-week home-based pulmonary rehabilitation program significantly improved pulmonary symptoms and functional performance in 19 post-COVID-19 patients experiencing ongoing dyspnea.

The program also enhanced expiratory resistance capabilities, suggesting it could be an effective and low-cost strategy for managing post-COVID respiratory issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19. Morgan, S., Visovsky, C., Thomas, B., et al.[2023]

Pulmonary rehabilitation (PR) significantly improved functional status in five patients recovering from acute COVID-19, who initially experienced severe dyspnea and fatigue that limited their daily activities.

After undergoing PR, two patients returned to work and three were able to return home, demonstrating the effectiveness of PR in enhancing recovery and independence in individuals affected by COVID-19.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of pulmonary rehabilitation on patients with acute COVID-19: a single-center case series. Lee, SM., Kim, MW., Shin, D., et al.[2023]

This study is evaluating the effectiveness of a 12-week home-based inspiratory muscle training (IMT) program on improving maximal functional capacity in 26 patients who experienced chronic COVID-19 symptoms after hospital discharge.

The trial is designed as a randomized controlled study, which means it will compare the IMT group to a usual care group to determine if the training significantly enhances patients' functional abilities, with outcomes measured by a blinded assessor.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a home-based inspiratory muscular training programme on functional capacity in patients with chronic COVID-19 after a hospital discharge: protocol for a randomised control trial (InsCOVID trial). Palau, P., Domínguez, E., Sastre, C., et al.[2022]

During the COVID-19 pandemic, home-based exercise interventions, particularly group-based virtually supervised sessions, became the primary method for improving physical function and patient-reported outcomes in cancer survivors.

Preliminary evidence suggests that these home-based exercise programs are feasible and effective, but further research with larger, well-designed trials is necessary to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise oncology during and beyond the COVID-19 pandemic: Are virtually supervised exercise interventions a sustainable alternative? Gonzalo-Encabo, P., Wilson, RL., Kang, DW., et al.[2023]

In a study involving 10 individuals recently discharged after severe COVID-19, all participants safely completed three different high-intensity interval training (HIIT) protocols without any adverse events, indicating that HIIT can be tolerated post-hospitalization.

The study found that while all HIIT protocols achieved high exercise intensities, they differed in the duration spent at maximum heart rate, suggesting that different HIIT formats can be effectively utilized for rehabilitation in COVID-19 patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fidelity, tolerability and safety of acute high-intensity interval training after hospitalisation for COVID-19: a randomised cross-over trial. Foged, F., Rasmussen, IE., Bjørn Budde, J., et al.[2023]

A study involving 57 patients with persistent fatigue post-COVID showed that a 4-week supervised exercise program significantly improved their maximal exercise capacity (VO2peak) compared to usual care, with no adverse events reported.

While both exercise and usual care groups experienced improvements in fatigue and quality of life over time, the exercise group engaged in significantly more physical activity during the follow-up period, suggesting that exercise is a safe option for enhancing recovery in post-COVID patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical exercise as a treatment for persisting symptoms post-COVID infection: review of ongoing studies and prospective randomized controlled training study. Kogel, A., Machatschek, M., Scharschmidt, R., et al.[2023]

Post-COVID-19 fatigue affects many individuals, with risk factors including older age, female sex, severe initial infection, multiple comorbidities, and a history of depression or anxiety, based on a systematic review of 20 studies involving 5,629 participants.

Various treatments have shown promise, such as Chinese herbal formulations, molecular hydrogen inhalation, hyperbaric oxygen therapy, and an 8-week physical therapy program, but more extensive controlled studies are needed to confirm their efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Post-COVID-19 fatigue: A systematic review. Joli, J., Buck, P., Zipfel, S., et al.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Benefits of Home-Based Exercise Training Following Critical SARS-CoV-2 Infection: A Case Report. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Home-Based Pilot Pulmonary Program for Dyspneic Patients Post-COVID-19. [2023]

4. Korea (South) pubmed.ncbi.nlm.nih.gov

Effect of pulmonary rehabilitation on patients with acute COVID-19: a single-center case series. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Effect of a home-based inspiratory muscular training programme on functional capacity in patients with chronic COVID-19 after a hospital discharge: protocol for a randomised control trial (InsCOVID trial). [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Exercise oncology during and beyond the COVID-19 pandemic: Are virtually supervised exercise interventions a sustainable alternative? [2023]

7. England pubmed.ncbi.nlm.nih.gov

Fidelity, tolerability and safety of acute high-intensity interval training after hospitalisation for COVID-19: a randomised cross-over trial. [2023]

8. Germany pubmed.ncbi.nlm.nih.gov

Physical exercise as a treatment for persisting symptoms post-COVID infection: review of ongoing studies and prospective randomized controlled training study. [2023]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Post-COVID-19 fatigue: A systematic review. [2022]