# Resistance Exercise Therapy After COVID-19 Infection: A Randomized Clinical Trial

## TL;DR

A 3-month resistance exercise program improved physical and psychological outcomes in adults recovering from COVID-19.

## Contribution

Demonstrates that personalized resistance exercise is effective in improving post-COVID-19 recovery.

## Key findings

- Resistance exercise improved walking distance by 36.5 meters more than usual care.
- Participants showed better quality of life, reduced anxiety, and stronger grip strength.
- The intervention had a 71% median adherence rate over 3 months.

## Abstract

What are the effects of a personalized resistance exercise intervention on physical and psychological function after COVID-19 infection?

In this randomized clinical trial that included 233 adults after COVID-19 infection, the mean change in Incremental Shuttle Walk Test distance at 3 months compared with baseline was 83 m in the intervention group and 47 m in the control group, a statistically significant difference of 36.5 m. Health-related quality of life, anxiety, depression, and grip strength also improved more in the intervention group than in the control group.

This study suggests that resistance exercise in a community and posthospitalized post–COVID-19 population improved physical function and psychological well-being.

Long COVID presents an unmet therapeutic need.

To determine the effects of a resistance exercise intervention on exercise capacity, health status, and safety among adults after COVID-19 infection.

A 2-arm, multicenter, randomized clinical trial including 233 adults with a hospital or community diagnosis of COVID-19 infection in the preceding 12 months was undertaken from June 1, 2021, to April 26, 2024. The intervention group comprised 117 individuals, and the control group comprised 116 individuals. A total of 224 individuals at baseline and 193 individuals at 3 months completed Incremental Shuttle Walk Tests.

The intervention group received the personalized resistance exercise intervention for 3 months, and the control group received treatment as usual.

The primary outcome was the distance achieved (in meters) in the Incremental Shuttle Walk Test undertaken 3 months after randomization. Secondary outcome measures included health-related quality of life (measured by the European Quality of Life 5-Dimension 5-Level Instrument [EQ-5D-5L]), anxiety and depression (measured by the Patient Health Questionnaire), and grip strength.

A total of 233 adults (median age, 53.6 years [IQR, 43.8-60.8 years]; 146 women [62.7%]; 91 [39.1%] hospitalized with COVID-19 infection) were randomized (117 [50.2%] to the intervention group and 116 [49.8%] to the control group). The median percentage adherence with the exercise intervention was 71.0% (IQR, 47.8%-96.8%), equivalent to performing the exercises 5 days per week. The mean (SD) distance achieved in the Incremental Shuttle Walk Test was 328 (225) m for 224 individuals at baseline and 389 (249) m for 193 individuals at follow-up. The mean (SD) change in Incremental Shuttle Walk Test distance at 3 months compared with baseline was 83 (118) m in the intervention group (n = 94) and 47 (95) m in the control group (n = 98) (adjusted mean difference, 36.5 m [95% CI, 6.6-66.3 m]; P = .02). By 3 months, compared with the control group, greater improvements in the intervention group were also observed for the health-related quality of life utility score (EQ-5D-5L) (0.06 [95% CI, 0.01-0.11]; P = .02), Patient Health Questionnaire category (0.5 [95% CI, 0.2-0.8]; P = .01), and handgrip strength (2.6 kg [95% CI, 0.9-4.2 kg]; P = .002).

In this randomized clinical trial, a 3-month program of resistance exercise among adults after COVID-19 infection appeared to improve walking distance, health-related quality of life, anxiety, depression, and grip strength. This pragmatic intervention may be a generalizable therapy for individuals with persisting physical symptoms after COVID-19 infection.

ClinicalTrials.gov Identifier: NCT04900961

This randomized clinical trial assesses the effects of a personalized resistance exercise intervention on exercise capacity, health status, and psychological function among adults after COVID-19 infection.