Medical sciences (Basel, Switzerland)May 27, 2026

Exercise Rehabilitation for Severe COVID-19 Survivors with Long COVID: A Small Randomized Study

Long Covid Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jun 28, 2026

Abstract

Essence

Six weeks of multicomponent rehabilitation improved function, physical activity, respiratory strength, and quality of life in severe COVID-19 survivors with long COVID, with limited added benefit from inspiratory muscle training.

Evidence

This randomized controlled pilot study assigned 30 severe COVID-19 survivors to multicomponent exercise alone or combined with inspiratory muscle training three times weekly for six weeks and measured quality of life, functional status, activity, and physical capacity.

Caveat

The study was a small pilot with baseline between-group differences and no non-exercise control, which limits how confidently the gains can be attributed to the intervention or to inspiratory muscle training specifically.

Simplified

INTRODUCTION: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This study aimed to evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19.

METHODOLOGY: A randomized clinical trial was conducted with 30 survivors allocated to two groups: multicomponent exercise (GEm) and multicomponent exercise combined with inspiratory muscle training (GEmTMI). The interventions were performed three times per week for 40-60 min. Quality of life, physical activity level, functional status, and physical capacity were assessed before and after six weeks.

RESULTS: Comparisons between GEm and GEmTMI showed significant differences in the 6 min walk test (6MWT) at baseline (= 0.043) and in the Physical Activity Index (IPAQ) after the intervention (= 0.002). When the total sample was analyzed, significant improvements were observed across all outcomes after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), physical activity level (IPAQ), respiratory muscle strength, and additional functional tests. Notable improvements included SF-36 Physical Functioning (= 0.006) and Social Functioning (= 0.009), PCFS (= 0.011), IPAQ (= 0.012), and performance in the 6MWT, STS, STS-1min, TUG, handgrip strength, PEmax, and PImax (all< 0.001). p p p p p p p

DISCUSSION: Multicomponent physical rehabilitation, with or without inspiratory muscle training, produced significant gains in physical activity level, functional capacity, dynamic balance, neuromuscular fitness, respiratory muscle strength, and quality of life. These findings underscore the importance of structured post-ICU rehabilitation to support comprehensive physical and psychosocial recovery in survivors of severe COVID-19.