An exercise program to be done at home, without the aid of equipment and under the remote supervision of physical education professionals, proved to be safe and effective in combating two possible consequences of Covid-19: hardening of the arteries and loss of muscle strength. involved in breathing.
The finding was made by researchers from the Universidade Estadual Paulista (Unesp) and UFSCar (Federal de São Carlos) in a clinical trial with 32 patients who were hospitalized after contracting SARS-CoV-2, between July 2020 and February 2021. group consisted of men and women, with a mean age of 52 years.
“Despite the relatively small number of participants, we were able to see statistically significant differences in these two variables. And it is worth mentioning that the intervention was safe, even done at home. No volunteer had an adverse effect caused by the exercises”, says Emmanuel Ciolac, professor at the Faculty of Medicine. Sciences (FC-Unesp), in Bauru, and research coordinator.
About a month after hospital discharge, the volunteers underwent a battery of tests and were randomly divided into two groups. Part received only a generic orientation to practice physical activity and return to the university after 12 weeks for a new evaluation. The others attended a face-to-face class, in which aerobic and strength exercises were taught, and then received a booklet with guidelines. This second group was monitored remotely by the researchers on a weekly basis, through phone calls and messages.
“They were recommended to practice resistance exercises at least three times a week, in addition to 150 minutes of aerobic activity during the period”, says Vanessa Teixeira do Amaral, a master’s student at the Graduate Program in Movement Sciences at the Faculty of Sciences (FC -Unesp) and first author of the article.
At the end of 12 weeks, all underwent a new battery of tests. In addition to weight and body mass index (BMI), blood pressure, heart rate and the so-called carotid-femoral pulse wave velocity (PWV) – a parameter used to measure arterial stiffness – were measured.
“To perform this test, sensors are placed in the carotid arteries [no pescoço] and femoral [na virilha]. They send the information to software, which calculates the speed at which the blood pumped by the heart goes from one point to another. The greater the arterial stiffness, the higher the velocity. Values above ten meters per second [m/s] are already worrying, as they represent a risk of cardiovascular complications”, explains Amaral.
Pulmonary function (spirometry) and respiratory muscle strength were also evaluated using a device known as a manuvacuometer, which measures maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax).
And finally, standardized physical tests were applied to assess the general state of muscle strength and health. The full results of the study —supported by Fapesp— were published on the medRxiv platform, in an article that has not yet been peer-reviewed.
complementary therapy
According to Ciolac, all study participants showed improvement in the parameters evaluated after 12 weeks. But only in the group that practiced the exercises with remote guidance was a significant reduction in pulse wave velocity observed.
As the researcher explains, arterial hardening is one of the consequences of the inflammation triggered in the body by Covid-19, but it is also a process that occurs naturally with aging. This condition increases the risk of hypertension and cardiovascular events such as heart attack and stroke. In an advanced stage, it can even lead to kidney failure, liver and other organ disorders.
“In the group that received the intervention, 35% of the volunteers had values above 10 m/s at the first measurement. After 12 weeks, we saw an average reduction of 2 m/s — a very good effect. were below 10 m/s in the second evaluation”, reports Ciolac.
The improvement in the values of inspiratory and expiratory pressure was also statistically significant only in the volunteers who underwent the intervention: 100% of them had, at the beginning of the program, MIP values below the expected for their age. In the second evaluation, this index dropped to 50%. In the case of MEP, 58% presented values below the expected in the first evaluation and 33% after 12 weeks of training.
“The findings suggest that home-based exercise with remote supervision may be a potential adjunctive therapy in the rehabilitation of individuals who have been hospitalized as a result of Covid-19,” the researchers conclude.
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