Effects of physical training on functional, clinical and psychosocial outcomes of adults and elderly post-infection by Covid-19: Covid-19 and rehabilitation study (core-study)

Introduction: People infected with the COVID-19 virus experience a series of signs and symptoms after the acute phase of the disease, which can result in losses in a series of outcomes, including functional capacity, quality of life, autonomy and social interaction. Rehabilitation programs via physical exercise are necessary to allow adults and elderly people who were infected by Sars-COV-2 to resume their daily activities. Objectives: To analyze the effects of multicomponent training on functional, clinical, morphological, behavioral and psychosocial outcomes of adults and elderly people post-COVID-19 infection. Methods: This is a randomized and controlled clinical trial, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation program, carried out at the Sports Center in partnership with the University Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. The participants were adults and elderly people, of both sexes, in a post-COVID-19 infection state, who presented moderate to severe clinical conditions during the infection. The intervention lasted 24 weeks and included a multicomponent physical training program, with gradual progression in frequency, duration and intensity over time. Regarding outcomes, before, on the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioral and psychosocial results were evaluated. Results: The outcomes of functional capacity and functionality symptoms showed significant improvements, especially in the GI, and even when in both groups, the improvements were more pronounced and with greater magnitude in the GI, highlighting aerobic capacity, fatigue level and fragility. The outcomes quality of life, quality of sleep, percentage of dilation (vascular parameters), isometric muscle strength of the lower limbs showed significant improvements only in the GI. The outcomes systolic blood pressure, diastolic blood pressure, mean arterial pressure, depressive symptoms, relative volume and carbon monoxide diffusion (respiratory parameter) showed a time effect, improving in both groups, intervention and control. In body composition, an improvement was identified in body mass index, body fat, fat mass, visceral adipose tissue and phase angle in the GI. No changes in physical activity levels and sedentary behavior were identified after 24 weeks of training. Conclusion: It is concluded that a multicomponent training protocol such as post-COVID rehabilitation lasting 24 weeks showed significant improvements in certain parameters that make up functional, cardiovascular, neuromuscular, respiratory and psychosocial outcomes only in the intervention group and in certain parameters significant improvements were observed in both groups.