Strength Training
Antiresistance training method is recommended for strength training. The training frequency of each target muscle group is two to three times a week, and its load is 8-12 RM (repeating 8-12 reps at most for each set). Patients should perform one to three groups each time. At the beginning, patients can perform body-weight strength training, then gradually transition to carrying light weights. Take body-weight training as an example to illustrate different muscle groups.
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TABLE 5.1 ACTIVITIES RECOMMENDED FOR DIFFERENT TYPES OF PATIENTS DURING HOSPITALIZATION |
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Exercise Intensity |
Exercise Frequency |
Exercise Duration |
Exercise Types |
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Mild |
Borg dyspnea score < 3 (out of 10 scores), with no fatigue on the second day. |
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15-45 minutes each time. |
Respiratory rehabilitation exercises, tai chi chuan or square dancing, etc. |
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Ordinary |
Between resting (1.0 METs) and mild physical activity' (< 3.0 METs). |
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Activity' duration is determined according to the patient’s physical condition, maintaining 15-45 minutes each time. For patients who are prone to fatigue or weak, they can perform interval training. |
Respiratory rehabilitation exercise, walking on the spot, tai chi chuan, and exercises to prevent thrombosis. |
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Severe/ Critically Severe |
Patients with poor physical strength can reduce the intensity of exertion. With time or activity' range maintained, they are just required to complete the movement. |
1-2 times a day. |
The total training time should not exceed 30 minutes each time to avoid the aggravation of fatigue. |
First, regularly turning over and moving on the bed, siting up from the bed, transferring from the bed to the chair, sitting on the chair, standing up, and walking on the spot, carrying out these exercises step by step in this order. Second, active/passive range of motion training. Third, for patients with sedation or cognitive impairment or biological constraints, passive lower limbs function bicycle ergometer, passive range of motion and stretch and neuromuscular electrical stimulation. |
Modern Rehabilitation Techniques for COVID-19
Upper Limbs Strength Training
1) Elbow flexors: Patients can choose standing, sitting, semirecumbent, or recumbent po sition for training. Take standing position as an example.
Place the upper limbs on either side of the torso. Keep the torso upright and keep eyesight straight forward with hands relaxed. Keep upper arms close to the chest. Bend the elbows when exhaling and return to the original position during inhaling. Do not hold the breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
2) Elbow extensors: Patients can choose standing, sitting, semirecumbent, or recumbent positions for training. Take the sitting position and the recumbent position for examples.
In the sitting position, ask the patients to bend one shoulder forward to the maximum degree, keeping the torso upright, looking at the front, hanging the forearm naturally behind the head, bringing the upper arm close to the ear. Then extend the elbow when exhaling and return to the original position when inhaling. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
Patients who cannot perform the above exercises while sitting can do these exercises while lying down, where their legs can flex so that the lumbar vertebra is attached to the bed surface and the shoulders of both upper limbs can be bent forward to the maximum degree with one forearm naturally under the bed edge. Extend the elbow when exhaling and return to the original position when inhaling. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
3) Shoulder anterior flexors: Patients can choose standing, sitting, semirecumbent, or recumbent positions for training. Take the sitting and recumbent positions as examples.
In the sitting position, place upper limbs on both sides of torso, and keep torso upright, looking at the front with hands relaxed. Then bend one shoulder joint forward. Bend shoulder joints forward when exhaling and return to the original position when inhaling. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
Patients who cannot perform the above exercises while sitting can do these exercises while lying, where the legs are flexing so that the lumbar spine is close to the bed surface. Bend one side of the upper limbs forward. Bend shoulders forward when exhaling and return to the original position when inhaling. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
4) Shoulder abductors: Patients can choose standing, sitting, semire-cumbent, or recumbent positions for training. Take the sitting and recumbent positions as examples.
In the sitting position, ask the patient to lay upper limbs on the sides of body, keeping the torso upright, looking at the front, keeping hands relaxed. Then stretch the upper limbs with elbow joints slightly flexed. Stretch shoulders out when exhaling and return to the original position when inhaling. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
Patients who cannot perform the above exercises while sitting can do these exercises while lying, where the legs are flexed so that the lumbar vertebra is close to the bed surface. Patients should stretch their upper limbs with elbow joints slightly flexed. Stretch shoulders out when exhaling and return to the original position when inhaling. In the supine position, the upper limbs can be slightly lifted from the bed. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
5) Shoulder posterior extensors: Patients can choose standing, sitting, semirecumbent, or recumbent positions for training.
In the standing position, ask patients to place both upper limbs on both sides of the torso, keeping the torso upright, eyesight on the front, and hands relaxed. Stretch one upper limb backward with elbow joints slightly bent. Stretch shoulders out when exhaling and return to the original position when inhaling. In the supine position, the upper limbs can be slightly lifted from the bed. Do not hold breath during exercise. Patients can select the appropriate weight load during exercise. A set consists of 8-12 reps. Three to four sets are required and should be performed on both sides in turn.
In the semirecumbent and recumbent positions, the legs are flexed so that the lumbar spine is attached to the bed surface. Keep the elbows flexed on both sides and the upper arm attached to the bed surface. When exhaling, try to exert efforts on the upper arm to approach the bottom of the bed as far as possible. At the same time, the upper back can be lifted slightly from the bed surface. When inhaling, return to the original position.
