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Practice Practice Pointer

Returning to physical activity after covid-19

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4721 (Published 08 January 2021) Cite this as: BMJ 2021;372:m4721

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Rapid Response:

Re: Returning to physical activity after covid-19 ; speed of increasing exercise/activity

Dear Editor

It is pleasing to read a very practical guide to helping people back towards recovery and even think new opportunities for a healthy lifestyle.

I am a little concerned that the message about not returning to exercise until at least 7 days symptom free may be mistaken as avoidance of activity until fully recovered; something we know does not happen for many patients after covid19. I appreciate the authors qualify their advice by (I think) excluding those with 'long covid; but it may be worth emphasising this point. The recent rapid NICE guide on 'long covid' (preferred term post covid-9 syndrome) talks about supporting self-management which may include activity/exercise strategies. A message to only return to exercise after 7 days free of symptoms may deter some patients from thinking about recovery strategies or guided self management.

My second concern is the daily % increase in exercise within the phases and wonder if this is too fast. Again, I acknowledge that in the text the authors offer qualifying statements and are not referring to those patient with post covid-19 syndrome, where I suspect activity increases would fall more within the CFS/ME spectrum of care.

with regards
keith

Competing interests: No competing interests

11 February 2021
keith R linsley
consultant psychiatrist and formerly clinical lead CFS/ME county durham and darlington
TEWV nhs foundation trust
derwent clinic, shotley bridge hospital