GET HCM
magazine
Sign up for the FREE digital edition of HCM magazine and also get the HCM ezine and breaking news email alerts.
Not right now, thanksclose this window
fibodo Limited
fibodo Limited
fibodo Limited
Health Club Management

Health Club Management

Follow Health Club Management on Twitter Like Health Club Management on Facebook Join the discussion with Health Club Management on LinkedIn Follow Health Club Management on Instagram
UNITING THE WORLD OF FITNESS
Get the latest news, jobs and features in your inbox
Health Club Management

Health Club Management

features

Rehab: Safe return

Simon Harling explains how exercise professionals can ensure a safe return to exercise for post-COVID patients

Published in Health Club Management 2020 issue 9
COVID-19 can cause heart damage, but many people, especially those who have been asymptomatic, may be unaware they’re at risk / Jacob Lund/shutterstock
COVID-19 can cause heart damage, but many people, especially those who have been asymptomatic, may be unaware they’re at risk / Jacob Lund/shutterstock
There will be many post-COVID patients who are asymptomatic and will be unaware of the risk of a cardiovascular event on their return to strenuous physical activities

As we look for ways to co-exist with COVID-19, fitness professionals face the prospect of managing the increased risk to the exposure to the virus for themselves, their clients and those clients who have previously been infected with COVID-19.

With considerable pressure being placed on routine medical and rehabilitation services for the foreseeable future, fitness professionals can play a significant role in providing knowledge in the form of education content, skill in the rehabilitation and care planning process and emotional support.

The illness severity pattern so far observed for COVID-19 is as follows:

1. Asymptomatic infected patients.

2. Symptomatic patients isolating at home.

3. Symptomatic patients admitted to hospital

4. Symptomatic patients requiring ventilatory support in critical care.

Clients who have received hospital treatment
During community reintegration, post COVID-19 patients should be supported with a long-term care plan that includes supported self-exercise and a return to work schedule.

Adaptation of clinical experience to a post-COVID rehabilitation programme to meet the occupational and environmental needs of the patient, will be our challenge.

Clients who have not received hospital treatment
In the UK, the numbers of post-COVID patients present in the community who did not require hospitalisation is unknown.

What we can be sure of is that many post-COVID patients based in the community will require rehabilitation aimed at relieving symptoms of dyspnoea, psychological distress and improving participation in rehabilitation, physical function and quality of life.

When is it safe to return to exercise?
COVID-19 is associated with cardiac complications, in particular, arrhythmias and myocardial injury, putting all patients exposed to COVID-19 at an increased risk of a cardiovascular event. The cause of the cardiovascular complications are likely multifactorial and include viral myocardial injury, elevated systemic inflammatory burden and hypotension.

Higher risk groups include those patients who have been hospitalised, required ventilatory support and those with co-existing diseases such as diabetes, hypertension and cardiovascular disease.

Aside from rehabilitation of post-COVID symptomatic patients there will be many post-COVID asymptomatic patients who will be unaware of the risk of a cardiovascular event on their return to strenuous physical activities.

It is imperative, therefore, that fitness professionals play a significant role in identifying, educating and managing the risk of both asymptomatic, symptomatic cardiovascular disease clients and those with co-existing diseases.

Key points:
• Any patient who has had COVID-19 should complete an assessment of their cardiac symptoms, recovery, function and potential impairments.

• Particular attention should be given to patients with underlying disease.

Patients returning to high-level sport or physically demanding occupation following confirmed myocarditis require a three- to six-month period of complete rest.

Exercise rehabilitation programme recommendations
It’s important to remember that exercise is considered an important element of pulmonary rehabilitation and when considering the prescription of exercise for post-COVID clients, the same principles of duration, intensity, frequency, specificity and reversibility apply.

Low intensity exercise (≤3 METs or equivalent) should be considered initially in all post-COVID patients. Patients with COVID-19 who experience the following symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest pain, cough or fever should avoid exercise (>3 METs or equivalent) for between two and three weeks after the cessation of those symptoms.

Clients requiring rehabilitation following COVID-19 should have a functional assessment to determine residual musculoskeletal impairments in order to determine appropriate rehabilitation.

Key points:
• Exercise training is effective when used as a tool in the treatment of pulmonary disease patients.

• Low intensity exercise (≤3 METs or equivalent) should be considered initially in all post-COVID patients.

• Clients with COVID-19 who experience the following symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest pain, cough or fever should avoid exercise (>3 METs or equivalent) for between two and three weeks. Resumption of training (>3 METs or equivalent) once the symptoms have cleared.

• Post-COVID clients with new-onset shortness of breath or chest pain, should have a full medical review.

With every client having a unique response to exercise, exercise prescription should be based on individual tolerance thresholds and workloads. Previous exercise tolerances and workloads should not be taken into consideration. It’s important to prescribe exercise on what the client can tolerate now.

The choice we face as an industry
The opportunity exists now to demonstrate the ability of the fitness industry to make a tangible difference. To have a bigger conversation.

The fitness industry is faced with a choice – we can ignore the inconvenient truth surrounding the increased risk of return to exercise for post-COVID-19 clients, or we can reach out to over-stretched medical and rehabilitation services, listen to their needs and those of their patients and offer our time, empathy – and our facilities.

We can essentially make a generous decision to engage a large section of the community that have been affected by COVID-19.

Well managed fitness programmes can restore health, but if we go down this road, they won’t all be well managed initially. The rehabilitation may be clumsy in some cases and the health service may be wary. Yet our intentions will be unquestionable and in time our knowledge, skills and relationships will flourish.

The alternative is to wait for a budget, a marketing plan or a campaign strategy.

What will you do? Wait, ignore or engage?

About the author

Simon Harling helps coaches build extraordinary coaching practices. An author and speaker, Harling has worked as a consultant to national governing bodies and professional sports teams.

More: [email protected]

References
The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Barker-Davies, R.M. et al. (2020). Br J Sports Med Epub ahead of print: doi:10.1136
Rehabilitation in the wake of COVID-19-A phoenix from the ashes. British Society of Rehabilitation Medicine. (2020).
Position Stand: Return to Sport, May 2020, in the Current Coronavirus Pandemic (SARS-CoV-2 / COVID-19). Nieß, A.M. et al., (2020). Dtsch Z Sportmed. 2020; 71: E1-E4

Sign up here to get HCM's weekly ezine and every issue of HCM magazine free on digital.
Members requiring rehabilitation following COVID-19 should have a functional assessment / Robert Kneschke/shutterstock
Members requiring rehabilitation following COVID-19 should have a functional assessment / Robert Kneschke/shutterstock
https://www.leisureopportunities.co.uk/images/2020/733547_962298.jpg
Simon Harling explains how exercise professionals can ensure a safe return to exercise for post-COVID patients
Simon Harling, post-covid exercise, fitness professionals,Covid-19, rehabilitation
HCM magazine
High quality user experience and good value for the operator. This is the winning formula behind an expanding Physical Company product range, says James Anderson
HCM magazine
This was a year when research helped transformed the gym sector into a serious political force. Two pieces of work stand out in terms of timely impact
HCM magazine
Nu Physio and Fitness has placed Egym at the heart of its protection and prevention model
HCM Magazine
Sponsored
Technogym introduced live and on-demand functionality to Mywellness in July. Here we find out more about operators who have adopted this solution
HCM Magazine
Local leisure
HCM talks to policy makers, operators and decision-makers about the public sector and trust response to the pandemic
HCM Magazine
The great debate
Given its support for the NHS, should the fitness industry be classified as an essential service, and if so, how do we get the sector reclassified? Kath Hudson asks industry leaders for their views
HCM Magazine
Research
Regular sessions of new-generation yoga can help tackle the lockdown blues, increase sleep quality and boost mental health
HCM Magazine
News report
A new study from the Global Wellness Institute highlights the scope of the $121bn mental wellness market, as Katie Barnes and Megan Whitby report
HCM Magazine
Opinion
Steve Ward celebrates the transformational energy being unleashed in the fitness industry by the pandemic
HCM Magazine
Profile
The chair of énergie and vice chair of BMF talks to Kate Cracknell about creating an omnichannel approach that brings together indoor, outdoor, online and VR
HCM Magazine
Latest News
Fitness First has launched a new free digital fitness hub, offering users a wide range ...
Latest News
The Gym Group has brought in Rio Ferdinand and Wais Shaifta as non-executive directors, signalling ...
Latest News
As the global vaccine rollout brings reopening closer and heralds the end of lockdowns, jostling ...
Latest News
Less than half (44.9 per cent) of children and young people in England met the ...
Latest News
An England-wide survey of over 5,000 adults found that 80 per cent of people aged ...
Latest News
The government needs to provide the fitness and physical activity sector with a plan which ...
Latest News
Book4Time, a leading cloud-based business management solution for the global hospitality, spa and wellness industry, ...
Latest News
Some Brits drop their exercise habits, eat unhealthily and drink more alcohol during lockdowns, according ...
Featured supplier news
Featured supplier: What does a socially distanced leisure centre and health club look like?
The world has had to get used to social distancing in 2020 and any business operating in the leisure and hospitality sectors has had to face this challenge more than most.
Featured supplier news
Featured supplier: Red Light Rising teams up with ITRM Clinic to supply red light therapy for injured athletes
Red light therapy equipment supplier, Red Light Rising, has partnered with Aidan Robinson of ITRM Clinic in the UK
Video Gallery
CPASE creates unforgettable luxury member experience at new boutique club with Technogym
Technogym
Technogym has equipped Clare Stobart's new boutique health club – CPASE. Read more
More videos:
Company profiles
Company profile: Life Fitness
Through our Life Fitness Solutions Partners, we can deliver design and build services, finance solutions, ...
Company profiles
Company profile: BLK BOX
The BLK BOX product range is built for athletes by athletes, includes modular storage systems, ...
Supplier Showcases
Supplier showcase - Egym: Game changer
Supplier Showcases
Supplier showcase - Powering through
Catalogue Gallery
Click on a catalogue to view it online
Directory
Exercise equipment
EXF Fitness Equipment: Exercise equipment
Fitness Software
FunXtion International BV: Fitness Software
Independent service & maintenance
Servicesport UK Limited: Independent service & maintenance
Management software
fibodo Limited: Management software
Fitness equipment
Precor: Fitness equipment
Spa software
SpaBooker: Spa software
Wearable technology solutions
MyZone: Wearable technology solutions
Uniforms
Service Sport: Uniforms
Skincare
Sothys: Skincare
Whole body cryotherapy
Zimmer MedizinSysteme GmbH / icelab: Whole body cryotherapy
Property & Tenders
11 - 25 Union St, London SE1 1SD
Bankside Open Spaces Trust
Property & Tenders
Waltham Abbey, Essex
Lee Valley Regional Park Authority
Property & Tenders
Diary dates
02-04 Feb 2021
Ericsson Exhibition Hall, Ricoh Arena, Coventry, United Kingdom
Diary dates
23-26 Feb 2021
IFEMA, Madrid, Spain
Diary dates
03-04 Mar 2021
NEC, Birmingham, United Kingdom
Diary dates
03-06 Jun 2021
Expo Centre & Riviera di Rimini, Italy
Diary dates
16-17 Jun 2021
ExCeL London, London, United Kingdom
Diary dates
21-24 Sep 2021
Messe Stuttgart, Germany
Diary dates
01-07 Dec 2022
tbc, Dunedin, New Zealand
Diary dates

features

Rehab: Safe return

Simon Harling explains how exercise professionals can ensure a safe return to exercise for post-COVID patients

Published in Health Club Management 2020 issue 9
COVID-19 can cause heart damage, but many people, especially those who have been asymptomatic, may be unaware they’re at risk / Jacob Lund/shutterstock
COVID-19 can cause heart damage, but many people, especially those who have been asymptomatic, may be unaware they’re at risk / Jacob Lund/shutterstock
There will be many post-COVID patients who are asymptomatic and will be unaware of the risk of a cardiovascular event on their return to strenuous physical activities

As we look for ways to co-exist with COVID-19, fitness professionals face the prospect of managing the increased risk to the exposure to the virus for themselves, their clients and those clients who have previously been infected with COVID-19.

With considerable pressure being placed on routine medical and rehabilitation services for the foreseeable future, fitness professionals can play a significant role in providing knowledge in the form of education content, skill in the rehabilitation and care planning process and emotional support.

The illness severity pattern so far observed for COVID-19 is as follows:

1. Asymptomatic infected patients.

2. Symptomatic patients isolating at home.

3. Symptomatic patients admitted to hospital

4. Symptomatic patients requiring ventilatory support in critical care.

Clients who have received hospital treatment
During community reintegration, post COVID-19 patients should be supported with a long-term care plan that includes supported self-exercise and a return to work schedule.

Adaptation of clinical experience to a post-COVID rehabilitation programme to meet the occupational and environmental needs of the patient, will be our challenge.

Clients who have not received hospital treatment
In the UK, the numbers of post-COVID patients present in the community who did not require hospitalisation is unknown.

What we can be sure of is that many post-COVID patients based in the community will require rehabilitation aimed at relieving symptoms of dyspnoea, psychological distress and improving participation in rehabilitation, physical function and quality of life.

When is it safe to return to exercise?
COVID-19 is associated with cardiac complications, in particular, arrhythmias and myocardial injury, putting all patients exposed to COVID-19 at an increased risk of a cardiovascular event. The cause of the cardiovascular complications are likely multifactorial and include viral myocardial injury, elevated systemic inflammatory burden and hypotension.

Higher risk groups include those patients who have been hospitalised, required ventilatory support and those with co-existing diseases such as diabetes, hypertension and cardiovascular disease.

Aside from rehabilitation of post-COVID symptomatic patients there will be many post-COVID asymptomatic patients who will be unaware of the risk of a cardiovascular event on their return to strenuous physical activities.

It is imperative, therefore, that fitness professionals play a significant role in identifying, educating and managing the risk of both asymptomatic, symptomatic cardiovascular disease clients and those with co-existing diseases.

Key points:
• Any patient who has had COVID-19 should complete an assessment of their cardiac symptoms, recovery, function and potential impairments.

• Particular attention should be given to patients with underlying disease.

Patients returning to high-level sport or physically demanding occupation following confirmed myocarditis require a three- to six-month period of complete rest.

Exercise rehabilitation programme recommendations
It’s important to remember that exercise is considered an important element of pulmonary rehabilitation and when considering the prescription of exercise for post-COVID clients, the same principles of duration, intensity, frequency, specificity and reversibility apply.

Low intensity exercise (≤3 METs or equivalent) should be considered initially in all post-COVID patients. Patients with COVID-19 who experience the following symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest pain, cough or fever should avoid exercise (>3 METs or equivalent) for between two and three weeks after the cessation of those symptoms.

Clients requiring rehabilitation following COVID-19 should have a functional assessment to determine residual musculoskeletal impairments in order to determine appropriate rehabilitation.

Key points:
• Exercise training is effective when used as a tool in the treatment of pulmonary disease patients.

• Low intensity exercise (≤3 METs or equivalent) should be considered initially in all post-COVID patients.

• Clients with COVID-19 who experience the following symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest pain, cough or fever should avoid exercise (>3 METs or equivalent) for between two and three weeks. Resumption of training (>3 METs or equivalent) once the symptoms have cleared.

• Post-COVID clients with new-onset shortness of breath or chest pain, should have a full medical review.

With every client having a unique response to exercise, exercise prescription should be based on individual tolerance thresholds and workloads. Previous exercise tolerances and workloads should not be taken into consideration. It’s important to prescribe exercise on what the client can tolerate now.

The choice we face as an industry
The opportunity exists now to demonstrate the ability of the fitness industry to make a tangible difference. To have a bigger conversation.

The fitness industry is faced with a choice – we can ignore the inconvenient truth surrounding the increased risk of return to exercise for post-COVID-19 clients, or we can reach out to over-stretched medical and rehabilitation services, listen to their needs and those of their patients and offer our time, empathy – and our facilities.

We can essentially make a generous decision to engage a large section of the community that have been affected by COVID-19.

Well managed fitness programmes can restore health, but if we go down this road, they won’t all be well managed initially. The rehabilitation may be clumsy in some cases and the health service may be wary. Yet our intentions will be unquestionable and in time our knowledge, skills and relationships will flourish.

The alternative is to wait for a budget, a marketing plan or a campaign strategy.

What will you do? Wait, ignore or engage?

About the author

Simon Harling helps coaches build extraordinary coaching practices. An author and speaker, Harling has worked as a consultant to national governing bodies and professional sports teams.

More: [email protected]

References
The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Barker-Davies, R.M. et al. (2020). Br J Sports Med Epub ahead of print: doi:10.1136
Rehabilitation in the wake of COVID-19-A phoenix from the ashes. British Society of Rehabilitation Medicine. (2020).
Position Stand: Return to Sport, May 2020, in the Current Coronavirus Pandemic (SARS-CoV-2 / COVID-19). Nieß, A.M. et al., (2020). Dtsch Z Sportmed. 2020; 71: E1-E4

Sign up here to get HCM's weekly ezine and every issue of HCM magazine free on digital.
Members requiring rehabilitation following COVID-19 should have a functional assessment / Robert Kneschke/shutterstock
Members requiring rehabilitation following COVID-19 should have a functional assessment / Robert Kneschke/shutterstock
https://www.leisureopportunities.co.uk/images/2020/733547_962298.jpg
Simon Harling explains how exercise professionals can ensure a safe return to exercise for post-COVID patients
Simon Harling, post-covid exercise, fitness professionals,Covid-19, rehabilitation
Latest News
Fitness First has launched a new free digital fitness hub, offering users a wide range ...
Latest News
The Gym Group has brought in Rio Ferdinand and Wais Shaifta as non-executive directors, signalling ...
Latest News
As the global vaccine rollout brings reopening closer and heralds the end of lockdowns, jostling ...
Latest News
Less than half (44.9 per cent) of children and young people in England met the ...
Latest News
An England-wide survey of over 5,000 adults found that 80 per cent of people aged ...
Latest News
The government needs to provide the fitness and physical activity sector with a plan which ...
Latest News
Book4Time, a leading cloud-based business management solution for the global hospitality, spa and wellness industry, ...
Latest News
Some Brits drop their exercise habits, eat unhealthily and drink more alcohol during lockdowns, according ...
Latest News
New year, new celeb workout as Mark ‘Bez’ Berry announces the launch of his own ...
Latest News
Frasers Group will open three new regional flagship Flannels-branded retail stores during 2021 – each ...
Latest News
The closing of gyms, leisure centres and swimming pools under COVID-19 restrictions is costing the ...
Featured supplier news
Featured supplier: What does a socially distanced leisure centre and health club look like?
The world has had to get used to social distancing in 2020 and any business operating in the leisure and hospitality sectors has had to face this challenge more than most.
Featured supplier news
Featured supplier: Red Light Rising teams up with ITRM Clinic to supply red light therapy for injured athletes
Red light therapy equipment supplier, Red Light Rising, has partnered with Aidan Robinson of ITRM Clinic in the UK
Video Gallery
CPASE creates unforgettable luxury member experience at new boutique club with Technogym
Technogym
Technogym has equipped Clare Stobart's new boutique health club – CPASE. Read more
More videos:
Company profiles
Company profile: Life Fitness
Through our Life Fitness Solutions Partners, we can deliver design and build services, finance solutions, ...
Company profiles
Company profile: BLK BOX
The BLK BOX product range is built for athletes by athletes, includes modular storage systems, ...
Supplier Showcases
Supplier showcase - Egym: Game changer
Supplier Showcases
Supplier showcase - Powering through
Catalogue Gallery
Click on a catalogue to view it online
Directory
Exercise equipment
EXF Fitness Equipment: Exercise equipment
Fitness Software
FunXtion International BV: Fitness Software
Independent service & maintenance
Servicesport UK Limited: Independent service & maintenance
Management software
fibodo Limited: Management software
Fitness equipment
Precor: Fitness equipment
Spa software
SpaBooker: Spa software
Wearable technology solutions
MyZone: Wearable technology solutions
Uniforms
Service Sport: Uniforms
Skincare
Sothys: Skincare
Whole body cryotherapy
Zimmer MedizinSysteme GmbH / icelab: Whole body cryotherapy
Property & Tenders
11 - 25 Union St, London SE1 1SD
Bankside Open Spaces Trust
Property & Tenders
Waltham Abbey, Essex
Lee Valley Regional Park Authority
Property & Tenders
Diary dates
02-04 Feb 2021
Ericsson Exhibition Hall, Ricoh Arena, Coventry, United Kingdom
Diary dates
23-26 Feb 2021
IFEMA, Madrid, Spain
Diary dates
03-04 Mar 2021
NEC, Birmingham, United Kingdom
Diary dates
03-06 Jun 2021
Expo Centre & Riviera di Rimini, Italy
Diary dates
16-17 Jun 2021
ExCeL London, London, United Kingdom
Diary dates
21-24 Sep 2021
Messe Stuttgart, Germany
Diary dates
01-07 Dec 2022
tbc, Dunedin, New Zealand
Diary dates
Search news, features & products:
Find a supplier:
fibodo Limited
fibodo Limited