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
BMF members were invited to continue paying during first lockdown and an incredible 83 per cent did so, with some paying double to cover others
HCM magazine
The science shows being fit mitigates against COVID-19. We’ve proven we can operate safely under the SAGE COVID-secure Framework. Time to join it up by securing essential service status
HCM magazine
Steve Ward celebrates the transformational energy being unleashed in the fitness industry by the pandemic
HCM Magazine
Sponsored
Venueserve Fitness enables clubs to offer white-label content streaming to optimise capacity and member engagement
HCM Magazine
Sponsored
Andy Hall, COO of data and tech solutions brand, Volution, looks at the trends we can expect to see emerging in the global fitness market in 2021
HCM Magazine
HCM People
Having someone just feeling comfortable walking into the gym is important
HCM Magazine
Promotion
Wattbike AtomX leads the future of indoor cycling, says Richard Baker
HCM Magazine
Consultation
With many older people in crisis due to the pandemic, ukactive’s head of health and wellbeing development, Kenny Butler, explains why the organisation is launching an active ageing consultation and how you can get involved
HCM Magazine
Interview
Smart clubs, a deal with 1Rebel and a collaboration with Amazon. The co-founder and CEO of Saudi Arabia’s Armah Sports talks to Kate Cracknell
HCM Magazine
Sponsored
Ruskin Fitness Club has transformed its gym in partnership with Technogym, adding the new Excite Live line, as well as dedicated workout zones
HCM Magazine
Latest News
Nick Whitcombe, the independent gym owner who refused to shut his gym during the October ...
Latest News
This year's UK government Spending Review, announced in Parliament by chancellor Rishi Sunak on 25 ...
Latest News
Up to 100k people will benefit from the free gym and physical activity sessions, thanks ...
Latest News
To the relief of the sector, the UK government confirmed yesterday (23 November) that gyms, ...
Latest News
Closing gyms and leisure facilities during any possible future lockdown would be "unthinkable", according to ...
Latest News
The University of Stirling has opened its new £20m sports and fitness centre. The building, ...
Latest News
Gyms are right near the bottom of the list in terms of places people have ...
Opinion
promotion
With January now close on the horizon your thoughts will be firmly focused on sales campaigns to attract new members through your doors in the new year rush.
Opinion: Sealing the Leaky Bucket – 7 Research-Based Tips for Retaining New Members in January 2021
Featured supplier news
Featured supplier: Primal Strength bolsters Scottish expansion with Matrix Fitness distribution win
Matrix Fitness has announced an exclusive partnership with Primal Strength to target an increased strategic focus on the Scottish market.
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
Freemotion CoachBike™
FreeMotion Fitness
Give your members the immersive cycling experience that keeps your members engaged – today and tomorrow. Read more
More videos:
Company profiles
Company profile: Keiser UK Ltd
Keiser began its history of visionary sports science leadership over 40 years ago, rejecting the ...
Company profiles
Company profile: MiE FitQuest
FitQuest (MiE Medical Research) are specialists in the field of human performance measurement. We have ...
Catalogue Gallery
Click on a catalogue to view it online
Directory
Management software
fibodo Limited: Management software
Uniforms
Service Sport: Uniforms
Software
Volution.fit: Software
Wearable technology solutions
MyZone: Wearable technology solutions
Exercise equipment
Matrix Fitness: Exercise equipment
Hydrotherapy / spa fragrances
Kemitron GmbH: Hydrotherapy / spa fragrances
Locking solutions
Monster Padlocks: Locking solutions
Direct debit solutions
Harlands Group: Direct debit solutions
Skincare
Comfort Zone - Davines S.p.A: Skincare
Fitness equipment
TRX Training: Fitness equipment
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
27-28 Nov 2020
Athena, Leicester, United Kingdom
Diary dates
03-03 Dec 2020
Virtual,
Diary dates
09 Dec 2020
Raffles City Convention Centre, Singapore, Singapore
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
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
Nick Whitcombe, the independent gym owner who refused to shut his gym during the October ...
Latest News
This year's UK government Spending Review, announced in Parliament by chancellor Rishi Sunak on 25 ...
Latest News
Up to 100k people will benefit from the free gym and physical activity sessions, thanks ...
Latest News
To the relief of the sector, the UK government confirmed yesterday (23 November) that gyms, ...
Latest News
Closing gyms and leisure facilities during any possible future lockdown would be "unthinkable", according to ...
Latest News
The University of Stirling has opened its new £20m sports and fitness centre. The building, ...
Latest News
Gyms are right near the bottom of the list in terms of places people have ...
Latest News
A new, Europe-wide initiative will look to chart the level of risk of COVID-19 infection ...
Latest News
UK Parliament will debate COVID-19 restrictions on gyms and leisure centres on Monday 23 November, ...
Latest News
The UK government has launched a £1bn Public Sector Decarbonisation Scheme (PSDS), providing grant funding ...
Opinion
promotion
With January now close on the horizon your thoughts will be firmly focused on sales campaigns to attract new members through your doors in the new year rush.
Opinion: Sealing the Leaky Bucket – 7 Research-Based Tips for Retaining New Members in January 2021
Featured supplier news
Featured supplier: Primal Strength bolsters Scottish expansion with Matrix Fitness distribution win
Matrix Fitness has announced an exclusive partnership with Primal Strength to target an increased strategic focus on the Scottish market.
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
Freemotion CoachBike™
FreeMotion Fitness
Give your members the immersive cycling experience that keeps your members engaged – today and tomorrow. Read more
More videos:
Company profiles
Company profile: Keiser UK Ltd
Keiser began its history of visionary sports science leadership over 40 years ago, rejecting the ...
Company profiles
Company profile: MiE FitQuest
FitQuest (MiE Medical Research) are specialists in the field of human performance measurement. We have ...
Catalogue Gallery
Click on a catalogue to view it online
Directory
Management software
fibodo Limited: Management software
Uniforms
Service Sport: Uniforms
Software
Volution.fit: Software
Wearable technology solutions
MyZone: Wearable technology solutions
Exercise equipment
Matrix Fitness: Exercise equipment
Hydrotherapy / spa fragrances
Kemitron GmbH: Hydrotherapy / spa fragrances
Locking solutions
Monster Padlocks: Locking solutions
Direct debit solutions
Harlands Group: Direct debit solutions
Skincare
Comfort Zone - Davines S.p.A: Skincare
Fitness equipment
TRX Training: Fitness equipment
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
27-28 Nov 2020
Athena, Leicester, United Kingdom
Diary dates
03-03 Dec 2020
Virtual,
Diary dates
09 Dec 2020
Raffles City Convention Centre, Singapore, Singapore
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
01-07 Dec 2022
tbc, Dunedin, New Zealand
Diary dates
Search news, features & products:
Find a supplier:
fibodo Limited
fibodo Limited