Research shows that as many as one in eight COVID-19 patients could get Long COVID, which means there are likely hundreds of New Zealanders still experiencing symptoms 12 weeks after testing positive.

New Zealand physiotherapists have been working closely with their counterparts overseas to find out more about Long COVID and how best to support those suffering long-term effects.

Physiotherapy New Zealand (PNZ) spokesperson Dr Sarah Rhodes says it is understandable that patients with Long COVID are increasingly frustrated that their recovery is so slow as the symptoms can persist for months and years in some cases. PNZ calls on the government to support people’s access to effective treatment for Long COVID, just as they have supported people through the pandemic.

“We know that COVID-19 affects people differently and it is the same with Long COVID. It doesn’t only affect those who are hospitalised with an acute COVID infection. It can also affect those whose initial symptoms are mild and even those who are asymptomatic with the acute COVID-19 infection.”

“The desire to get back to normal life after COVID-19 is understandably important for all of us. With today’s busy lifestyles, it’s often hard to be that person who needs to rest instead of going back to work, getting back into your leisure activities, and looking after children and/or older family/whānau members. However, rest is an essential part of managing an acute COVID-19 infection as it is likely to reduce the risk of developing Long COVID,” says Dr Rhodes.

Members of PNZ’s Cardio-Respiratory Special Interest Group have developed some general tips to help guide people through a prolonged period of symptoms.

Fatigue

This is the most common symptom of Long COVID. Undertaking daily activities which were easily managed prior to COVID-19, such showering, can be exhausting.

• Be kind to yourself. Don’t take on too much. Ask for help.
• Working out which tasks require more or less energy can help you prioritise your time and activities so that you stay within your available energy levels. Keeping a diary of how you feel after each activity can be useful in identifying which activities make you more or less fatigued.
• Pace yourself by doing small tasks or breaking up activities and allowing yourself to take rests in between. Choose some activities that you give you pleasure to help support your mental well-being.
• Plan out your week to allow for periods of activity and periods of rest and recovery.
• Take regular breaks throughout the day and if you need a rest, listen to your body. Don’t push through the feeling of exhaustion.
• When fatigue is worsened by physical or mental effort, this may indicate you have post exertional symptom exacerbation (PESE). Exercise is not recommended for rehabilitation of people experiencing PESE as it can worsen symptoms. A physiotherapist can help support you in managing your fatigue.
• Remember that some activities, like being with friends, may contribute to symptom exacerbation. Connecting with others is important for your mental well-being so you may need to reduce the time you spend with others to conserve your energy for other activities in the day.
• Adapt activities to make them easier. e.g., sitting down to prepare the vegetables for dinner.
• Getting outside and spending time in nature can have benefits for both your mental and physical health.

Breathlessness

Breathlessness is another commonly experienced symptom in those with Long COVID.

• Feeling breathless can be a frightening experience.
• Seek support from a physiotherapist about positions and breathing techniques that can help alleviate feelings of breathlessness.
• It is important to get an individual assessment of your breathing as a one-size-fits-all approach doesn’t work.
• A physiotherapist can also screen for disruptions in your pattern of breathing that may contribute to some of the symptoms you are experiencing.

Muscle and Joint Pain

• Some patients with Long COVID experience muscle aches and joint pain. Gentle stretching and yoga may help relieve these symptoms.
• Check with your health professional before starting any exercises.

Return to exercise

• Exercise is not recommended if it worsens your fatigue.
• If you are not experiencing worsening symptoms, a cautious approach to commencing exercise is recommended. Your response to exercise should be monitored carefully. A safe return to exercise requires careful clinical decision making and a physiotherapist can support you through this.

Physiotherapy can help manage symptoms of Long COVID. However, for some patients a multi-disciplinary approach, involving other health professionals, is recommended.

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