In the early months of the pandemic, many health professionals did not know what strategies to use with people with covid-19 and wanted to return to training. Over time, recommendations have emerged from the American College of Sports Medicine as well as from SBMEE (The Brazilian Society of Sports Exercise and Sports Medicine), but the most complete has been a return to the UK Sports Flow Chart, which I explain here.
Reflecting on the scientific environment movement in the world and with the discussion among researchers about the consequences in people recovering from the coronavirus, famous Brazilian researchers came together and created an extraordinary material, with the support of Cref-SP (Regional Council for Physical Education) and Acad (Brazilian Association of Academies, titled ” Prescribing guidelines for patients infected with SARS-COV-2.
According to Cref-SP President, Nelson Lim, “The Guidelines responsibly impact all physical education professionals, due to their relevance and application content, while providing the latest studies and research related to physical activity. The professional contributes to prescribing appropriate exercises. For people affected by Covid disease. The professional wins , for having a modern tool on the subject, and the population in general, to be attended by specialists suitably prepared for the challenge of practicing a prescription.”
Dr. Ailton Figueira Jr., one of the authors of the guidelines, a professor and researcher in the master’s and doctoral program at the University of São Judas Tado, explains that the proposal was based on evidence of punitive conditions already described in the literature, following 4 points:
- display of epidemiological indicators (15-20%) of the document;
- Current consequences identified in the literature (20-25%) of the document;
- functional assessment of affected patients (30-40%);
- Training recipe on the basis of the evaluation discussed in item 3, and the search for criteria allowed by the tools, to adjust the training recipe in 4 levels, according to the progress of functional capabilities.
The guide also contains worksheets and guidelines for improving strength, cardiorespiratory fitness, and other psychofunctional indicators. The material followed several scientific criteria in selecting global impact studies, and views from scientific institutions such as CDC (American Center for Disease Control and Prevention), ACMS and Johns Hopkins University (USA), in addition to searching international databases. Like PubMed, prioritizing articles and recommendations guiding “what to do,” based on the consequences of COVID-19.
In addition to Figueira, I spoke with the authors Dr. Moises Diego Germano, Professor and Researcher at Itabira University Center and Coordinator of the Sports Department of Itabira, Prof. I. Leonardo Lima, researcher and doctoral student at the University of São Judas Tado and Professor Dr. curse. Luis Ottavio Moscatelo (Taveco), author of books and speaker in the fields of sports, personal and career coaching.
Paula Machado. How important is the guide for the general population and professionals in this field?
Elton Figueira. With the how-to guide published by Cref-4, physical education professionals will have complete guidance in understanding post-Covid sequels and how to assess and describe exercises, following exacerbation levels. The material distributed free of charge is the only one in the world with steps from understanding the causes of contamination and risk factors, mechanisms associated with sequelae and aspects associated with immune system barriers against coronavirus, a full range of physical assessment and the most complete guidance on exercise prescription. The people of Brazil will benefit from the work of professionals with more scientific information.
Paula Machado. What is the general advice for those with Covid-19 to return to training?
Leonardo Lima. The most important point is to conduct a clinical analysis focused on monitoring changes in inflammatory markers, disease exacerbation (level of virus infection) and sequelae, as well as clinical clinical release of physical activity. From these factors, we track the entire progress of the training, while respecting the integrity of the practitioner.
Paula Machado. What behavior should a student expect from a physical education specialist?
Musa Germano. The student should expect acceptance and knowledge. Welcoming is essential in the process of understanding the biological and psychological conditions of an individual infected with COVID-19, while knowledge is essential to reverse the negative changes caused by infection, and thus improve health standards. Above all, the professional should organize the training program with the aim of developing physical abilities, i.e. improving strength, endurance, strength, flexibility and cardiopulmonary conditioning. From the gains in physical abilities, gains in sleep quality, mood levels, stress, fatigue, and even greater effectiveness in exercise are to be expected, which is a key factor in adherence and longevity to the training program.
Paula Machado. What is the difference between the behavior adopted when a person has seasonal influenza and when they have the virus?
Luis Ottavio Moscatelo. Although influenza infection and covid-19 present similar symptoms at first, they are diseases that can cause complications at different levels. However, in both cases, at the time of the onset of greater symptoms, physical exercise should be avoided. In the case of COVID-19 infection, depending on the degree of involvement, after the patient recovers, the doctor will release the best time to start the protocols of breathing exercises and light intensity exercises related to resistance and muscle strength, which will be carried out gradually and accompanied. In the case of normal influenza, after improvement of symptoms and general condition, the practitioner can now resume the dynamics of the exercise routine, taking care to start with lower volumes and intensity than those before influenza, and gradually developing, initially trying to train and then resting for 48 hours.
* To access the book online for free, click here: Prescribing Practice Guidelines for Patients with SARS-CoV-2
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