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Post-COVID-19 Muscle Health and Exercise Rehabilitation
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Post-COVID-19 Muscle Health and Exercise Rehabilitation

A special issue of COVID (ISSN 2673-8112). This special issue belongs to the section "Long COVID and Post-Acute Sequelae".

Deadline for manuscript submissions: 30 November 2026 | Viewed by 4091

Special Issue Editor

Dr. Eleni Kortianou

E-Mail Website
Guest Editor
Clinical Exercise Physiology and Rehabilitation Laboratory, Physiotherapy Department, University of Thessaly, Lamia, Greece
Interests: cardiac and pulmonary rehabilitation; physiotherapy in ICU patients; physical activity in adults with chronic respiratory; cardiac and metabolic dysfunctions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is great concern about persistent symptomatology and functional impairment among patients who recovered from COVID-19 infections. Fatigue and exercise impairment may be evident in a significant proportion of patients who present with muscle atrophy, weakness, and, consequently, reduced physical performance.

On the biochemical level, exercise triggers different cellular and molecular pathways that have beneficial effects on the tissues and reduce the concentration of proinflammatory cytokines, contributing to improvements in muscle health.

Exercise-induced bioactive molecules, named exerkines, play a crucial role in skeletal muscle development, mitigate anti-inflammatory-driven pathologies, and promote systemic beneficial effects. Exerkines have emerged as key mediators of the health benefits associated with physical activity and systematic exercise.

Effective rehabilitation strategies (face-to-face, remote, synchronous, and asynchronous) are essential to counteracting the effects of muscle dysfunction, promoting recovery, and restoring functional independence. 

This Special Issue, “Post-COVID-19 Muscle Health and Exercise Rehabilitation”, aims to present innovative approaches and evidence-based practices for improving muscle health and rehabilitation in post-COVID-19 individuals. We invite contributions that address a wide range of topics, including the underlying mechanisms of muscle dysfunction post-COVID-19, the role of exercise interventions, nutritional support, and other multidisciplinary approaches to optimize recovery.

The Special Issue also welcomes research on population-specific challenges, such as in older adults or individuals with pre-existing conditions, as well as novel technological or therapeutic advancements for enhancing rehabilitation outcomes.

Dr. Eleni Kortianou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. COVID is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • post-COVID-19
  • long-COVID-19
  • muscle health
  • physical exercise
  • exerkines
  • muscle atrophy
  • inflammation
  • biomolecules
  • rehabilitation
  • physical activity

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Published Papers (3 papers)

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Research

11 pages, 384 KB  
Article
Intra-Rater Reliability of 30 s Sit-To-Stand and Timed-Up-and-Go Tests in Older Adults with Post-COVID-19 Syndrome: A Pilot Study
by Marina Kloni, Alexandros Heraclides, Theognosia Panteli, Alexios Klonis, Panagiotis Rentzias and Christos Karagiannis
COVID 2026, 6(5), 77; https://doi.org/10.3390/covid6050077 - 28 Apr 2026
Viewed by 44
Abstract
Background: Post-COVID-19 syndrome (PCS) is associated with impairments in mobility, balance, and physical function, which may reduce quality of life. The 30 s Sit-to-Stand (30STS) and Timed Up and Go (TUG) tests are widely used clinical measures; however, their intra-rater reliability in older [...] Read more.
Background: Post-COVID-19 syndrome (PCS) is associated with impairments in mobility, balance, and physical function, which may reduce quality of life. The 30 s Sit-to-Stand (30STS) and Timed Up and Go (TUG) tests are widely used clinical measures; however, their intra-rater reliability in older adults with PCS has not been established. Reliable outcome measures are essential for clinical assessment and rehabilitation planning. Methods: In this single-center pilot study, nineteen older adults with PCS were recruited as a convenience sample. Participants completed three trials of the 30STS and TUG tests on day one, with the protocol repeated after three days. The 30STS evaluates lower-limb strength and functional performance, while the TUG assesses balance, gait, and fall risk. Intra-class correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC) were calculated. Results: The TUG showed an ICC of 0.995 (95% CI: 0.991–0.998), SEM of 0.48 s, and MDC of 1.33 s. The 30STS showed an ICC of 0.986 (95% CI: 0.973–0.994), SEM of 0.26 repetitions, and MDC of 0.72 repetitions. Conclusions: The TUG and 30STS demonstrate excellent intra-rater reliability and appear to be feasible clinical tools for assessing functional performance in older adults with PCS. However, findings should be interpreted cautiously due to the small, single-center pilot design and single evaluator. Further research is needed to confirm generalizability across broader PCS populations and clinical settings. Full article
(This article belongs to the Special Issue Post-COVID-19 Muscle Health and Exercise Rehabilitation)
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19 pages, 397 KB  
Article
Functional Dependence in Brazilian Adults One Year After COVID-19 Infection: Prevalence and Risk Factors in a Cross-Sectional Study
by Natália Milan, Carlos Laranjeira, Stéfane Lele Rossoni, Amira Mohammed Ali, Feten Fekih-Romdhane, Wanessa Baccon, Lígia Carreira and Maria Aparecida Salci
COVID 2026, 6(1), 23; https://doi.org/10.3390/covid6010023 - 20 Jan 2026
Viewed by 695
Abstract
One of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on [...] Read more.
One of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on quality of life, plan rehabilitation and healthcare, identify the most vulnerable groups, measure the socioeconomic impact, and support public policies and clinical decisions. Objectives: The objectives of this study are as follows: (a) to assess the prevalence of functional dependence in Brazilian adults with COVID-19; (b) to analyze the association between the study variables; and (c) to determine the factors associated with functional dependence. Methods: This was an observational, cross-sectional study with 987 adults (18 to 59 years old) living in the State of Paraná (Brazil) hospitalized for COVID-19 between March and December 2020. Data were collected by telephone 12 months after the acute infection using an instrument to retrieve sociodemographic and health information, and a functional dependence scale to assess dependence before COVID-19 retrospectively (using participant recall information) and at the time of the interview. Data were analyzed using penalized logistic regression after imputing missing data. Data were analyzed using penalized logistic regression after imputing missing data. Results: Functional dependence after COVID-19 was 5.0% and was associated with low levels of education, not having a partner, living with someone, not owning a home, experiencing job changes, requiring care, obesity, smoking, multimorbidity, ICU admission in the acute phase, use of invasive ventilation, or having Long COVID. Individuals who required care or used invasive ventilation support were, respectively, 9.3 and 6.5 times more likely to develop dependence after COVID-19. Despite adjustment for multiple factors, the magnitude of the observed effects warrants cautious interpretation, as unmeasured or residual confounding effects may still be present. Sample recall bias due to collection after 12 months and the presence of the alpha variant without COVID-19 vaccination coverage may limit data generalization. Conclusions: The results highlight the need to emphasize the public health implications of identifying functional dependence. In this vein, it is necessary to implement preventive measures, identify and monitor more vulnerable groups, plan rehabilitation programs, and develop public health policies. Full article
(This article belongs to the Special Issue Post-COVID-19 Muscle Health and Exercise Rehabilitation)
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29 pages, 1086 KB  
Article
Balneotherapy Enhances Musculoskeletal Health and Fatigue in Post-COVID-19 Patients: Results from a Longitudinal Single Blind Randomized Trial
by Lolita Rapolienė, Giedrė Taletavičienė, Aelita Bredelytė, Antonella Fioravanti and Arvydas Martinkėnas
COVID 2026, 6(1), 5; https://doi.org/10.3390/covid6010005 - 23 Dec 2025
Cited by 2 | Viewed by 1066
Abstract
Background: Balneotherapy (BT) has been proposed as a supportive intervention for post-COVID-19 musculoskeletal (MSK) and fatigue-related symptoms; however, comparative evidence across different BT delivery modes remains limited. This study aimed to evaluate the long-term effects of a BT-based treatment program on MSK health [...] Read more.
Background: Balneotherapy (BT) has been proposed as a supportive intervention for post-COVID-19 musculoskeletal (MSK) and fatigue-related symptoms; however, comparative evidence across different BT delivery modes remains limited. This study aimed to evaluate the long-term effects of a BT-based treatment program on MSK health and related functional outcomes in individuals with a history of COVID-19. Methods: This secondary analysis was derived from a multicenter, randomized, controlled, single-blinded trial conducted from January to September 2023 across six Lithuanian medical spa centers. Participants with a self-reported history of COVID-19 and persistent multisystem symptoms were assigned to one of three BT modalities or a control group. Primary outcomes included MSK pain, muscle tension and spasm, handgrip strength, and trunk flexibility. Secondary outcomes included fatigue, sleep, quality of life, and analgesic use. Assessments were performed at baseline, post-treatment, and at three- and six-month follow-ups. The 2-week BT program consisted of daily sessions of light pool exercise, mineral baths, sapropel body wraps, and halotherapy. Data were analyzed using repeated-measures GLM in IBM SPSS Statistics (version 28.0). Results: Significant time effects were observed for MSK pain, muscle tension, spasms, fatigue, sleep disturbance, flexibility, and quality of life (all p < 0.05). Improvements occurred primarily within groups and were most pronounced immediately post-treatment, with partial maintenance at 3–6 months. Between-group differences were modest; however, ambulatory BT, inpatient BT, and BT combined with nature therapy demonstrated greater long-term improvements in several outcomes. Conclusions: BT was associated with beneficial changes across MSK and psychosocial domains in individuals recovering from COVID-19, although differences between BT modalities were limited. These findings support BT as a complementary component within multimodal post-COVID rehabilitation frameworks and highlight the need for further research on long-term maintenance and individualized treatment strategies. Full article
(This article belongs to the Special Issue Post-COVID-19 Muscle Health and Exercise Rehabilitation)
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