To contrast and reverse skeletal muscle weakness by Full-Body In-Bed Gym in chronic COVID-19 pandemic syndrome

Abstract

Mobility-impaired persons, either very old or younger but suffering with systemic neuromuscular disorders or chronic organ failures, spend small amounts of time for daily physical activity, contributing to aggravate their poor mobility by resting muscle atrophy. Sooner or later the limitations to their mobility enforce them to bed and to more frequent hospitalizations. We include among these patients at risk those who are negative for the SARS-COV-2 infection, but suffering with COVID-19 pandemic syndrome. Beside managements of psychological symptoms, it is mandatory to offer to the last group physical rehabilitation approaches easy to learn and self-managed at home. Inspired by the proven capability to recover skeletal muscle contractility and strength by home-based volitional exercises and functional electrical stimulation, we suggest also for chronic COVID-19 pandemic syndrome a 10-20 min long daily routine of easy and safe physical exercises that can activate, and recover from weakness, the main 400 skeletal muscles used for every-day mobility activities. Persons can do many of them in bed (Full-Body in-Bed Gym), and hospitalized patients can learn this light training before leaving the hospital. It is, indeed, an extension of well-established cardiovascular-respiratory rehabilitation training performed after heavy surgical interventions. Blood pressure readings, monitored before and after daily routine, demonstrate a transient decrease in peripheral resistance due to increased blood flow of many muscles. Continued regularly, Full-Body in-Bed Gym may help maintaining independence of frail people, including those suffering with the COVID-19 pandemic syndrome.

Fig 1.

The purpose of the routine is to contract all major skeletal muscles, alternating exercises to mobilize arms and legs, spine and neck, diaphragm and accessory ventilation muscles Duration of the routine (i.e., the number of repetitions and subsequently their speed of execution) must always reach the fatigue threshold.

Fig 2.

The aim of the routine is to contract all main skeletal muscles, alternating exercises to mobilize arms and legs, spinal cord and neck, diaphragm and ventilation accessory muscles. Intensity of the routine (as number of repetitions and then speed) must be up to fatigue threshold.

Fig 3.

The aim of the routine is to contract all main skeletal muscles, alternating exercises to mobilize arms and legs, spinal cord and neck, diaphragm and ventilation accessory muscles. Intensity of the routine (as number of repetitions and then speed) must be up to fatigue threshold.

Fig 4.

Arterial pressure and cardiac frequency before and after 10 minutes of Full Body in-Bed Gym (25 repetitions of each exercise, including push-up) during seven consecutive days (November 8 to 14, 2016). Mean +/- SD. After a self-challenging routine, cardiac and ventilatory frequency increased together with the maximal, but not the minimal arterial pressure. Indeed, the latter is more related to peripheral blood resistance. The exercise-induced increase of blood perfusion of all the main skeletal muscle of the body occurs if the series of exercise reach the level of fatigue threshold.