@article{Berry_C-2025_217907,
title = {Resistance exercise therapy after COVID-19 infection: a randomized, controlled trial},
author = {Berry, C. and McKinley, G. and Bayes, H. and Anderson, D. and Lang, C. and Morrow, A. and Sykes, R. and Taggart, D. and Kamdar, A. and Welsh, P. and Dawkes, S. and McConnachie, A. and Gray, S.},
month = {nov},
year = {2025},
abstract = {Importance: Long COVID presents an unmet therapeutic need. Objective: To determine the effects of a resistance exercise intervention on exercise capacity in adults after COVID-19 infection. Secondary objectives included assessments of health status. Design: A two-arm randomized, controlled clinical trial including adults with a hospital or community diagnosis of COVID-19 in the preceding 12 months was undertaken during June 2021-April 2024. Setting: Community and secondary care, multicenter. Participants: 233 individuals with Long-COVID were randomized. 117 (50.2%) individuals were assigned to the intervention group, and 116 (49.8%) individuals were assigned to the control group. Shuttle walk tests at baseline and 3-months were completed in 224 and 193 participants, respectively. Intervention: Personalized resistance exercise intervention for 3-months. Control: Treatment-as-usual. Main outcome measures: The primary outcome was the distance achieved (m) in the incremental shuttle walk test undertaken 3-months after randomization. Secondary outcome measures included health-related quality of life (EQ-5D-5L), anxiety and depression (Patient Health Questionnaire) and grip strength. Results: 233 adults (median (interquartile range) 53.6 (43.8, 60.8) years; 146 (62.7%) female, 91 (39.1%) hospitalized with COVID-19) were randomized (n=117 (50.2%) intervention group, n=116 (49.8%) control group). The median (interquartile range) percentage adherence with the exercise intervention was 71.0 (47.8, 96.8), equivalent of performing the exercises on 5 days/week. The mean (SD) distances achieved in the incremental shuttle walk test at baseline and at follow-up were 328 (225) m and 389 (249) m, in 224 and 193 individuals, respectively. The change in incremental shuttle walk test distance at three months compared to baseline was 83 (118) m in the intervention group (n=94) and 47 (95) m in the control group (n=98) (effect estimate (95%) confidence interval 36.5 (6.6, 66.3) m; p=0.017). By three months, compared to the control group, greater improvements in the intervention group were also observed for the health-related quality of life utility score (EQ-5D-5L) (0.06 (0.01, 0.11); p=0.018), Patient Health Questionnaire category (0.5 (0.2, 0.8); p=0.013) and handgrip strength (2.58 (0.92, 4.24) kg; p=0.002). Conclusions and Relevance: In this randomized clinical trial, a program of resistance exercise for 3 months in adults after COVID-19 infection improved exercise capacity and appeared to improve health-related quality of life, anxiety and depression, and grip strength.},
volume = {8},
issue = {11},
journal = {JAMA Network Open},
publisher = {American Medical Association},
url = {https://doi.org/10.1001/jamanetworkopen.2025.34304},
}
