{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:06:56Z","timestamp":1789578416999,"version":"build-2803163510"},"reference-count":114,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Federal University of Rio Grande do Norte (UFRN), Brazil"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Introduction: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This study aimed to evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19. Methodology: A randomized clinical trial was conducted with 30 survivors allocated to two groups: multicomponent exercise (GEm) and multicomponent exercise combined with inspiratory muscle training (GEmTMI). The interventions were performed three times per week for 40\u201360 min. Quality of life, physical activity level, functional status, and physical capacity were assessed before and after six weeks. Results: Comparisons between GEm and GEmTMI showed significant differences in the 6 min walk test (6MWT) at baseline (p = 0.043) and in the Physical Activity Index (IPAQ) after the intervention (p = 0.002). When the total sample was analyzed, significant improvements were observed across all outcomes after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), physical activity level (IPAQ), respiratory muscle strength, and additional functional tests. Notable improvements included SF-36 Physical Functioning (p = 0.006) and Social Functioning (p = 0.009), PCFS (p = 0.011), IPAQ (p = 0.012), and performance in the 6MWT, STS, STS-1min, TUG, handgrip strength, PEmax, and PImax (all p &lt; 0.001). Discussion: Multicomponent physical rehabilitation, with or without inspiratory muscle training, produced significant gains in physical activity level, functional capacity, dynamic balance, neuromuscular fitness, respiratory muscle strength, and quality of life. These findings underscore the importance of structured post-ICU rehabilitation to support comprehensive physical and psychosocial recovery in survivors of severe COVID-19.<\/jats:p>","DOI":"10.3390\/medsci14020222","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:31:56Z","timestamp":1777465916000},"page":"222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exercise-Based Rehabilitation in Severe COVID-19 Survivors with Long COVID: A Randomized Controlled Pilot Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-292X","authenticated-orcid":false,"given":"Edson Fonseca","family":"Pinto","sequence":"first","affiliation":[{"name":"Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil"},{"name":"Department of Physical Education, State University of Rio Grande do Norte\u2014UERN, Mossor\u00f3 59625-900, Brazil"},{"name":"Systematic Review and Metanalysis Laboratory (Lab-Sys\/CNPq), Federal University of Rio Grande do Norte, Natal 59078-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-5406","authenticated-orcid":false,"given":"Nailton Jos\u00e9 Brand\u00e3o","family":"Albuquerque Filho","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Federal Rural University of Pernambuco\u2014UFRPE, Serra Talhada 56909-535, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica Costa","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, UNIFACISA University Center\u2014Para\u00edba, Mossor\u00f3 59625-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatianne Moura Estrela","family":"Gusm\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, UNIFACISA University Center\u2014Para\u00edba, Mossor\u00f3 59625-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa Nayara","family":"de Souza","sequence":"additional","affiliation":[{"name":"Graduate Program in Health and Society\u2014PPGSS, State University of Rio Grande do Norte, Mossor\u00f3 59625-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9517-6823","authenticated-orcid":false,"given":"Roque Ribeiro da","family":"Silva J\u00fanior","sequence":"additional","affiliation":[{"name":"Multicenter Graduate Program in Physiological Sciences (PPGMCF), Faculty of Health Sciences, State University of Rio Grande do Norte (UERN), Mossor\u00f3 59625-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Irany","family":"Knackfuss","sequence":"additional","affiliation":[{"name":"Department of Physical Education, State University of Rio Grande do Norte\u2014UERN, Mossor\u00f3 59625-900, Brazil"},{"name":"Graduate Program in Health and Society\u2014PPGSS, State University of Rio Grande do Norte, Mossor\u00f3 59625-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2343-7251","authenticated-orcid":false,"given":"Grasiela","family":"Piuvezam","sequence":"additional","affiliation":[{"name":"Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil"},{"name":"Systematic Review and Metanalysis Laboratory (Lab-Sys\/CNPq), Federal University of Rio Grande do Norte, Natal 59078-970, Brazil"},{"name":"Department of Public Health, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","unstructured":"Cascella, M., Rajnik, M., Aleem, A., Dulebohn, S.C., and Di Napoli, R. 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