背景：疲憊是感染新型冠狀病毒後最常見的症狀，疲憊影響日常生活、生活品質下降，並造成運動不耐受，導致患者傾向避開身體活動，間接的造成心肺功能下降而更容易疲憊，形成惡性循環。過去文獻指出運動介入可降低慢性病患者的疲憊症狀，然而關於感染新冠病毒疾病（coronavirus disease 2019, COVID-19）又稱長新冠（long COVID-19）後的疲憊之研究卻仍欠缺一致性結果及整合。目的：本文目的為藉由文獻綜整，對COVID-19後疲憊症狀的運動介入方式進行整合，已提供臨床上未來照護此類病人之參考依據。方法：以系統性文獻回顧，歸納運動對COVID-19後疲憊影響的證據，蒐集Cochrane Library、Pubmed、Medline、CINAHL及CEPS等資料庫，刊登自2019年迄2024年1月的英文或中文為主之隨機對照研究都納入評讀。結果：多數研究顯示有氧運動合併肌力訓練對長新冠疲憊症狀具有緩解的效果，且多數支持須為期至少8週訓練效果才顯著，但相較對照組則差異不大，此外，不僅實證資料偏少，且結果不盡一致。部分研究資料甚至在運動處方的描述欠缺詳細說明，無統一報告標準，因此未能進行統合分析。結論／實務應用：運動對緩解長新冠疲憊的研究仍過少，未來需要更多嚴謹的研究探討運動對疲憊的影響。建議長新冠患者應時常檢視自己的身體狀況，在不加劇疲憊的情況下適當運動，有氧及肌力訓練皆要進行，每種運動一週至少進行2～3次，且持續時間至少8週，甚至維持規律長久的運動習慣。本文期望藉此提供臨床做為規劃長新冠病人健康促進策略之參考。
Background: Fatigue is the most common sequela after the novel coronavirus infection, negatively impacted quality of daily life and led to exercise intolerance. Patients with fatigue symptoms tend to avoid physical activities that further decline their cardiopulmonary functions, therefore, created a vicious cycle between the two problems. Literature review indicates that exercise intervention can reduce fatigue symptoms in patients with chronic diseases; however, studies on post-COVID-19 fatigue/long COVID-19 lack consistent results and integration. Purpose: The purpose of this paper is to synthesize the literature on exercise interventions for post-COVID-19 fatigue symptoms, to provide a reference for future clinical care for these patients. Methods: A systematic literature review to summarize evidence on the impact of exercise on post-COVID-19 fatigue. Collect studies published from 2019 to January 2024 in both English and Chinese from databases from Cochrane Library, Pubmed, Medline, CINAHL, and CEPS. Results: The majority of studies indicated that aerobic exercise combined with strength training had a moderate effect on long COVID fatigue symptoms. Most studies supported that exercise training need to last at least 8 weeks to effectively alleviate fatigue; however, the difference compared to control groups was not significant. There is insufficient empirical data and the results were also inconsistent. Some studies lack detailed descriptions of the exercise prescriptions. It impossible to conduct a meta-analysis when there is no consensus reporting standard. Conclusions/ Implications for Practice: There is limited research on exercise as a relief for long COVID fatigue; therefore, more rigorous studies are needed in the future to explore the impact of exercise on fatigue. It is recommended that long COVID patients regularly check their physical condition and exercise appropriately without exacerbating fatigue. Exercises recommended including both aerobic and strength training for at least 2-3 times a week, and for at least 8 weeks. The goal is to maintain a regular long-term exercise routine. This article hopes to provide a reference for clinical planning of health promotion strategies for long COVID patients.
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