Date of Award
Spring 2025
Document Type
Dissertation
Degree Name
Doctor of Physical Therapy (DPT)
Department
Physical Therapy
First Advisor
Sandra Hunter
Second Advisor
Linda Piacentine
Third Advisor
Marie Hoeger Bement
Fourth Advisor
Paula Papanek
Abstract
Coronavirus (COVID-19) is caused by the SARS-CoV-2 virus. Long COVID is secondary to an acute COVID-19 infection and is characterized by chronic symptoms that persist for >3 months after initial infection with minimal information about the mechanisms and who is most vulnerable. Further, the protective effects of physical activity (PA) on the acute symptoms of COVID-19 and persistent symptoms of Long COVID are not known. The purpose of this dissertation was to determine (1) PA levels before, and after COVID-19 infection, and the persistent effects of COVID-19 on (2) physical function and (3) psychological health in non-hospitalized COVID-19 survivors. We hypothesized that higher PA prior to infection would lessen the acute and persistent symptoms affiliated with Long COVID in people who had not been hospitalized for their acute COVID-19 infection. Aim one demonstrated that PA (self-reported) declined in COVID-19 survivors from pre-COVID-19 to an average of 8.5 months following infection and rebounded to levels similar to pre-COVID on average 4.25 years later. PA declined the most among participants who reported Long COVID symptoms after initial infection. Furthermore, both COVID-19 survivors and age- and sex- matched controls (non-COVID) experienced reduced PA, highlighting the broader impact of the pandemic on activity levels. Aim two demonstrated that persistent symptoms in COVID-19 survivors had a negative impact on muscular and cardiopulmonary function, potentially influencing exercise tolerance even 8.5 months after infection. However, higher levels of PA prior to COVID-19 infection appeared to help preserve maximal handgrip and lower-extremity muscle strength, maximal oxygen utilization (predicted V̇O2), and pulmonary function in people who experienced Long COVID symptoms. Aim three demonstrated greater self-reported fatigue, depression, anxiety and stress in COVID-19 survivors compared with matched controls. These attributes of psychological health were worse in COVID-19 survivors who reported the most symptoms acutely and in people with Long COVID symptoms. These dissertation findings highlight the critical role of PA in mitigating some of the long-term effects of COVID-19 on physical and psychological health. These results emphasize the importance of promoting PA to support recovery, maintain functional and performance abilities, and maintain the overall well-being in COVID-19 survivors.
