Table 5.

The new combined post-COVID-19 exercise protocol.

Training	Modality	Frequency	Intensity	Duration
Aerobic continuous training	Walking or cycling	2→5 days/week; 150–300 min/week	Walking 80% of peak walking speed achieved on the 6 MWt; Cycling at 50–60%→70% WR max or 60–75%-->80–85% HR max estimated from 6 MWt or Borg 4–6→10; between AT and RC estimated from CPET	20–30 min→65 min per session; 8–12 weeks long
Interval training	Walking or cycling		Short bouts (10–30 s) of moderate–high intensity at 50–100% peak exercise capacity and a longer recovery (80–60 s)	30 min aerobic interval training (5 min bout + 1 min rest repeated 5 times)
Resistance/ Strength training	Upper and lower body strength	2–3→5 times/week	10–15→40→80% of 1 RM; 3–5 on Borg scale; wall push-ups, chair squat, dumbbells shoulder press, dumbbells biceps curls, dumbbells arm extension and abdominal curl-ups	8–12→15 repetitions with 1 min of rest between steps for 1–3→4–6 times; 10→45 min for each session
Inspiratory muscles training	Using a commercial hand-held resistance	2 times/day; 2 sessions/week	60% of maximal expiratory mouth pressure	3 sets with 10 breaths in each set with a rest period of 1 min
Cough Exercise	Under the guidance of a rehabilitation therapist	2 sessions/week		3 sets of 10 active coughs
Diaphragmatic muscle training	Supine position	2 sessions/week	placing a medium weight (1–3 kg) on the anterior abdominal wall to resist diaphragmatic descent	30 maximal voluntary diaphragmatic contractions
Stretching Exercise	Supine or lateral decubitus with the knees bent to correct the lumbar curve, moving their arms in flexion, horizontal extension, abduction and external rotation		Titrate to symptoms	One set of 4–5 stretching exercises for 15–30 s
Balance Exercise	Leg stances, semi-tandem and tandem stance, toe walking, heel walking, tandem gait, walking on a balance board, eye–hand and eye–leg coordination; under the guidance of a rehabilitation therapist	2–3 days/week		Among the different training days
Flexibility Exercise	Static and dynamic stretching leading to progressive increase in range of motion; dynamic stretching in warm-up, whereas static stretching exercise at the end in the cool-down phase; under the guidance of a rehabilitation therapist	2–3→5 days/week	5 min long
Slow breathing Sessions	The patient connected to a device providing rhythmic sounds for the progressive lowering of the respiratory rate	6 b/min 30′ daily		20–30 min for every daily session