1. The document discusses fatigue experienced by some COVID patients, known as "Long COVID". It describes physical and mental fatigue and strategies to manage it. 2. It recommends activity pacing and graded exercise therapy. Activity pacing involves structuring activities with rest periods to avoid excessive mental or physical fatigue. Graded exercise therapy slowly increases the amount or intensity of exercise over time. 3. The strategies aim to help patients pace themselves and prioritize tasks based on their energy levels, taking rest breaks as needed to avoid running their "battery" flat and worsening their symptoms.

1. 1

3. By

4. “Long COVID”
What we know so far

21.  Fatigue is a feeling of exhaustion that does not get better
with sleep. It can be physical or mental/cognitive fatigue.
 Fatigue can change at different times and isn’t the same for
everyone.

26. Physical fatigue:
 Feeling low in energy, your body may feel heavy and you may
feel like you have lost a lot of strength.
 Even small tasks, like walking to the bathroom, might take up
a lot of energy.

29. Mental/cognitive fatigue:
 Your brain might feel foggy or cloudy, with even simple tasks
exhausting or difficult. You might find it hard to concentrate
and focus on work tasks.

31. Fatigue or tiredness? What’s the
difference?

33.  Fatigue after COVID is way more than just feeling tired.
Fatigue is more than being worn out or sleepy.
 It’s an excessive tiredness that persists despite resting or
good sleep. It’s likely a result of our body’s strong immune
response to the virus.

37. Two strategies:
Activity pacing and graded exercise therapy.

38. Activity pacing
 Is a strategy to help limit the amount of physical and mental
fatigue at any period of time, by structuring activities which
involve either physical or mental effort in between appropriate
rest periods.

39. Graded exercise therapy
 Aims to slowly progress either the amount or intensity of
exercise/activity an individual is able to complete and adapt
to over time. By beginning with a manageable level of exercise
or activity.

40. Graded exercise therapy
 Involves using the effects of exercise training to help increase
overall endurance, capacity and reduce the effects of fatigue
over time.

41. Activity pacing and graded exercise therapy.

42.  Pace yourself: adjust the return to normal activities
to your energy levels.
 Choose your priorities and focus on what you can do rather
than what you can’t.

59. Activity pacing
 Plan your tasks around your tiredness, and break up tasks
throughout the week.
 For example, instead of cleaning the house in one day, do
one room or part of that room each day.

60. Activity pacing
 Take as many rest periods as you need throughout the day
to recharge.
 If you are too tired to continue, that’s ok. Take a rest and
try again tomorrow.

61. 1. Don’t rush,slow down your rhythm as a slow and regular
rhythm uses less energy.
2. Break down difficult tasks into smaller steps
3. Take frequent breaks.
4. You should always aim to leave some energy at the end
of the exercise- Don’t keep going until you feel tired.
Pace yourself:

62. 1. Use correct lifting techniques. Sometimes it is easier to
push or pull an object than lift it .
2. Breathe out during the most strenuous part of your activity.
For example, breathe out when you stand up from a chair.
3. Sit rather than stand for activities when possible.
Be energy efficient:

64.  If you consider your energy as a battery,The aim of pacing
is to look after your battery and avoid running it flat:
always leaving something in there!
 You should always aim to leave some energy at the end of
the exercise- Don’t keep going until you feel tired.

67.  Many people find that they have slightly better and worse
days.
 On a better day, people are often more physically and/or
mentally active and they may tackle things they are normally
unable to do.

68.  “When people tackle too much on a better day they can
unintentionally run their battery flat.
 It can then take a while for them to re-charge the battery
whilst their body forces them to recover.
 Once the battery has some charge in it again, this can result
in them ‘overdoing things’ which in turn leads to feeling worse,
and the cycle continues of better and worse days. We refer
to this as ‘Boom and Bust’.

74.  Pacing is an important strategy to help you to work within
the limits of your fatigue. Overdoing it can make you feel
more exhausted.
 Stay within your current ability, and slowly progress your
activity levels as you feel able to do so.

75.  “Energy pacing is a fatigue management technique to help
conserve energy for those with chronic fatigue issues.
 Basically, it's allowing a short time of physical activity with
a rest period, so you don't overexert yourself”.

76. ACTIVITY PACING & GRADED EXERCISE THERAPY FOR CFS

78.  “When you start exercising initially, you may feel more tired
than usual. You may also feel that your energy levels are
decreased. We want to assure you that this is normal and you
should not worry at all.
 This may last for 4-6 weeks. While exercising, you should go
slow and increase your activities gradually.