Volume 28, Issue 10 (12-2021)                   RJMS 2021, 28(10): 25-39 | Back to browse issues page

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jamali A, Shahrbanian S. The Effects of Exercise on Cognitive Dysfunction in Patients with Coronavirus and Sports Recommendations for Their Recovery. RJMS 2021; 28 (10) :25-39
URL: http://rjms.iums.ac.ir/article-1-7011-en.html
Department of Sport Sciences, Faculty of Humanities, Tarbiat Modares University,Tehran, Iran , sh.shahrbanian@modares.ac.ir
Abstract:   (1780 Views)
Background & Aims: Beginning in 2020, a deadly disease called COVID-19 spread throughout the world, plunging all countries into a viral infection. Viral infections are naturally associated with upper respiratory tract infections, which are commonly reported with fever, headache, and cough. COVID-19 virus can infect a person's respiratory system and lungs, eventually leading to death. The virus can first activate and infect macrophages. Macrophages then transfer COVID 19 to T cells and make them weak. In addition, by weakening T cells, T cell subsets are activated to increase cytokines to enhance the immune response. T cells, CD4 + T cells and CD8 + T cells play an important antiviral role in the body. It is noteworthy that CD4 + T cells in the body produce T cell-dependent (B) cells to increase virus-specific antibodies. On the other hand, CD8 + T cells are a toxic cell and can kill virus-infected cells. Most published studies have focused on the effect of aerobic exercise on immune system function. Recent studies have shown that tai chi and yoga exercises can also be beneficial for immune system function. Exercise has long been known as an important modulator of inflammatory processes. Exercise can apparently have both tonic and suppressive effects on the immune system. The effect of exercise on innate and acquired safety parameters depends on the intensity, load and duration of exercise. As the severity increases, immune function and ultimately the risk of infection increase. These risks depend on immune system regulators (genetics, nutritional status, psychological stress, circadian rhythms), environmental stressors (extreme temperatures, airway irritants) that increase inflammation. In response to exercise, immune cells grow, proliferate, and produce molecules such as cytokines and cytotoxic granules. Prolonged exercise, at least in healthy individuals, appears to reduce basal inflammatory status by reducing the circulation of inflammatory cytokines. Regular periods of short-term training (i.e., up to 45 minutes) with moderate intensity boost the immune system (increase T cells) while frequent periods of long-term high-intensity training (> 2 hours) can suppress the immune system. Acute exercise, even in healthy individuals, leads to a strong inflammatory response that is mediated by leukocyte mobilization (even for short periods of 6 minutes) and increases potent inflammatory mediators such as TNF-α, IL-1. The effect of increasing aerobic capacity on improving lung function and preventing lung injury can be summarized in four mechanisms. The first mechanism of aerobic exercise can prevent the suppression of the immune system by affecting the immune system and increase anti-inflammatory factors. The second mechanism contains the role of aerobic capacity in restoring the elasticity of lung tissue to normal and increasing the strength and endurance of the respiratory muscles, which helps increase ventilation, and reduce lung damage. The third mechanism includes the role of aerobic capacity as an antioxidant to limit the production of free radicals and oxidative damage. The fourth mechanism involves the role of aerobic capacity in reducing cough and clearing the airways by improving pulmonary safety and autonomic modulation.
Methods: Google Scholar, ScienceDirect, PubMed, Scopus, SID, Noor, and Magiran databases were reviewed to find studies with exercise training on cognitive impairment in patients with coronavirus and exercise recommendations for their recovery.
Results: New research has shown that neurological complications are emerging as an important cause of disease and mortality in the COVID-19 epidemic. In addition to the respiratory failure caused by COVID-19, many hospitalized patients report neurological manifestations ranging from headache and loss of smell to confusion and stroke. It is also predicted that the COVID-19 can damage the nervous system in the long run. The entry of SARS-COV-2 into human tissues is facilitated by ACE2. However, the lack of ACE2 receptors in the central nervous system (CNS) does not mean that it is resistant to this type of virus. It has been suggested that the virus can reach CNS through the neural circuitry in trans synaptic pathways. One of the consequences of COVID-19 pandemic and its quarantine is depression. Researchers believe that exercise can effectively reduce depression, and one of the strongest modulators of neuroprotective and antidepressant effects of physical activity and exercise is Brain-derived neurotrophic factor (BDNF). Many areas of the brain are affected by depression, but the area that is most often affected in people with depression is the hippocampus, which is involved in memory, emotional processing and stress management. The effect of exercise on the brain can have systemic effects on the whole body because exercise-induced euphoria is associated with the release of endogenous opioids (endorphins), which are significantly increased after running. The adaptive effects of exercise depend on the intensity and duration of the training sessions. Available data suggest that to strengthen the immune system, moderate-intensity exercise for up to 45 minutes can help the immune system adapt. On the other hand, strenuous exercise can suppress the function of the immune system, causing infection of the upper respiratory tract and reappearance of the latent virus.
Conclusion: During the COVID-19 pandemic, quarantine is the best way to prevent infection, but its consequences can weaken the physical, mental, and emotional well-being of individuals. Home-based sports activities can be a good way to prevent or control the above-mentioned issues. Providing training models unique to the target community according to its characteristics and conditions can play an effective role in maximizing the benefits of exercise. Given the potential for the brain to be negatively affected by quarantine-induced inactivity and the possibility of coronavirus invading brain tissue, exercise appears to be effective in brain health. During the quarantine period, all groups in the community must maintain their health by following the WHO physical activity recommendations for at least 150 minutes of moderate-intensity exercise. Considering the decline in cognitive function in old age and its aggravation along with implicit diseases It is better for the elderly to exercise in a way that stimulates their nerves and muscles. It is not clear, so that the exercise of these people improves their memory and executive function.
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Type of Study: review article | Subject: Exercise Physiology

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