Long COVID rehabilitation for physical therapists. Post-acute COVID syndrome (PASC), chronic COVID symptoms, post-exertional malaise, dysautonomia, fatigue, exercise intolerance, pacing strategies, PT treatment protocols from Mount Sinai NYC.
COVID Long Haulers: What PTs Need to Know | Mount Sinai ARC Inservice w/ Jenna Tosto
What happens when “mild” COVID doesn’t go away?
00:00 – Chronic COVID Is Not “In Your Head”
02:45 – From Stroke Rehab to COVID Pivot
05:45 – The 5–15% Long Hauler Reality
09:10 – The Symptom Cluster PTs Must Recognize
13:46 – Building the Interdisciplinary Team
18:00 – Level A: Stabilize Before You Push
21:54 – Level B: Aerobic Rehab (Done Carefully)
26:17 – 6-Minute Walk Test & VO₂ Max Strategy
27:38 – The Levine Protocol Adapted for Long COVID
43:42 – This Is PT’s Time to Shine
An estimated 5–15% of patients with mild to moderate COVID infections develop persistent symptoms — fatigue, brain fog, dyspnea, dysautonomia, exercise intolerance, and more. These “Long Haulers” are showing up in outpatient clinics, often misunderstood and often under-treated.
In this inservice from the Mount Sinai Abilities Research Center (NYC), Jenna Tosto breaks down:
• What we’re actually seeing in Long COVID patients
• Why traditional rehab models can backfire
• The red flags PTs must recognize
• The treatment paradigms Mount Sinai is using right now
• How to safely dose activity in patients with post-exertional symptom exacerbation
If you’re a physical therapist treating post-COVID patients — or you’re about to — this is essential viewing.
Because recovery isn’t just about lungs.
It’s about load management, autonomic regulation, pacing, and precision.
Science isn’t finished until it’s applied.
