Covid recovery program by Heilsustofnun Rehabilitation Clinic



Application summary:

The innovative program that Heilsustofnun Rehabilitation Clinic is presenting is the post-Covid rehabilitation program, designed by Heilsustofnun during the Covid-19 pandemic in 2021 as a reaction to the increase of post-Covid patients referred to the clinic. Majority of those patients are suffering from long-Covid symptoms, such as chronic fatigue, decreased stamina and cognitive impairment (“Brain fog”). Extensive tests have been conducted, and results show excellent results. Patients express increased stamina, increased muscular strength, less fatigue and better cognitive health (results in supporting materials).

1. Project Description:

The program is a 4-6 week inpatient rehabilitation program for patients recovering from Covid-19, with emphasis on patients suffering from medium to severe post-Covid symptoms.

At time of admission the patients meet with a physician, a nurse and a physiotherapist. Several test are administered, such as Quality of Life Scale, Chalder Fatigue Scale, Sit/stand 1 minute test and Walking 2 minute and 6 minute tests. Following this evaluation an individualized program is assembled. Patients take part in soft exercise, such as water gym, yoga, thai-chi, guided walks in the nearby nature, as well as mindfulness and meditation, massage and psychotherapy. Emphasis is on “Pacing”, a method for managing physical, mental and social energy levels, recognizing the body´s own limits and staying within them. The aim is to remain as active as possible while avoiding the relapses resulting from overexertion.

The program is individualized and administered by the post-Covid multidisciplinary team. Once per week the team evaluates the program and adjusts it to the needs of the patient. Before discharge the tests are repeated. As of to date the results have been excellent and promising for future rehabilitation of post-Covid patients. Those results are presented in supporting materials. 

2. Originality:

a. Is it unique (USP) and not adapted from other Health Spa Programme?

This program is unique, created by the clinical staff at Heilsustofnun and has not been adapted from any other facility.  

During the fall of 2020, Heilsustofnun started receiving referrals for patients recovering from Covid-19, with long-Covid symptoms such as extreme fatigue, shortness of breath, decreased stamina, decreased muscular strength, depression and overall decrease in quality of life. Heilsustofnun has good experience in working with patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) as well as other post-viral syndromes.  Most patients admitted after Covid-19 infection have abnormal tiredness as their main symptom, and some fulfil the criteria for CFS. The clinical team utilized this knowledge of CFS to construct a program aimed towards the need of the patients admitted for rehabilitation. Emphasis of the treatment is on calming the autonomous nervous system by using the signature elements at the clinic, geothermal water, peloid therapy/mud baths, the surrounding nature and healthy food. 

Being able to accommodate the patients 24.  hours a day, 7 days a week is an extremely important factor, as these patients can easily deplete their energy by doing simple tasks such as driving from home to an outpatient clinic. Heilsustofnun is the only rehabilitation clinic in Iceland that has provided inpatient rehabilitation for this clientele using the natural remedies the clinic can offer.

b. Is it meant for disease prevention and/or healthy lifestyle enhancement and/or overall health and/or wellbeing balance?

The program is intended for increasing overall health for patients suffering from post-Covid complications/long-Covid. The overall goal of treatment is to increase stamina, increase strength, improve mental health and increase quality of life through individualized treatment plans.

The emphasis of the treatment is on calming the autonomous nervous system and the immune system.  The clinic offers calm, supportive environment, healthy and clean vegetarian food, daily walks in nature surrounding the clinic. It also offers various relaxation methods such as warm indoor and outdoor swimming pools, sauna and steam baths, floating in warm water with specialized floating equipment, hot and cold-water therapies such as kneipp, hot/cold immersion therapy, and hot and cold water tubs. Patients also participate in yoga, mindfulness and tai-chi.

For long-Covid patients it is necessary to learn Pacing. Pacing is a method for managing physical, mental, and social energy levels. It is about learning to recognize the body´s own limits and staying within them. Most patients are able to undergo soft cardiac rehabilitation with careful monitoring of symptoms before and after. Water gymnastic is useful and good therapy for those patients with cardiac illness as well as yoga and tai chi for some.

Other treatments at the clinic incorporated in the program are massage therapy, acupuncture, physiotherapy and psychotherapy as needed.

c. Is there a methodology to measure and control the efficiency of the health programme?

The following tests are administered at admission and discharge:

  • Quality of Life Scale: Measured at the beginning and end of each client’s stay. Measures for example endurance, concentration, communication, sleep, anxiety, depression, physical health and pain
  • Chalder Fatigue Scale: Measures physical and mental fatigue in chronic fatigue syndrome patients
  • Sit/stand 30 sec and 1 minute test
  • Walking 2-minutes and 6-minute test
  • 30 sec arm curl test
  • Energy Diary: Scale 0-5 before and after activity (0 no energy – 5 full energy), monitored every day
  • VAS Scale: A Visual Analogue Scale (VAS) measures pain intensity, which has been widely used in diverse adult populations 

*Results from these tests are in supporting material

d. Does the programme include signature and/or local elements?

Utilizing the uniqueness of Heilsustofnun is key element in this program. Signature elements, such as geothermal water for balneotherapy and locally harvested mud for peloid therapy have been among the trademarks at Heilsustofnun for close to 70 years and are integrated into the program as a way of relaxation and pain management.

Geothermal heat is utilized in the swimming pools and balneotherapy treatments at Heilsustofnun, as well as to grow GMO free vegetables in the greenhouses at the clinic. Nutrition is an important part of the program, as a part of the holistic approach to wellness, recognizing the importance of a health promoting diet. Heilsustofnun offers mainly vegetarian food, and fish twice per week.  Location close to nature and the integrative approach to maintaining and improving overall health is as well essential to the rehabilitation approach at the clinic.

For patients with severe fatigue, it is essential to be able to stay at the clinic 24 hours a day, 7 days a week in private rooms as it can take very little in activities of daily living to deplete their energy.

3. Impact and benefits

Heilsustofnun builds on almost 70 years of experience in rehabilitation and illness prevention, and has a contract with the Icelandic Health Insurance. When patients with long-Covid symptoms started to get referred by their general physicians to the clinic in the fall of 2020, management and clinical staff made an effort to understand the medical needs of this group and build a program around them with the best possible service for their needs. By conducting various tests, the clinic was able to demonstrate that the treatment was giving great results. During 2021, the Icelandic Health Insurance initiated a contract with the clinic to serve patients with long-Covid symptoms. The success in the rehabilitation of these patients was among the reason the Icelandic Health Insurance initiated this contract for this group. This has also led to increased attention for other programs offered at the clinic from the public and the healthcare system. 

4. Sustainability

Sustainability and nature conservation is an extremely important factor at Heilsustofnun and is included in the mission of Heilsustofnun.  For example, Heilsustofnun grows own vegetables in greenhouses and on the grounds of the clinic, to as much extent as possible. Heilsustofnun has is own hot water system, providing the clinic with its own hot water and steam as well as its own cold water supply from nearby mountain. Additionally all electricity at the clinic is renewable green energy.

This year, The Nature Health Association of Iceland, owners of the clinic, began construction of apartments on the land of Heilsustofnun for individuals who want to enjoy the closeness and services of the clinic. This is a unique opportunity for those who prioritize good health and well-being, to live close to the clinic and enjoy the programs offered.

The apartments will be sustainable certified with the LEED certification system. Sustainable housing is not only healthy, but also contributes to lower operating costs and the ecological footprint is minimized both during construction and over the life of the housing. Since the apartments will be certified sustainable (LEED), buyers are offered green and more favourable loans from most credit institutions.

Additional supporting material:


Heilsustofnun NLFI
Graenamork 10, Hveragerdi, 810, Iceland