Physiotherapy especially Cardio-respiratory physiotherapy has emerged as a vital piece of recovery for patients after Covid-19. It works hand in hand with medicinal care to ensure effective management of symptoms like dyspnea, recurrent cough, shortness of breath, fatigue among the Covid patients.
How physiotherapy can help people recover from COVID-19?
A recent information packet created by the Departments of Rehabilitation Medicine at Columbia University Irving Medical Center and Weill Cornell Medical Center as part of the New York-Presbyterian Hospital System, proposes Physiotherapy led Pulmonary Rehabilitation to maximize recovery from COVID-19. It proposes Pulmonary rehabilitation to help you improve your shortness of breath, increase your exercise capacity, and improve quality of life. These exercises include breathing exercises to strengthen the muscles of your chest as you recover from your lung infection; and muscle strengthening exercises which address the weakness and muscle loss that can occur after a lengthy hospital stay.
“Physiotherapy led Rehabilitation can be very important for those recovering from the virus,” says Dr Kavya Bhatia, Cardio-respiratory therapist at ReLiva Physiotherapy & Rehab; based on her experience with Covid-19 patients in India.
Physiotherapy for Effective Management of Symptoms of Covid-19
According to recent studies fever, cough, breathlessness, fatigue, bodyache are the cardinal symptoms of covid 19 which usually last for 7-14 days. But in some cases, it is reported that breathlessness, cough and fatigue may go on for longer. These patients are termed as “Long Haulers”. The symptoms for these persons may not be so acute to warrant a hospital stay but recurrent enough to keep them from getting back to their normal pre-Covid life. These patients are likely to benefit the most, from a comprehensive rehabilitation program like RespiRehab to manage and recover in a safe and timely fashion.
“RespiRehab incorporates different exercises for different patients as per their needs. But, in general, everyone can benefit from the program to help with mobility, cardiac and pulmonary function, flexibility, strength, endurance, mental health, independence and self-care management, and more.” Dr Huda (PT) said.
Is there anything in Physiotherapy for Preventive measures?
We had enough evidence to support the role of physiotherapy in management of cardiovascular and pulmonary conditions like COPD, but little was known about its pivotal role in treating the symptoms of Covid-19. As we head further into dealing with the virus globally, medical specialists alongwith physiotherapists have shown promising results in treating Covid 19 symptoms. It has also made its way into preventive measures being advised for asymptomatic patients and non-Covid persons. Afterall breathing better ensures overall good health for both mind and body.
Role of Physiotherapy in ICU for Covid-19:
The virus affects the lung parenchyma causing pneumonia which may exacerbate into Acute respiratory distress syndrome, pulmonary edema or multi organs failure which results in decreased pulmonary compliance, acute hypoxaemia which further increases work of breathing, leading to breathlessness. Meaning that one can adapt physiotherapy recommendations, more specifically the Dyspnea Relieving Positions according to their comfort.
While the patients are on ventilator, the physiotherapist may still mobilise them to edge of bed and ask to take few breaths. For those who are in critical care, physiotherapists can help with weaning off ventilators and beginning early rehabilitation to lessen the muscle deconditioning and weakness that happens during a severe illness.
Role of Physiotherapy in out-patients or acute settings of Covid-19:
Weakness or wasting of muscles along with emotional and mental symptoms, termed as DECONDITIONING, has been observed after discharge from intensive care units. To improve the strength of the muscles and make patients functionally independent (ADL), physiotherapist designs the Progressive Exercise Protocol for them accordingly. Relaxation techniques can also help these patients to improve their Psycho-social levels of well-being.
Cough production is a major symptom observed in these patients, so a physiotherapist can help them with appropriate airway clearance techniques for moving secretions and bringing them out by coughing. Since cough generates aerosols, it is important that Infection Control Guidelines are considered in order to reduce the contamination or droplets infection.
Physical Exercise for Good Health: Walk, Run, Jump
Most of us are aware of the benefits of exercises, but to gain maximum mileage out of it one must know the correct techniques and posture to perform them, by seeking guidance from a qualified and experienced physiotherapist. As the name suggests, thoracic expansion exercises can be used to expand the lungs to the fullest and improve the oxygenation as well as mobility of the thorax. According to the recent studies, regular and mild to moderate intensity exercises have shown the boosting effects on immune systems in Covid-19 patients, which includes aerobic exercises of upper and lower extremities, walking around, by continuous monitoring their vitals.
Exercising regularly can improve balance, strength, flexibility, mobility, cardiovascular endurance and psychosocial well-being by boosting their energy levels.
By adding few exercises into daily routine like static cycling, rope skipping, lunges, squats, push ups will improve the aerobic capacity and overall well-being in non-Covid population as well.
Physiotherapist Dr Kavya (PT) concludes, “Physiotherapists continue to educate patients on when and how to exercise, and what signs and symptoms to watch out, for during exertion that might slow their progress.”
This post is based on the inputs from Dr Kavya Bhatia (PT) and Dr Huda (PT). Dr Kavya is a Masters in Cardiorespiratory Sciences and Dr Huda is a physiotherapist. They are working closely with Covid-19 patients in Mumbai, helping them in their rehabilitation during the pandemic break in 2020.
