Physical Therapy in the Era of COVID-19

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Physical Therapy in the Era of COVID-19

physical therapist working on shoulder

 

The COVID-19 pandemic changes daily, leading to a growing record number of hospitalizations worldwide. COVID-19 primarily affects the lungs but also can influence heart and muscle joint complications. Patients affected directly by the coronavirus or who have limited physical activity due to self-isolation may notice problematic symptoms such as heightened fatigue, muscle weakness, difficulty breathing, poor endurance, and reduced balance.

During the pandemic, physical therapists provided invaluable support by doing their part to reduce strain on overwhelmed healthcare workers. Through proven methods, physical therapy supported patients with pain from delayed procedures, as well as becoming a critical component in treatment for coronavirus survivors.

How Does COVID-19 Reduce Body Function & Mobility?

According to the Centers for Disease Control and Prevention (CDC), older adults and people with serious underlying medical conditions – like asthma, pulmonary hypertension, cystic fibrosis, or chronic obstructive pulmonary disease (COPD) – have a higher risk for severe illness from COVID-19 and developing long-term complications. Patients surviving treatment from an intensive care unit may see symptoms associated with post-intensive care syndrome (PICS). Patients who develop PICS can experience a combination of symptoms, which range from muscle weakness, difficulty with walking and balance, trouble with taking care of themselves (dressing, bathing), apprehension towards driving and returning to work, and problems managing medications and finances.

Data also suggests that mental health problems have a higher risk of manifesting in patients recovering from COVID-19. Mental health symptoms range from mild anxiety or irritability to severe depression, sleep disturbances, and post-traumatic stress disorder. Cognitive changes may include difficulty thinking, remembering, or concentrating.

How Can Physical Therapists Provide Care During COVID-19?

Physician practices were hit hard by the COVID-19 pandemic, with many of them reducing office hours, spacing patient visits to increase social distancing, or increasing telemedicine capabilities. But most Physical Therapy clinics modified their daily procedures to better protect patients and doctors from exposure to the coronavirus. These procedural changes include:

• Continuous patient and staff screenings for potential Coronavirus (COVID-19) exposure
• Adhering to strict health and hygiene protocols
• Requiring all physical therapists, patients, and staff to wear face masks or face coverings in clinics
• Following the latest Centers for Disease Control guidelines, including frequent and thorough hand washing and sanitization throughout the day
• Sterilizing all clinic surfaces with medical-grade disinfectants
• Adhering to recommended social-distance practices when not delivering hands-on care
• Limiting the number of in-person office visitors
• Scheduling seniors and other at-risk patients into lower-traffic hours when possible

All patients should understand and respect the safety protocols in place. By ensuring your physical therapy provider takes the necessary steps to keep you safe from COVID-19, you can focus your energy on returning to your optimal level of body function and activity.

How Does Physical Therapy Support COVID-19 Recovery?

Physical therapists have an important role in supporting hospitalized COVID-19 patients. Rehabilitation care is vitally important for patients who experience any type of debilitating illness. Not every patient needs physical therapy, but for those who’ve been on ventilators for weeks and sometimes months, the ability to simply swallow, hold up their head, or sit up is a challenging task.

For some patients, recovering from the virus is just beginning. Without rehabilitation care, many post COVID-19 patients continue to have weakness and/or cognitive impairment for a period of time and in some cases permanently. Rehabilitation care may include a combination of:

Exercise Training
• Strengthening for breathing muscles
• Upper and lower body strengthening
• Balance and body reconditioning

Education
• Hygiene & nutrition
• Energy conservation
• Activity modification

Manual Therapy
• Torso and chest wall mobility
• Diaphragm stretching/release
• Breathing control/retraining
• Body positioning training

What is Pulmonary Rehabilitation and How Does it Benefit COVID-19 Patients?

Additionally, your physical therapist may implement a structured regimen focusing on pulmonary rehabilitation. Pulmonary Rehabilitation refers to the service and education program that physical therapists use for patients suffering from lung disease and other symptoms of breathlessness. Pulmonary rehabilitation can provide a myriad of benefits for COVID-19 patients, such as improving quality of life, decreasing symptoms of the disease/condition, increasing stamina, and decreasing shortness of breath. Individuals with chronic lung problems are more prone to depression, anxiety, and other emotional issues.

The Role of Telehealth in Physical Therapy

The way physical therapists deliver services underwent some changes in the wake of the Coronavirus. Due to the social distancing requirements stemming from the COVID-19 pandemic, video conferencing has become increasingly common. By utilizing video-based platforms, patients can connect with mental health therapists, nurse practitioners, and physicians with just a few clicks. Telehealth benefits patients recovering from COVID-19 through:

Increased Convenience: Using technology allows patients to communicate with virtual physical therapists from the safety of home
Easy Communication: Patients now have increased access to their healthcare providers.
Save Money: Patients no longer have to worry about taking a whole day off from work or traveling costs
Advanced Care: Patients can receive care rather than foregoing treatment to save time and money

However, patients who need assistance with movements, are at risk for falls, a movement disorder, or who have a neurological injury with a functional deficit should continue in-person physical therapy, if possible.