This resource will be continuously updated as evidence and guidelines emerge. Information was correct at time of publishing. Date Updated: 22/11/2022
Supporting Healthcare Professionals
Resources for GPs
When to refer to a Physiotherapist
You should consider referring a patient to physiotherapy if they are struggling to return to usual activity or have ongoing signs and symptoms of COVID-19 twelve weeks. You should only refer to physio once you have out ruled any other cause for their symptoms.
How to refer to a Physiotherapist
Physiotherapists play a key role in the care and treatment of COVID-19 patients in hospitals and at home.
On discharge patients may be referred on to the community physio or brought back to a COVID-19 clinic to monitor progress.
For patients who have not been admitted to hospital they may be referred to physio in the community by a GP or public health nurse. Patients may also self-refer to a physiotherapist in private practice. To find a list of physiotherapists in private practice who have completed training in treating Long COVID visit the ‘Find a Physio’ page and apply the filter ‘Long-COVID’ under conditions treated.
Post COVID-19 Clinics
Post COVID-19 Clinics specialise in the assessment and management of patients who have ongoing symptoms or issues 4 weeks or more after the start of their confirmed or suspected acute COVID-19 infection. A GP can contact their local hospital service to find out referral criteria.
Examples of how physios can help
Physiotherapists will assess and screen patients appropriately, referring onwards as required for further investigations and collaborate with the patient to create an individualised patient specific treatment plan, utilising goal setting to assist in the management of the following areas:
- Fatigue and activity management
- Breathing pattern disorders
- Breathlessness and airway clearance
- Persistent cough
- Reduced exercise tolerance
- Reduced range of movement in limbs
- Joint and muscle pain or discomfort
- Muscle weakness
- Post Exertional Symptom Exacerbation.
Medical Research and Resources on Physio Role in COVID-19
- World Physiotherapy Association https://world.physio/resources/covid-19-information-hub
- The Chartered Society of Physiotherapy (UK) https://www.csp.org.uk/publications/rehabilitation-adults-who-are-hospitalised-due-acute-covid-19-or-long-covid
Resources to support diagnosis and management in primary care
Management of post-acute covid-19 in primary care (Greenhalgh et al, 2020)
- Clinical assessment – history of symptoms and examination
- Investigations – may be required to understand causes of symptoms and exclude conditions
- Medical management and provision of self management advice (e.g. pulse oximetry, breathing techniques).
- Specialist referral may be required, e.g. pulmonary rehabilitation, cardiology referral
- Also consider comorbidities, social and financial circumstances, mental health
Helpful Links
- Support for rehabilitation: self-management after COVID-19-related illness | WHO
- https://world.physio/covid-19-information-hub/long-covid
- https://longcovid.physio/
- https://www.physio-pedia.com/Long_COVID
- Covid | COVID19 Updates | The Association of Occupational Therapists of Ireland (aoti.ie)
- Context | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE
- MEA-PVF-and-PVFS-Following-Coronavirus-Infection-30.04.20.pdf (meassociation.org.uk)
- How to manage post-viral fatigue after COVID-19 – RCOT
- Coronavirus: how physiotherapists are helping patients recover – Trinity News and Events (tcd.ie)
- https://www.csp.org.uk/publications/rehabilitation-adults-who-are-hospitalised-due-acute-covid-19-or-long-covid
- https://www.csp.org.uk/system/files/publication_files/001745_Community%20Rehab%20Standards_A4_Final.pdf
- https://www.nice.org.uk/guidance/ng188
- https://apps.who.int/iris/bitstream/handle/10665/332196/WHO-2019-nCoV-clinical-2020.5-eng.pdf
- https://world.physio/sites/default/files/2021-06/Briefing-Paper-9-Long-Covid-FINAL-2021.pdf
Patient Specific Links:
- NHS – YourCOVIDRecovery program – https://www.yourcovidrecovery.nhs.uk/
- LongCOVIDPhysio – https://longcovid.physio/