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Physiotherapy post COVID-19

This resource will be continuously updated as evidence and guidelines emerge. Information was correct at time of publishing. Date Updated: 22/11/2022

Alongside doctors and nurses, physiotherapists have played a key role in the care and treatment of COVID-19 patients in hospitals and at home.

If you are admitted to hospital with COVID-19 physios will be involved in your acute respiratory care as well as helping you become fit enough to return home. Depending on how unwell you are you may need rehab to help you learn to sit up by yourself and walk again as well as ongoing respiratory physio support to help you manage breathlessness and secretions. On discharge you may be referred on to the community physio or brought back to a COVID 19 clinic to monitor your progress.

If you have not been admitted to hospital you may be referred to physio in the community by your GP or public health nurse. You may choose to access a private physio in which case you can self refer.

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

What to expect from a Physio session

Physiotherapists will pace activity and potentially see patients more often for shorter treatment sessions. It can be exhausting for patients with Long COVID fatigue symptoms and rehabilitation will be carefully planned and paced to the needs of each individual.

Recovery and rehabilitation may take time so the use of ”tele-health” or other remote physiotherapy might be used to support patients.

The World Health Organization recommends that Long COVID rehabilitation should include educating people about resuming everyday activities conservatively, at an appropriate pace that is safe and manageable for energy levels within the limits of current symptoms, and exertion should not be pushed to the point of fatigue or worsening of symptoms.

Physical activity and exercise interventions warrant caution as rehabilitation strategies among people with Long COVID and persistent symptoms of disproportionate breathlessness on exertion, inappropriately high heartbeat (tachycardia), and/or chest pain. Exercise prescription in Long COVID should be approached with care to minimise risk and to ensure exercise programmes are restorative and do not make the individual’s symptoms worse.  Rehabilitation should aim to prevent oxygen desaturation on exertion. A specialist respiratory physiotherapist may help where there are signs of hyperventilation and breathing pattern disorders.

Graded exercise therapy should not be used, particularly when post-exertional symptom exacerbation is present.

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