COVID-19 is a disease caused by the coronavirus SARS-CoV-2. Coronaviruses are large single-stranded RNA viruses that infect humans and a wide array of animals. It is thought that SARS-CoV-2 succeeded in making its transition from animals to humans in the Huanan seafood market in Wuhan, China.

COVID-19 typically attacks the respiratory system but can also affect other organs. Symptoms tend to arise around 2-5 days after a person is infected but can take up to 14 days to show. A person with COVID-19 can be infectious for up to 2 days before displaying symptoms.

COVID-19: Physiotherapy Management 




  • Inspiratory muscle training may be included in the post-acute phase to recondition inspiratory muscles.
  • Deep, slow breathing, thoracic expansion (with shoulder elevation), diaphragmatic breathing, mobilization of respiratory muscles, airway clearance techniques (as needed), and positive expiratory pressure devices can be added based on assessed needs.
  • Care must be taken to avoid overloading the respiratory system and causing distress, therefore aerobic exercise must be implemented gradually when suitable.


Long COVID-19:

  •  Strong focus on breathing pattern disorders and managing post-exertional malaise (fatigue).
  • Education on self-management strategies for activity including pacing, pausing, recovery and rest.
  • Reducing the effort of breathing via education to; reduce accessory muscle work and improve diaphragmatic recruitment
  • Education regarding management of postural heart flutter i.e., managing salt/fluid intake, exercise, and sleep.




  • Early active mobilization is important for improving muscle strength, promoting better mobility when the patient is discharged from the hospital and better quality of life following discharge.
  • Early ehabilitation after an acute phase of respiratory distress is very important in limiting the severity of ICU-acquired weakness and promoting rapid functional recovery unless contraindications are present.
  • Early intervention can include positional changes (i.e., sitting up in bed, progressing to a standing position) and performance of simple exercises and activities of daily living.


Long COVID-19:

  • Post-viral pain management with manual therapy techniques such as soft tissue massage and trigger point release.
  • Gradually increasing cardio and resistance exercise within an individual’s fatigue tolerance.
  • Other fatigue management strategies such as sleep hygiene, pacing strategies, energy conservation, gradual resumption of activities.
  • Encouraged to be as active as possible within limits imposed by illness and tolerance.
  • Education and advice to help people control their fatigue and breathing throughout ADL’s, work, hobbies, and sports.

The team at PhysioSouth are experienced in assessing individuals and designing return to activity programs specific to their needs. Call 0508 4 Physio (0508 474 974) to make an appointment to start on your road to recovery!
For more information on COVID-19 and what you can do to help please see:
Velavan, T. P., & Meyer, C. G. (2020). The COVID‐19 epidemic. Tropical medicine & international health, 25(3), 278.
Ministry of Health and Allied Health Aotearoa New Zealand. 2020. Guidance for the rehabilitation of people with or recovering from COVID-19 in Aotearoa New Zealand. Wellington: Ministry of Health and Allied Health Aotearoa New Zealand. (2020)
Cardio-Respiratory Special Interest Group Webinar. Treating Long COVID. Presenter: Tania Clifton-Smith
Sheehy, L. M. (2020). Considerations for post-acute rehabilitation for survivors of COVID-19. JMIR public health and surveillance, 6(2), e19462.
Thomas, P., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L., & van der Lee, L. (2020). Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. Journal of Physiotherapy, 66(2), 73-82.

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