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
Respiratory
Post-acute:
- 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.
Musculoskeletal
Post-acute:
- 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.
