India has witnessed a sudden surge in COVID 19 cases, which is not only affecting older adults but also the younger population. Symptoms such as breathlessness, fatigue and muscle weakness are among the most commonly reported complaints that persist even after recovery. These symptoms can last up to a few weeks or even months depending on the severity of the condition.
The above symptoms, if not managed on time, can lead to a prolonged limitation in functional capacity, exercise tolerance, hamper the quality of life and delay return to work and everyday routine.
As per WHO guidelines, physiotherapy can play an important role in the rehabilitation of patients with COVID-19 to improve these symptoms.
What is Post COVID Rehabilitation?
A set of interventions that are particularly developed to minimize the disability and restore the normal functioning in the patient is called Rehabilitation.
When the patient recovers from the novel coronavirus infection and experiences residual symptoms, rehabilitation can be a key strategy to minimize the impact of COVID-19 on the body functions and health of the individual. And, it is important to note that physiotherapy plays a crucial role in the rehabilitation efforts in all stages to facilitate early discharge, support the patient, and improve his physical and psychological abilities. Also, it reduces the risk of readmission.
Manifestations of Long COVID:
Here are some residual effects that the patient may experience after the coronavirus infection subsides. 1. Long Covid Effects on Respiratory system:
Lung fibrosis: The condition which makes the patient’s lungs turn scarred, and the patient may suffer from shortness of breath, weight loss, and fatigue.
Pulmonary artery hypertension: It results in high blood pressure in the patient’s lungs resulting due to obstruction in the lungs’ small arteries. It may cause chest pressure, dizziness, and shortness of breath.
Pulmonary embolism: When there is a blockage in one of the pulmonary arteries of your lungs, usually due to blood clots that traverse to the lungs from deep veins in the legs, you may suffer from a pulmonary embolism. It may cause cough, chest pain, and shortness of breath.
2. Long Covid Effects on Cardiovascular system:
Palpitation: It makes you suffer from a discomforting pounding sensation in the chest.
Myocarditis: When you suffer from an inflammation of the heart muscle that reduces the ability of your heart to pump, thereby resulting in abnormal heart rhythms, you are said to suffer from myocarditis.
Cardiomyopathy: It’s the ailment of the heart muscle which makes it hard for your heart to pump blood to the rest of the parts of your body. Swollen feet and legs, breathlessness, and a bloated stomach are some of the common symptoms.
Cardiac failure: When your heart muscle fails to pump blood as it should normally, it is called cardiac or congestive heart failure.
3. Long Covid Effects on the Nervous system:
Anosmia: Loss of ability to sense one or more smells
Short-term memory loss
Reduced attention span
Poor quality of sleep
Cognitive impairment
Cognitive blunting
Stroke syndromes: A set of symptoms that enable you to identify which area of the brain is injured due to a stroke.
More severe and rare neurological complications include brain inflammation, delirium, strokes, and nerve damage.
4. Residual Effects of COVID on Mental health:
Anxiety
Depression
Irritability
Reduced consciousness (at times even seizures)
Post-traumatic stress disorder: It is a psychological health condition that results in nightmares, severe anxiety, and flashbacks.
Sleep disturbance
5. Residual Effects of COVID on Musculoskeletal and others
Chronic fatigue syndrome
Polyarthritis
Myalgia
Excessive fatigability
Other residual effects of COVID include a prolonged loss of smell and taste, and more serious issues, such as new-onset diabetes and mini-strokes, may occur.
How Physiotherapy is Crucial in Post-COVID Rehabilitation?
Improve exercise tolerance with a clinically important amount in post-acute Covid infection.
Reduce number of hospital re-admissions
Enhanced health-related quality of life – Help return to your full potential physically and help you return to work and daily activities by managing fatigue and muscle pain.
Improved respiratory muscle function and relieve dyspnea/breathlessness
Enhance skeletal muscle function of upper and lower limbs.
Teach appropriate techniques to manage fatigue and be functional and independent while performing daily activities.
Especially for older patients with diabetes, hypertension, recovering from pneumonia etc. physiotherapy serves as a solution to improve – lung function, recondition, improve endurance, balance and participate in their social environment.
Exercises for Early Mobilization
Early mobilization movements and exercises in Post-COVID rehabilitation may include:
Bed mobility
Simple bed exercises
Frequent posture changes
Sit to stand movements
ADLs – Active Daily Living exercises
a. Under the guidance of expert physiotherapists, the patients may perform active limb exercises and progress to practice progressive muscle strengthening exercises for six weeks. b Simple exercises, such as walking, cycling, and arm ergometry, can help the patient achieve aerobic reconditioning. c. Over time, you can increase the duration of your progressive aerobic exercises to 20 to 30 minutes.
Respiratory Physiotherapy in post-COVID rehab
In patients who undergo sputum inducing procedures during post-COVID rehab need airborne precautionary measures. They may find respiratory physiotherapy from experienced physiotherapists beneficial. Also, activities, such as progressing from lying to sitting position, bedside ADLs, walking, prone positioning, and walking, with the assistance of physiotherapists can help the patient immensely.
Precautions that Physiotherapists may Employ during post-COVID rehab
Here are some safety measures and care tips that you should follow when performing physio exercises during rehabilitation.
Before beginning with your exercise session and in the breaks, use a pulse oximeter to monitor your oxygen levels and heart rate.
Make sure that you begin to perform various physio exercises only if you are stable clinically.
If you happen to experience pain in the chest, dizziness, exhaustion, or palpitation, stop exercising immediately.
Lifestyle and Diet Tips Mental Health & Diet:
In addition to physiotherapy, you should also take good care of your lifestyle and diet. a. Have a continuous sleep at night for 7 hours b. Avoid having alcohol as it reduces your sleep. c. Follow a healthy and balanced diet. d. Perform appropriate exercises regularly with the doctor’s consultation e. Do not go for caffeine at noon, as it remains in your body for several hours and adversely affect your sleep. f. Engage in positive communication with your friends and family when in isolation.
So, if you or any of your family members are recovering from coronavirus infection and need post-COVID rehabilitation at home, get in touch with us at Nightingales on 1800 103 4530 or https://www.nightingales.in. Our post Post-COVID Rehab services from expert physiotherapists and healthcare professionals can facilitate your safe and smooth recovery. So, make no delay, reach out to us online with a few clicks or over a call, and experience smooth recovery and good health in the comfort of your home. Stay safe and get well soon.
Resource:
1.Back to life Physiotherapy Team(www.backtolifehealthcare.com)
2.https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385804/
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