Providing home-based respiratory and general physiotherapy support for all affected with, or recovering from Covid-19
Covid-19 resource websites:
Patient Information Guides:
COVID CARE RESOURCE Q AND A:
Physiotherapists play an important role in assisting gradual return to physical functioning and exercise tolerance. This is especially important for patients that were admitted to the ICU during their hospital stay as those patients tend to develop Post intensive care syndrome. The physiotherapist will give graded exercise programs and have measurements in place to track progress made to ensure that the body (including the heart and lungs) are not overloaded and causing further damage.
The Physiotherapist will assess your lungs, breathing pattern, breathing rate and blood oxygen levels. According to the outcome of the assessment, the therapist will teach you optimal breathing patterns, relaxation techniques and resting position for optimal aeration of your lungs. Physiotherapists have a wide variety of techniques to help with secretion clearance and oxygenation, this will assist in your recovery from COVID-19 as it will help prevent the build up of mucus inside your lungs and teach you exercises and methods to optimise your lung function. Physiotherapists can perform manual chest physiotherapy as well as teach you breathing techniques and exercises in order to improve and maintain oxygen levels in the body. If you are on oxygen, the therapist will assist to wean you off the oxygen to enable you to breathe on room air again. The therapist will continuously monitor and re-assess your condition to ensure that you are stable and to refer to a doctor if necessary.
This is known as “proning”. There is more lung tissue at the back of your body. Lying on your stomach then increases the lungs’ ability to oxygenate your blood. The “air sacs” in your lungs are then in a more optimal position to exchange oxygen from the lungs to the blood in the arteries.
This will depend on the severity of your condition, if you were hospitalised or if you were in the ICU etc. It also depends if you are still on oxygen at home or not. After your initial assessment, your physiotherapist will be able to give you a more accurate amount of sessions needed.
COVID-19 is transmitted via respiratory droplets that come from inside the respiratory tract (lungs, airway and nasal passages). When a person infected with COVID-19 coughs or sneezes, they release respiratory droplets containing the virus into the air. The droplets then fall onto nearby surfaces for example tables, counters in shops, seats in cars/taxi etc. If you touch these surfaces the virus may transfer to your hands and then to mouth, nose or eyes only when you touch your face, you cannot become infected through your skin. The virus also spreads when people breath in respiratory droplets, via their nose or mouth, of a person infected with COVID-19 if standing with 1 meter of the infected person.
Wearing a face mask that covers both your nose and mouth can lower your risk of contracting COVID-19 because it will prevent you from inhaling infected respiratory droplets from an individual who has tested positive for COVID-19 who coughs or sneezes near to you. You can also protect others by wearing a mask that covers both your nose and mouth because if you cough or sneeze, your respiratory droplets will not be distributed into the surrounding air or onto nearby surfaces. Remember that it is possible to have COVID-19 without having any symptoms, meaning that you, or somebody else may not know if you have the virus, and so wearing a mask in public areas and around people who you do not share a home with is vital to stop the spread of COVID-19.
One of the ways that COVID-19 spreads is if you touch your eyes, nose or mouth after you have touched a surface that has been contaminated with the virus. Surfaces, such as countertops at grocery stores, door handles, car seats etc. that are in public places can be contaminated when an individual who has the virus coughs or sneezes and the respiratory droplets settle on the surface. It is not always easy to avoid touching objects that other people may have come into contact with and so by frequent hand washing and sanitizing you can ensure that when you do touch your eyes, nose or mouth your hands are clean and virus free. Remember that other people who have touched contaminated surfaces and who have not washed their hands carry the virus on their hands and you never know what they have touched. It is also important to note that the virus does not get absorbed through the skin but the skin can carry the virus.
If you are experiencing COVID-19 like symptoms such as coughing, shortness of breath, high temperature, loss of taste and/or smell and nausea you should self-isolate until after your symptoms have gone. If your symptoms persist you should consider going for a COVID-19 test, this way you will know if you have the virus or not and if you should continue with your self-isolation. Self-isolating will help to protect you family members from contracting the virus and it is the responsible thing to do.
Self-isolation is when an individual presenting with COVID-19 symptoms or who has tested positive for the virus avoids any contact with other people as well as public places. At home you should stay in a separate room and use a separate bathroom if possible. You should also eat on disposable crockery and use disposable cutlery. Other household members should avoid coming in to your room and you should not be having any visitors during your isolation period. Isolating is a way to prevent spreading COVID-19 to other people in your home and in the community.
Once the virus has gone into your respiratory system it can bind to cells on the linings of the lungs and reproduce. This causes an overload of the virus inside your lung tissue which can result in coughing due to irritation in the lungs. Healthy lung tissue and blood vessels surrounding the lungs exchange oxygen and carbon dioxide, with oxygen going into the blood stream from the lungs and the carbon dioxide moving from the blood stream into the lung to be exhaled. In lung tissue infected by COVID-19 this process is affected as the lung and blood vessel linings become thickened by inflammatory substances as your body will have a natural inflammatory response to the viral infection, causing carbon dioxide retention and poor oxygenation. Part of the body’s natural response to infection is the blood vessel linings becoming more porous which can lead to the virus getting through from the lung into the blood stream and spreading to all other organs in the body resulting in a wide variety of symptoms. Prolonged inflammation around the blood vessels in the body cause damage to the blood vessel walls resulting in the formation of blood clots and restriction of blood flow thereby further reducing oxygenation around the body making it feel difficult to breath.
It is very important to monitor the oxygen saturation of a person infected with COVID-19 as our bodies need oxygen to function and produce energy and the process of oxygenation is largely affected in COVID-19 patients. If their oxygen levels are lower than normal you should consult a doctor for advice on home oxygenation or being admitted to hospital. You should also ensure that amongst taking medication, the person you are caring for drinks enough fluids and eats nutrient full meals to aid their recovery. While caring for a COVID-19 positive patient at home it is important to follow isolation protocols as well as both wear a mask when near each other.
Yes, our physiotherapists are equipped with protective equipment and also sanitize equipment in between patients. Furthermore, movement and exercise is vital for maintaining function, reducing pain and returning to a higher functional level, especially for patients with or recovering from COVID-19.
These videos provide additional general exercise suggestions that may be helpful for some patients. Please use discretion when performing these exercises on your own. Please do not proceed if you experience shortness of breath, chest pain, palpitations, exhaustion, or dizziness/lightheadedness, and consult with your physician or physiotherapist for further guidance.
Upper Body Exercises:
Published by NYP Rehab – April 2020
Lower Body Exercises:
Published by NYP Rehab – April 2020