Bounce back to life with post COVID Rehabilitation

In the year 2020, the whole world has witnessed the catastrophe of the COVID-19 pandemic. Currently, several countries round the world are in several stages of novel coronavirus infection, with many nations getting into the post-COVID phase. As per WHO (World Health Organization), about 10% to fifteen of COVID cases happen to develop the ailment, and, about 5% of patients happen to fall critically ill. Usually, it takes two to 6 weeks for many of the coronavirus infected individuals to get over the infection. However, for a few patients, certain discomforting symptoms may last for weeks or maybe months. The long-term effects referred to as ‘Long COVID’ are often observed in hospitalized COVID patients also as patients who have had mild, acute symptoms of the virus infection .

Some individuals might even be in danger of long-term impairment. albeit the extent of impairment within the post-COVID phase isn't yet known clearly, early research has made it clear that the infected patients would require rehabilitation in various phases of the ailment, namely, acute, post-acute, and long-term. So, let’s have a glance at what exactly manifestations of Long COVID are and rehabilitation after COVID is, and the way post-COVID physiotherapy are often effective in rehabilitating the patient.

What is Post COVID Rehabilitation?

A set of interventions that are particularly developed to attenuate the incapacity and restore the traditional functioning within the patient is named rehabilitation. When the patient recovers from the novel coronavirus infection and experiences residual symptoms, rehabilitation are often a key strategy to attenuate the impact of COVID-19 on the body functions and health of the individual. And, it's important to notice that physiotherapy plays an important role within the rehabilitation efforts altogether stages to facilitate early discharge, support the patient, and improve his physical and psychological abilities. Also, it reduces the danger 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 therefore the patient may suffer from shortness of breath, weight loss, and fatigue.

Pulmonary artery hypertension: It leads to high vital sign within the patient’s lungs resulting thanks to obstruction within the lungs’ small arteries. it's going to cause chest pressure, dizziness, and shortness of breath.

Pulmonary embolism: When there's a blockage in one among the pulmonary arteries of your lungs, usually thanks to blood clots that traverse to the lungs from deep veins within the legs, you'll suffer from a embolism . it's going to cause cough, pain , and shortness of breath.

2. Long Covid Effects on Cardiovascular system:

Palpitation: It causes you to suffer from a discomforting pounding sensation within the chest.

Myocarditis: once you suffer from an inflammation of the guts muscle that reduces the power of your heart to pump, thereby leading to abnormal heart rhythms, you're said to suffer from myocarditis.

Cardiomyopathy: It’s the ailment of the guts muscle which makes it hard for your heart to pump blood to the remainder of the parts of your body. Swollen feet and legs, breathlessness, and a bloated stomach are a number of the common symptoms.

Cardiac failure: When your cardiac muscle fails to pump blood because it should normally, it's called cardiac or congestive coronary failure .

3. Long Covid Effects on the Nervous system:

Anosmia: Loss of ability to sense one or more smells

Short-term memory loss

Reduced span 

Poor quality of sleep

Cognitive impairment

Cognitive blunting

Stroke syndromes: a group of symptoms that enable you to spot which area of the brain is injured thanks 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's a psychological health condition that leads to nightmares, severe anxiety, and flashbacks.

Sleep disturbance

5. Residual Effects of COVID on Musculoskeletal system and other systems 

Chronic fatigue syndrome

Polyarthritis

Myalgia

Excessive fatigability

Other residual effects of COVID include a protracted loss of smell and taste, and more serious issues, like 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 assist you return to figure and daily activities by managing fatigue and muscle pain.

Improved respiratory muscle function and relieve dyspnea/breathlessness

Enhance striated 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 is an answer to enhance – 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 face movements

ADLs – Active Daily Living exercises

a. Under the guidance of expert physiotherapists, the patients may perform active limb exercises and reach practice progressive muscle strengthening exercises for 6 weeks.

b Simple exercises, like walking, cycling, and arm ergometry, can help the patient achieve aerobic reconditioning.

c. Over time, you'll increase the duration of your progressive aerobic exercises to twenty to half-hour .

Respiratory Physiotherapy in post-COVID rehab

In patients who undergo sputum inducing procedures during post-COVID rehab need airborne precautionary measures. they'll find respiratory physiotherapy from experienced physiotherapists beneficial. Also, activities, like progressing from lying to sitting position, bedside ADLs, walking, prone positioning, and walking, with the help 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 simply should follow when performing physio exercises during rehabilitation.

Before beginning together with your exercise session and within the breaks, use a pulse oximeter to watch your oxygen levels and pulse .

Make sure that you simply begin to perform various physio exercises as long as you're stable clinically.

If you happen to experience pain within the chest, dizziness, exhaustion, or palpitation, stop exercising immediately.

Lifestyle and Diet Tips psychological state & Diet:

In addition to physiotherapy, you ought to also take excellent care of your lifestyle and diet.

a. Have endless sleep in the dark for 7 hours

b. Avoid having alcohol because it reduces your sleep.

c. Follow a healthy and diet .

d. Perform appropriate exercises regularly with the doctor’s consultation

e. don't choose caffeine at noon, because it remains in your body for several hours and adversely affect your sleep.

f. Engage in positive communication together with your friends and family when in isolation.

References:

https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385804