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At the moment in physiotherapy, all eyes are on the growing need for rehab after COVID. As we are still in the early stages of fully understanding this unmet need, we learn over time. To create rehab programs or services to address this need, we first need to understand how long we expect someone to feel unwell after a postcovial infection. While we are living through the pandemic, this is difficult, but we can learn from history and previous coronavirus infections.
This is exactly the aim of a new systematic overview that was published in Physical Therapy at the end of July. The research team wanted to compare the results of physical function and fitness in individuals infected with SARS-CoV with healthy controls. They searched for the keywords for SARS-CoV and physical fitness in reputable and relevant databases. 10 articles were used for the review, including 516 patients. The measures used to assess fitness and function were VO2 max and 6MWT.
It was clear that VO2max and 6MWT after SARS infection were reduced than the control groups. The degree of reduction was influenced by many factors, including pre-existing comorbidity and the duration of the infection, but exercise and rehab were effective in increasing the rate of recovery.
Clinical Implications
First of all, it must be taken into account that the applicability of these results is based on the similarities between SARS-CoV and COVID-19 in both the clinical presentation and the pathology. This evidence tries to determine how long we should think the symptoms persist and how this affects quality of life and function. According to the results of this systematic review, most of the restoration of function takes place in the first months after the infection. However, incomplete recovery occurs in many people and we should think that impairments can last up to 2 years after infection.
The aim of this systematic review was to take the effects on COVID-19 rehab into account and not to give us exact answers, as this is not known.
It is also interesting to consider that there is likely to be a different need for those who need intensive care than normal hospital care because of a mixed picture of COVID-19-related postviral fatigue and lung tissue damage, as well as Well's insisted post-critical care acquired weakness and delirium.
It is also worth noting that this only takes into account that a person is infected once, not multiple times, as current COVID-19 evidence suggests. Furthermore, only the use of the 6MWT as a measure of the physical result limits its practical applicability, since more socio-economic considerations are not considered as occupational health considerations.
Are you involved in COVID-19 rehabilitation and want to learn more about current best practices? Take a look at our course below.
COVID-19 post-acute rehabilitation
People with severe COVID-19 infection have rehabilitation needs in the acute, post-acute and long-term phases of the disease. Many people who have had COVID-19 may now be at risk of long-term impairment or disability. Physiotherapists are critical to rehabilitation efforts in all phases of this disease. Rehabilitation has a positive impact on health and functioning, improves recovery and can reduce disabilities, facilitate early discharge and reduce the risk of readmission. Physiotherapists also play a key role in supporting and empowering people through rehabilitation processes.
Rehabilitation is the key to long-term recovery