The Role of Physical Therapy in Battling Covid-19

Covid-19, a respiratory disease triggered by a lately identified coronavirus, has resulted in massive human life disruption in almost every part of the globe. Ever since this deadly virus has come into the picture, it has claimed lives in huge numbers every day.

And in a situation where nobody, not even experts, has any idea where it came from and when it will disappear from the world, all we should focus on is looking after our health. We should not leave any stone unturned to strengthen our bodies. By now, all of us are aware to some degree that people with weak immunity and underlying health problems remain at a higher risk of experiencing the worst consequences of Covid-19.

From Asian countries such as China, Japan, and India, to European countries such as Italy, Germany, France, and the UK, to North American countries like the US and Canada, Covid-19 is smashing every part of the world. Therefore, on a personal level, you have to have a roadmap to stay healthy and prevent the spread of this deadly virus.

Here is how relying on physical therapy can help you fight this virus and maintain reasonable physical, emotional, and mental well-being.

As Preventative Care

Ideally, physical therapy can help you in three different ways; the first one is preventative care. Just remember one thing, you don’t necessarily have to fall sick to consult a physical therapist. It means you can also meet them and seek their care plans to prevent a disease or viral infection from intruding on your body.

Keep raising the bar for improving your physical health, including your joint, muscle, and bone health. Similarly, your mental health is also essential. It’s everywhere in the news that people who struggle with Covid-19 experience mental health issues such as anxiety and depression during the disease and after getting tested negative.

Besides, as per the limited data available to us, they also remain at a high risk of heart diseases. So the intelligence says that you should take every preventative measure to keep the virus at bay. The most reliable way to achieve your health goals is to visit a competent physical therapist regularly.

Working on your body based on the guidance of a physical therapist will help you experience quick results. Your chances of staying safe from corona will increase if you focus on strengthening your body.

Treating People in the Intensive Care Unit

When Covid-19 patients are admitted to the Intensive Care Unit, they are sedated and intubated for at least seven to ten days. Intubation is the process of inserting a plastic tube into the airway through the mouth to maintain an open airway. Intubation is performed for patients who could not breathe with their own assistance. The main aim of intubation is to get adequate oxygen into the patient’s blood.

The lung condition gradually improves in those ten days due to intubation, and then the doctors would remove the sedation. The patients are then ventilated through a tracheostomy. It is a tube that runs through the windpipe.

Physical therapists are allowed to work with highly trained multidisciplinary teams to manage the Covid-19 disease better and mitigate the number of deaths. Patients who require ventilatory care and are transformed to the Intensive Care Unit are provided with patient education, prone positioning, early mobilization, and respiratory physical therapy.

Physical therapists will assist the patients and provide them with mobility treatments and rehabilitation. Medical professionals believe that early rehabilitation of Covid-19 patients helps them get moving while still on a ventilator and promotes their discharge from the intensive care unit as earlier as possible.

The early intervention of physical therapists includes simple exercises that force the patients to breathe a little harder. They help the patients to sit up and walk by taking at least a few steps.

Respiratory physiotherapy helps patients in ventilation who suffer from severe acute respiratory failure or acute respiratory distress syndrome. The Covid-19 disease severely damages the lungs and causes interstitial pneumonitis. Pulmonary rehabilitation is proved to be effective in treating such patients.

Proning physiotherapy is crucial for patients to improve their lung function. Proning is the process of turning a patient from their back to their abdomen with safe movements. This process can clear the lungs and increase oxygenation.

Post Covid-19 Rehabilitation

Patients who were in the intensive care unit for an extended period would experience muscle weakness and physical disability in the longer term. Some people also develop disturbing symptoms and side effects that last for several months, and this condition is termed as long covid.

The Centers for Disease Control and Prevention(CDC) lited the symptoms of long covid that includes

  • Fever, cough, and headache
  • Muscle weakness and joint pain
  • Loss of smell or taste
  • Difficulty in breathing
  • Loss of function and strength
  • Fatigue
  • Chest pain
  • Depression or Anxiety

Physical therapists can treat these side effects most effectively. Physical therapy can also help you quicken your recovery period once you get tested negative. Becoming Covid negative doesn’t mean you have become healthy again. All it means is the virus inside your body is no longer infecting your body.

However, the damage it has already done will continue to create problems for you until you fully recover. For example, if your lungs are not in good shape, you will have to put the effort in many ways to bring them back to shape. And investing in physical therapy is one of the most incredible ways of doing that.

The physical therapist will check the following before coming up with an effective treatment plan for you.

  • The electrocardiogram (ECG)
  • Oxygen saturation (SaO2)
  • Medical history

After obtaining the details about your health, they will analyze other things, such as your flexibility and range of motion to create a treatment plan to address your health problem. Most people who fail to get proper care continue to face the issues for months after getting tested negative. So if you want to avoid complications, try physical therapy.

Physical therapy for post covid rehabilitation includes the following treatment.

  • Stretching and strengthening exercises
  • Balance training
  • Breathing exercises to improve lung capacity
  • Aerobic exercises to improve pulmonary health

1) Breathing Exercises

People affected by Covid experience a decreased lung functioning that needs to be treated. Hence breathing exercises are crucial to restore diaphragm function and improve lung capacity. They also reduce stress and anxiety in people who were in the intensive care unit for several days.

Active Cycle of Breathing Techniques (ACBT)

People affected by Covid-19 often cough and produce more sputum in their lungs. Physical therapists recommend Active Cycle of Breathing Techniques to remove excess sputum from the lungs and improve lung function. Physical therapists should assist their patients in performing these exercises.

Step 1: Breathing Control

  • Place your hands on the abdomen.
  • Start breathing slowly as you feel your abdomen rise and fall with each breathe-in and breathe-out process.
  • You can try the breathe-out process by closing your eyes as it needs to be done in a relaxed way.

Step 2: Deep Breathing

Deep breathing is done with the diaphragm. The diaphragm is an important muscle that helps an individual breathe as it is responsible for 80% of breathing. It strengthens the diaphragm, improves lung function, lowers blood pressure, and promotes relaxation. It is also called diaphragmatic breathing.

Deep Breathing While on Your Back

Lie down on your back with your knees bent. Place one of your hands on top of your stomach. Close your lips by placing your tongue on the roof of your mouth. Breathe in through the nose and draw air down into your stomach. Now exhale through the nose slowly. Repeat this breathing exercise for one minute.

Deep Breathing While on Your Stomach

Lie down on your stomach, resting your head on your hands. Close your lips by placing your tongue on the roof of your mouth. Breathe in through the nose and draw air down into your stomach. Now exhale through the nose slowly. Repeat this breathing exercise for one minute.

Deep Breathing While Sitting

Sit straight on the edge of a chair. Place your hands on your stomach. Close your lips by placing your tongue on the roof of your mouth. Breathe in through the nose and draw air down into your stomach. Now exhale through the nose slowly. Repeat this breathing exercise for one minute.

Deep Breathing While Standing

Stand straight on the ground. Place your hands on your stomach. Close your lips by placing your tongue on the roof of your mouth. Breathe in through the nose and draw air down into your stomach. Now exhale through the nose slowly. Repeat this breathing exercise for one minute.

Step 3: Huffing

A huff is breathing through an open mouth and throat instead of coughing. This process moves phlegm up the airways and helps you to remove it in a controlled manner. To perform huffing, hold breathe for two to three seconds. Then use your abdominal muscles to exhale or huff the air forcefully.

Step 4: Coughing

You need to perform this step only when you feel like the phlegm comes to the back of your throat. If not, then perform the breathing cycle again.

2) Warm-up Exercises

Patients recovering from covid-19 disease need to perform warm-up exercises as these exercises can prepare their body for exercising and preventing injury.

Shoulder shrugs

Lift your shoulder slowly and then down again.

Shoulder circles

  • Keep your arms relaxed by placing them on your lap
  • Slowly move the shoulders round in a circle forwards and then backward.

Side bends

  • Stand straight on the floor
  • Place your arms by the side.
  • Gently bend each arm towards its sides.

Knee lifts

  • Gently lift one knee up and down.
  • Do not raise the knee higher than your hip.
  • Now lift the other knee.

Ankle taps

  • Stand straight on the ground.
  • Use one foot to tap the toes and then the heel on the floor.
  • Repeat the same step with the other foot

Ankle circles

  • Roll the ankles slowly, one at a time.
  • Move just the ankle and foot, not the leg.

3) Strengthening Exercises

Physical therapists’ primary aim to recommend strengthening exercises is to improve the muscle strength of the patients affected by Covid-19. Their muscles would have become weaker due to the illness and staying in the hospital for longer days. Below are some of the exercises that strengthen your muscles.

Bicep Curls

  • Hold some weight in each hand. Place your arms by your sides and palms facing forwards.
  • Keeping the top part of your arms stable, lift the lower part of your arms gently and bring the weights up.
  • You can increase the weight while progressing with the exercise.

Wall Push Off

  • Place both of your hands flat against a wall.
  • Your hands should be at the height of your shoulder.
  • Place your feet roughly a foot away from the wall.
  • Now slowly lean towards the wall by bending your elbows.
  • Push yourself away from the wall again until your arms are straight.

 Arm Raises to the Side

  • Hold some weight in each hand. Place your arms by your sides and palms facing inwards.
  • Raise your arms out to the side and up to your shoulder level.
  • Now, gently lower the arms down.

Sit To Stand

  • Sit on a chair comfortably with your feet flat on the floor.
  • Place a table in front of you so that it provides support to you when you feel unsteady.
  • Rise to a stable standing position slowly by leaning your chest forward.
  • Hold the position for some time.
  • Now sit back to the normal position slowly.

Heel Raises

  • Stand in the back of a chair.
  • Keep your feet eight inches apart and flat on the floor.
  • Now bend your knees slightly.
  • Lift your heels to rise onto your toes. Reach out to the back of the chair for balance.
  • Return to the normal position slowly.

4) Fitness Exercises

Do fitness exercise for 20-30 minutes five days a week. Start small and gradually increase the time taken for doing these exercises.

Walking

Choose a flat route to walk and use a stick if needed. Increase the speed or distance you walk as you feel progress in your body condition.

Marching on the spot

  • Hold onto a chair for support
  • Lift your knees one at a time.
  • Increase the height of lifting your knees as you progress with the exercise.

 Step-ups

  • Use only the bottom step of the stairs.
  • Step up and down by changing the leg you start with every ten steps
  • Increase the height of the step as you progress with the exercise.

Final Thoughts

Physical therapy plays a crucial role in helping the Covid-19 patients. From assisting them in the intensive care unit to post recovery exercises, physical therapists help patients improve their lung function and muscle strength and educate them to cope with anxiety followed by hospitalization for several days.