Need for respiratory distress rehabilitation

June 9, 2021 0 By FM

For a significant proportion of people, COVID-19 leads to medium- to long-term effects that can have a significant impact on the quality of life. Some symptoms may linger or recur for days, weeks or months following initial recovery, while some patients develop medical complications that may have lasting lifetime health effects. Recovery time is different for everyone.

Short-term effects include fatigue, cough, cold, congestion, shortness of breath, loss of taste/smell, headache, body ache, nausea, chest pain, abdominal pain and confusion. Prolonged and persistent symptoms due to disruption in body systems and affected organs is also something that recovered patients have faced over time. Long term impact including damage to heart muscle, heart failure, lung tissue damage, restrictive lung failure, anosmia, pulmonary embolism, stroke, cognitive impairment, anxiety, depression, PTSD, sleep disturbances, muscle/joint pain, chronic fatigue, breathlessness and chest pain can severely impact a patient’s future if not treated properly.

Often, such COVID-19 patients need a level of medical care and rehabilitation that is difficult to achieve at home. Some of them need continuous monitoring and non-invasive clinical intervention supervised by a medical expert even after they have recovered. This is possible with a comprehensive and planned post -COVID-19 rehabilitative program.

Once the patient is admitted, a detailed assessment is carried out by the doctors. Physio, Occupational and Respiratory therapists map out the therapy sessions and fine-tune a goal-oriented treatment plan depending on the condition of the patient. Over the course of the treatment, the progress of the patient is assessed on a weekly basis with the Borg Dyspnea Scale, the six-minute walk test, the 12-minute walk test, the TUG scale and the Cough Sputum Score. The treatment is an amalgamation of Physio, Occupational and Respiratory therapy.

Physiotherapy is carried out in three phases. Phase 1 comprises diaphragmatic breathing exercises to encourage oxygen exchange, slow down heartbeats and stabilize blood pressure. Thoracic expansion exercises to help loosen secretions from the lungs. Thoracic mobilization exercises clear secretions from the lungs. The teaching of relaxed positions ease breathlessness. All the above exercises are done at the patient’s bedside. In phase 2, the focus is on strength and endurance training to improve exercise tolerance using dumbbells and Thera bands, activities on the stepper, staircase training, hurdle training and bicycle ergometer without resistance for the initial days and resistance added as the patient regains efficacy. In Phase 3 which is also known as the maintenance phase, the patient is given enough education to carry on the exercises with the list of dos and don’ts at home.

Occupational therapy teaches patients how to conserve their energy and avoid fatigue through certain adaptive postures while performing daily activities. This is specific to each patient. These include, for instance, taking adequate breaks while using the stairs, tying a shoelace in a sitting position rather than bending, and so on.

Respiratory therapy makes use of devices like Acapella and Flutter, which play a major role in lung secretion clearance. Resistance training with the help of power breaths, incentive spirometry, respiratory muscle training are among the few exercises that help the patient recover and restore their respiratory health in the most optimal manner.

Optimal care is crucial for the speedy recovery and early return to normal life at home after discharge from the hospital. A rehabilitative care programme delivers
out-of-hospital care that enables patients to achieve optimal recovery in a best suited environment.

The author is Founder & CEO, Sukino Healthcare