Physical rehabilitation plays a crucial role in helping patients regain muscle strength, respiratory function, and overall mobility after severe illness from COVID-19. The ongoing COVID-19 pandemic has affected many patients with long-term physical, cognitive, and mental impairments that require rehabilitation (1). Even before COVID-19, however, most patients who needed rehabilitation services were not able to access the care that they required, because rehabilitation services were not prioritized by most medical care centers (4). The high incidence of long covid and severe illness from COVID-19 has reinstated the critical importance of rehabilitation services for improving patients’ quality of life after hospitalization or an ICU stay.
While rehabilitation is a specialized service within the medical field, rehabilitation care involves the coordination of multiple kinds of services to improve different aspects of physical, cognitive, and mental function (4). For example, many patients recovering from COVID present with respiratory complications and could benefit from respiratory physiotherapy (1). Respiratory physiotherapy may be combined with speech therapy in certain instances to improve both respiratory function and speech through diaphragmatic breathing techniques, resistance breathing exercises, resting techniques for respiratory muscles, and speech coordination (1).
Physical therapy and occupational therapy may also be involved in a patient’s physical rehabilitation care plan after COVID-19. Physical therapy may involve muscle strengthening, stretching, and functional and resistance training to improve muscle strength and mobility. Occupational therapy can help patients learn to take care of themselves and conserve energy in their daily life (1). Psychological and cognitive therapy approaches may also be combined with physical rehabilitation techniques to help patients manage their mental health and cognitive symptoms as they continue to recover.
Nearly all patients who were hospitalized for COVID-19 will need some degree of rehabilitation care to assist in their recovery. Patients who underwent bed rest during their hospitalization often experience weakness in their limbs and extremities and may also present with cognitive impairments like delirium and decreased attention (3). Cognitive rehabilitation techniques help patients regain cognitive function so that they can function in day-to-day life safely. Studies have also demonstrated that lengthy hospital stays can correlate with mental health challenges like anxiety and depression (3). As a result, patients need to be screened for symptoms of depression and anxiety and given resources to help manage these psychological effects of COVID.
To give COVID-19 patients the best chance of recovery, a multidisciplinary team of providers from various medical fields and expertise should work together in rehabilitation (4). Previously, rehabilitation services have been deprioritized and lacked the proper clinical resources to provide high-quality care, including doctors and psychologists who were trained in rehabilitation (4). Coordinated care and strategies for delivering rehabilitation care need to be in place for patients to access the support they need with their recovery after viral infections like COVID or prolonged hospital stays.
Integrated, intensive, and well-coordinated rehabilitation services have demonstrated a strong positive impact on patients’ ability to function and quality of life. In one study, patients demonstrated significant gains in muscle strength and lean muscle mass through an inpatient rehabilitation program (1). As nearly twenty percent of adults infected by COVID-19 in the United States experience long COVID and long-term symptoms, the pandemic continues to have a large socioeconomic and public health impact (6). Prioritizing physical and cognitive rehabilitation after COVID-19 can help lessen the health burden of COVID-19 on communities and improve quality of life for those most seriously affected.
References
- Imamura, Marta et al. “Rehabilitation of patients after COVID-19 recovery: An experience at the Physical and Rehabilitation Medicine Institute and Lucy Montoro Rehabilitation Institute.” Clinics (Sao Paulo, Brazil) vol. 76 e2804. 14 Jun. 2021, doi:10.6061/clinics/2021/e2804
- “Recovering from COVID-19: A Patient Guide.” New York-Presbyterian Rehabilitation Medicine, Weill Cornell Medicine, and Columbia University Irving Medical Center. rehabmed.weill.cornell.edu/sites/default/files/post_covid_rehab_-_patient_guide_0.pdf
- Urban, Kylie. “Rehabilitation Care is Needed for Many COVID-19 Patients.” Michigan Medicine, University of Michigan, July 14 2020, www.michiganmedicine.org/health-lab/rehabilitation-care-needed-many-covid-19-patients
- Wade, Derick T. “Rehabilitation after COVID-19: an evidence-based approach.” Clinical medicine (London, England) vol. 20,4 (2020): 359-365. doi:10.7861/clinmed.2020-0353
- Wahlgren, Carl et al. “Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms.” eClinical Medicine, vol. 43, 101219, January 2022, doi: 10.1016/j.eclinm.2021.101219
- Zhang, Hui, and Bin Cao. “Post-infection rehabilitation of COVID-19 patients: Findings and prospects.” The Lancet regional health. Europe vol. 22 (2022): 100496. doi:10.1016/j.lanepe.2022.100496