Effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: A rapid review

Abstract

Objective: Guidelines regarding physical therapy for COVID-19 patients are often based on expert opinion. Recent clinical trials have reported effects on several rehabilitation outcomes in COVID-19 patients. This review summarizes the effects of physical therapy in COVID-19 patients. Data sources: PubMed, Web of Science and Scopus databases were systematically searched for studies investigating the effect of any physical therapy modality on impairments in adult COVID-19 patients. Included studies were (non)-randomized controlled trials, pre-experimental studies, and cohort studies in which a pre–post analysis was performed. Data extraction: After the screening process, data of interest were extracted from eligible studies and their risk of bias was assessed. Included outcome measures were divided into 3 groups: pulmonary function, physical function, and psychosocial function. Data synthesis: A total of 15 studies were included in this review. Physical therapy seems to have positive effects on pulmonary function, physical function, and psychosocial function. However, these effects differ between clinical settings (e.g. home care, intensive care unit, inpatient units). Due to the low-to-moderate quality of the included studies, no robust conclusions can be drawn. Conclusion: Further high-quality research is required, taking into account the different clinical settings, in order to draw conclusions about the effectiveness of physical therapy on impairments in COVID-19 patients. Lay Abstract Guidelines regarding physical therapy for COVID-19 patients are often based on expert opinion or on evidence from studies of physical therapy in patients with other diseases. More and more clinical studies are investigat-ing the effect of physical therapy on the recovery of COVID-19 patients. Prior to this review, the importance of physical therapy for COVID-19 patients was not clear. This review summarizes the effects of physical therapy in COVID-19 patients. We reviewed and assessed the quality of the existing literature on this topic. Fifteen studies with a total of 1,341 COVID-19 patients were included in this review. Physical therapy appears to improve lung function, physical function, and psychosocial func-tion in COVID-19 patients. However, the effect can differ between clinical settings; for example, home care, intensive care unit, or other inpatient units. Due to the low-to-moderate quality of the included studies, no robust conclusion can be drawn. Further high-quality research is needed, taking into account the different clinical settings.

Clinical effectiveness of rehabilitation in ambulatory care for patients with persisting symptoms after COVID-19: a systematic review

“…Previous reviews on rehabilitation interventions for patients with persisting symptoms after COVID-19 focussed on pulmonary rehabilitation [ 65 ] or only included RCTs [ 66 ]. Other reviews covered all or other (i.e., earlier) stages of rehabilitation of COVID-19 patients [ 67 – 69 ]. Their evidence suggests that, in line with our results, physical training and breathing exercises can be useful in patients with persisting symptoms after COVID-19.…”

Evaluation of patients with negative PCR tests after COVID-19 pneumonia in intermediate-level intensive care unit

“…Rehabilitation has been widely recommended in people with COVID-19 pneumonia [15]. In a meta-analysis examining the effect of physical therapy on COVID-19-related disorders, it was reported that physical therapy had positive effects on lung function, physical function, and psychosocial function [16]. Another study concluded that respiratory physiotherapy and physical rehabilitation practices in COVID-19 patients in ICU reduced ICU-related complications and increased patients' quality of life [17].…”

Effectiveness of Rehabilitation on Functional Changes of the Respiratory System in Persons with Severe and Critical Form of Covid-19 Disease

“…Asmenims, sirgusiems Covid-19, rekomenduojama reabilitacija, kurią sudaro raumenų jėgos bei pusiausvyros ir koordinacijos lavinimo, širdies ir kraujagyslių, kvėpavimo sistemų funkcinės būklės grąžinimo ir gerinimo pratimai (Wade, 2020;Agostini et al, 2021). Pasak Debeuf et al, (2022), veiksmingiausia reabilitacija yra ta, kurią sudaro kvėpavimo bei aerobinės ištvermės lavinimo pratimai. Reabilitaciją pasveikusiems nuo ligos rekomenduojama pradėti kuo anksčiau, nes tai skatina širdies ir kraujagyslių bei kvėpavimo sistemų funkcijų atsistatymą (Iannaccone et al, 2020).…”