Physiotherapy has solution to tackle Post-Intensive Care Syndrome
| Date :18-Nov-2020 |
Principal Correspondent :
Those who tested positive for coronavirus, taken treatment, tested negative after 14 days, of them some suffer weakness, lost balance while walking etc. Some medicos too don’t have the solution to these problems, but physiotherapists have. Most people post-Covid are experiencing tremendous improvement thanks to physiotherapy. ‘The Hitavada’ talked to some well-known physiotherapists who elaborated the importance of physiotherapy vis-a-vis Covid-19 pandemic.
Dr Shailesh Patil, noted Physiotherapist of the region explained, “After long intensive care hospital stay, patients may experience symptoms of post-intensive care syndrome (PICS ) which include muscle weakness, difficulty with walking and balance, problems with taking care of themselves (dressing, bathing), and problems managing medications and other tasks essential for independent living. People also have challenges returning to work and driving. Mental health symptoms range from mild anxiety or irritability to severe depression, sleep disturbances, and post-traumatic stress disorder. Cognitive changes include difficulty thinking, remembering or concentrating.”
Stating the role Physiotherapist is playing, Dr Sudeep Kale, Maharashtra State Council for Occupational Therapy and Physiotherapy said, “Amongst health-care workers, physiotherapists, especially respiratory physiotherapists, are also playing an important role in managing and caring novel COVID-19 patients. They are involved in conservative care, posture correction, mobilization and while training to wean of from the weaning from invasive mechanical ventilator support. Physiotherapist is a key element of the multidisciplinary team of active hospital services and intensive care unit. Physiotherapy may be useful in the treatment of respiration, in the treatment of COVID-19, in addition to proven work to prevent or delay intensive care.”
Dr Umanjali Damke, Principal of School of Physiotherapy at Government Medical College and Hospital (GMCH) pointed out, “Physiotherapy might be applicable for COVID-19 patients presenting with profuse airway discharges which patients cannot clear individually. Patients having associated diseases (like neuromuscular disease, respiratory diseases, lung fibrosis etc.) leading to increased secretion or weak cough may also be benefited from physiotherapy.
Physiotherapists working in ICU can help in clearing airways for patients who are ventilated and provide assistance in placing them in proper position.” Dr Shailesh Patil further said, “People who develop PICS can experience a combination of these symptoms, which may be entirely new problems, or worsening of problems that were present before the critical illness. Physiotherapists can effectively provide treatments to optimize improvements in a patient's physical functioning, including being able to return to work. With an increased understanding of the problems people experience following critical illness, home- and community-based physiotherapists will be more equipped to recognize the physical, mental health, and cognitive problems that these people are experiencing.”
According to Dr Y Praveen Kumar, Professor and Head at VSPM College of Physiotherapy, for those who are in critical care, physiotherapists can help with weaning off ventilators and beginning early rehabilitation to lessen the muscle deconditioning and weakness that happens during a severe illness. Once the patient has left the Intensive Care Unit, the rehabilitation team continues to help progress their exercise tolerance, monitor their reactions to exercises and provide individualized strengthening exercises to help gain back the strength lost during their ICU stay, added Dr Praveen Kumar.
Dr Vishal Patle, who is presently in United States of America for getting himself upgraded in physiotherapy branch talked about rehabilitation, “Many people who have suffered from COVID-19 may now be at risk of long-term impairment or disability. Physiotherapists are critical to the rehabilitation efforts in all phases of this disease. Rehabilitation has a positive effect on health and functioning outcomes, it improves recovery and can reduce disability, it may facilitate early discharge and reduce the risk of readmission.” Corona damages respiratory system so protecting it is very important. Physiotherapy can do wonders this is what Dr Shailesh Patil feels. He stated, “Nowadays lot of lung fibrosis (damage to the lung tissue) patients are coming to OPD. When patients who have been on ventilator or had required very high oxygen levels during their hospital stay come back to the OPD, most of them have lower oxygen than normal. This is because of a condition known as lung fibrosis.
So, any damage to the lung leads to fibrosis, and it is an irreversible damage. So many patients coming to the OPD practice are hypoxic, with low oxygen concentration, and they are requiring home oxygen also. So they are somewhat bedridden, if at all home-bound. Cardiorespiratory physiotherapy encompasses many things, from teaching patients different types of breathing exercises, mobilization exercises and manual techniques to providing postural advice and correction by positioning the body for optimal lung function and oxygen management. Everyone can benefit from exercises to help with mobility, cardiac and pulmonary function, flexibility, strength, endurance, mental health, independence and self-care management, and more.”