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Physiotherapy for COVID-19 PowerPoint Presentation

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Description : Check out this medical presentation on Physiotherapy and Physical Rehabilitation, which is titled "Physiotherapy for COVID 19", to know about Physiotherapy for COVID-19.

Tags : Physiotherapy, Physical Rehabilitation, COVID 19

Published on : Aug 02, 2021 | Views : 2066 | Downloads : 7

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Physiotherapy for COVID 19 Dr. Satyen Bhattacharyya (PT) MPT, COMT, CMT, CDNP, DOMTP (Pursuing), PhD Scholar Associate Professor: BIMLS, Bardhaman Chief Physio: Fit O Fine www.fitofine.in Dr. Aurodeep Dasgupta (PT) MPT (Cardio-thoracic Disorders), FIMT, C/DN, C/PFT Senior Physiotherapist, Bengal FAITH Hospital
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Physiotherapy in COVID-19 Where it works? ICU General ward Post hospitalization Even for non Covid patients to increase their lung capacity
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When Physiotherapist is required in ICU? If ventilated patient develop secretions If patient unable to clear airway secretion by himself, mainly post-extubation in the ICU If exudative consolidation develops and difficulty in clearing secretions If comorbidity like COPD, cystic fibrosis, chronic bronchitis, emphysema, ALS, DMD present For preventing complications like DVT, pressure sores, CRIMYNE
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In-Patient on Mechanical Ventilator Positioning – Prone positioning / propped up (60 degree) Chest Physiotherapy: vibration, percussion (if D - Dimer normal) intercostal stretch Limb Physiotherapy: general limb movement as much as tolerated by the patient Active Mobilization (if possible, by pt)
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Post Extubation in ICU Diaphragmatic breathing Pursed-Lip Breathing Alternate Nostril breathing If required Coughing Mechanism Suctioning Slow Deep breathing Exercise Postural drainage
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Patient not in ventilator Positioning prone (12 to 16 hours) propped up Chest Physiotherapy vibration with proper assessment percussion with proper assessment slow deep breathing ACBT as tolerated Incentive spirometry as tolerated Limb Physiotherapy AROM Bedside sitting Dynamic quad Sitting on bed / chair Bedside ambulation if tolerated
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General ward Positioning conscious proning (12 – 16 hours) propped – up positioning (2 – 4 hours) Chest Physiotherapy: Slow deep breathing ACBT Segmental expansion Coughing out if congestion present Chest percussion if congestion present Chest vibration if congestion present Incentive spirometry (inhalation only) stream inhalation
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General ward Contd. Limb Physiotherapy: AROM exercises Isometric exercise as tolerated Graded functional exercise Ambulated as tolerated
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For stable patient (General ward) Diaphragmatic breathing Lung expansion technique Manual mobilization to the rib cage Respiratory muscle training Incentive spirometry
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Exercise after leaving Hospital Improve fitness Reduce breathlessness Increase muscle strength Improve balance and coordination Improve your thinking Reduce stress and improve mood Increase confidence Improve your energy
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Warm-up exercises Warming up prepares your body for exercise to prevent injury. Your warm-up should last around 5 minutes, and at the end you should feel slightly breathless. Warm-up exercises can be done in sitting or in standing. If you do your warm-up in standing, hold on to a stable surface for support if needed. Repeat each movement 2-4 times
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Start slowly
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Follow the steps
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Fitness exercises You should aim to do fitness exercise for 20-30 minutes, 5 days each week. Some examples of different types of fitness exercises are described below, but any activity that makes you feel moderately to almost severely breathless can be counted towards your fitness exercise. Time your fitness exercise and gradually build up the amount of time you can manage. This may be in small increases such as an additional 30 seconds or 1 minute of activity. It may take a while to return to the level of activity you were normally able to do before you became unwell.
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9. Walking — Use a walking frame, crutches, or stick if needed — Choose a Progressing this exercise: route that is relatively flat — Increasing the speed or distance you walk, or if accessible - include walking uphill in your route When you might choose this exercise: — If you can get outdoors to exercise
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10. Jogging or cycling Only do jogging or cycling if it is medically safe for you When you might choose this exercise: If walking is not making you out of breath enough If you could jog or cycle before you became unwell
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Strengthening exercises Strengthening exercises will help improve muscles that have become weaker as a result of your illness. You should aim to do three sessions of strengthening exercise each week. Strengthening exercises will not make you feel breathless in the same way as fitness exercises. Instead, your muscles will feel like they have worked hard. You should aim to complete up to 3 sets of 10 repetitions of each exercise, taking a short rest in between each set. Do not worry if you find these exercises hard. If you do, start with a smaller number of repetitions in each set and build up to achieving sets of 10. As you get better with the exercises, use heavier weights to make your muscles work harder. You can use tins of food or bottles of water as weights. Some strengthening exercises for your arms and legs are described below, which can be done in sitting or standing. These can be done in any order. Keep a good posture, with your back straight and your tummy tucked in, and complete the exercises slowly. Remember to breathe in as you prepare to do the hardest part of the exercise and breathe out as you make the effort.
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Examples of strengthening exercises for your ARMS
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Examples of strengthening exercises for your LEGS
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Endurance exercises (when tolerated)
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Phase 1 / Initial Phase For five minutes, walk at a pace where you can speak in full sentences. The goal is to walk for five minutes without stopping. Initially, you may need to take breaks as needed until you can walk five minutes continuously. If walking is too difficult, try performing some light marching in place, holding onto a counter for support if needed. Walk 3-5 times per day
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Phase 2 / Intermediate Phase For 10 minutes, walk at a pace where you can speak in full sentences. The goal is to walk for 10 minutes without stopping. Initially, you may need to take breaks as needed until you can walk 10 minutes continuously. Walk 2-3 times per day.
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Phase 3 / Final Phase Endurance Activities For 30-45 minutes, walk at a pace where you can speak in full sentences. The goal is to walk at least 30 minutes without stopping. Initially, you may need to take breaks as needed until you can walk at least 30 minutes continuously. Start by walking on flat surfaces. As you progress and gain endurance, try challenging yourself by walking on hills and inclines. Walk five times per week.
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Cool down exercises Cool down exercises allow your body to return to normal before stopping exercise. Your cool down should last approximately 5 minutes, and your breathing should be back to normal by the end. Try working through all these suggestions, but if you cannot manage all the exercises or stretches, do the ones that you can.
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Start with low pace 1. Walking at a slower pace or gently marching on the spot, for approximately 2 minutes 2. Repeat the warm-up exercises to move your joints; these can be done in sitting or standing
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References https://www.youtube.com/watch?v=QmrZkV4AOMM Post Covid-19 physiotherapy advice and exercise programme by NHS Support for Rehabilitation Self-Management after COVID-19- Related Illness by WHO PHYSIOTHERAPY MANAGEMENT FOR COVID-19 IN THE PRIMARY, COMMUNITY AND ACUTE (HOSPITAL) SETTINGS GPA Preliminary Guideline for COVID-19. Version 1.0 April 23, 2020. COVID-19 Proning for Self care by Ministry of Health & Family Welfare Government of India