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Early Physical Therapist Interventions for Patients With COVID-19 in the Acute
Care Hospital: A Case Report Series
#MMPMID33492400
Eggmann S
; Kindler A
; Perren A
; Ott N
; Johannes F
; Vollenweider R
; Balma T
; Bennett C
; Silva IN
; Jakob SM
Phys Ther
2021[Jan]; 101
(1
): ? PMID33492400
show ga
OBJECTIVE: The aim of this case series was to describe the experience of Swiss
physical therapists in the treatment of patients with COVID-19 during their acute
care hospital stay and to discuss challenges and potential strategies in the
clinical management of these patients. METHODS: We report 11 cases of patients
with COVID-19 from 5 Swiss hospitals that illustrate the various indications for
physical therapy, clinical challenges, potential treatment methods, and
short-term response to treatment. RESULTS: Physical therapists actively treated
patients with COVID-19 on wards and in the intensive care unit. Interventions
ranged from patient education, to prone positioning, to early mobilization and
respiratory therapy. Patients were often unstable with quick exacerbation of
symptoms and a slow and fluctuant recovery. Additionally, many patients who were
critically ill developed severe weakness, postextubation dysphagia, weaning
failure, or presented with anxiety or delirium. In this setting, physical therapy
was challenging and required specialized and individualized therapeutic
strategies. Most patients adopted the proposed treatment strategies, and lung
function and physical strength improved over time. CONCLUSION: Physical
therapists clearly have a role in the COVID-19 pandemic. Based on our experience
in Switzerland, we recommend that physical therapists routinely screen and assess
patients for respiratory symptoms and exercise tolerance on acute wards.
Treatment of patients who are critically ill should start as soon as possible to
limit further sequelae. More research is needed for awake prone positioning and
early breathing exercises as well as post-COVID rehabilitation. IMPACT: To date,
there are few data on the physical therapist management of patients with
COVID-19. This article is among the first to describe the role of physical
therapists in the complex pandemic environment and to describe the potential
treatment strategies for countering the various challenges in the treatment of
these patients.
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