When the COVID-19 pandemic hit India, no one imagined that physiotherapy would play a significant role in the management of symptoms, recovery and rehabilitation of patients with COVID-19.
Even as the world celebrated the World Physical Therapy Day on 8 September 2020 to ‘generate awareness about the crucial contribution physiotherapists make to society, enabling people to be mobile, well, and independent’, the role of physiotherapists remains largely undermined and unnoticed.
Physiotherapy or physical therapy is a treatment method focussing on the ‘science of movement’ to assist patients in ‘restoring, maintaining and optimising the physical strength, function and motion’. It’s an allied field that includes ‘rehabilitation, injury prevention, fitness and health promotion.
Physiotherapy primarily treats acute/chronic pains, physical injuries and movement impairments. Basically, physiotherapy aims at an ‘holistic approach’ for the treatment of a patient suffering from musculoskeletal impairments originating from illness, injury or trauma.
COVID-19 after-effects too severe
The panic and fear surrounding the COVID-19 outbreak is not unfounded. Not only is the virus highly infectious, the effects on the body are severe and long standing. Several patients infected with COVID-19 complain of the remnant effects weeks after the infection and long after being discharged from the hospital.
When 35-year-old Delhi-based bank employee Sharad Singh (name changed) tested positive for COVID-19, he did not panic. He had managed to get himself admitted to a private COVID-care facility and also knew that age is on his side. He, however, never anticipated that the dreaded infection will leave his lungs severely damaged. “It’s been over a month since I left the hospital. I can still feel how badly the virus has impaired me, particularly my lungs,” says Sharad.
In severe cases of the SARS CoV-2 (COVID-19 to the layman) infection, the lungs of the patient are badly damaged and cause acute respiratory distress syndrome. The after-effects of the viral infection can be seen in many patients where owing to damaged lungs, the patient experiences “dyspnea or air hunger,” i.e shortness of breath.
“I was in a lot of distress due to shortness of breath and constant fatigue. Even a little walking or talking would be difficult for me for many weeks after I left the hospital,” says Sharad.
Thankfully for him, a physiotherapist friend came to his assistance as cardiorespiratory physiotherapy works towards management of acute and chronic respiratory conditions. “My friend helped me through the physical recovery. Like me, most people are not aware of how beneficial physiotherapy can be in the physical rehabilitation and respiratory treatment of COVID-19 patients.”
Post-COVID rehabilitation through physiotherapy
Through physiotherapy, Sharad began doing “pulmonary exercises to help increase the lung capacity and aid deep breathing” and saw positive results soon.
Very few facilities are focussing on a rehabilitation programme for severely-affected patients who continue to suffer for weeks after being discharged. Most suffer from lung fibrosis that leads to impaired lung function, oxygen imbalance followed by extreme exhaustion.
This is where the role of physiotherapists is critical who facilitate post-COVID treatment rehabilitation through thoracic expansion exercises, chest manipulation techniques, diaphragmatic and segmental breathing, inspiratory muscle stimulation, positioning for proper lung ventilation, etc. Something as simple as sleeping on your stomach can alleviate difficulty in breathing.
It’s was not surprise that this year’s theme of World Physical Therapy Day focussed on ‘rehabilitation and Covid-19’ and ‘delivery of physiotherapy through telehealth’.
Physiotherapy helps in treating chronic pain
Today, most health issues arise out of bad lifestyle and unhealthy habits. The lack of physical activity and long hours seated at work create multiple health issues. Physiotherapy works towards rebuilding strength of the affected body part by reversing the damage, restoring the affected functionality that has been impaired or lost completely and by educating the patient on healthy behaviour and proper movements.
“For many years, I had developed a chronic pain in the lower back that had affected the quality of life adversely. I had to think twice before undertaking any physical activity. On some days, even sitting and lying down would not relieve me of the pain. Medicines would only mask the pain for a few hours,” says 34-year-old Hyderabad-based software professional Kiran Reddy.
It was Kiran’s lifestyle, particularly the demands of her job that required her to “sit in front of a computer for long hours, often uninterrupted” that led to the chronic condition. “In the beginning, I ignored the symptoms thinking they’ll fade away. But the discomfort quickly progressed to excruciating pain limiting all kinds of movements for me. It was a horrible feeling to not be able to play with my children, drive my car, and plan holidays with the family… I was starting to get depressed,” recalls Kiran. After suffering for nearly “four years”, Kiran consulted a physiotherapist and was “shocked to realise how well her body responded”. “I never took physiotherapy seriously earlier… I thought physiotherapists only helped sportspersons with their cramps and dislocations. Only after my condition improved did I realise how underrated physiotherapy is in modern-day healthcare management.”
Physiotherapy is extremely helpful in treating chronic pain associated with shoulder pain, cervical and thoracic pain, rheumatoid arthritis, osteoarthritis, etc.
Physiotherapy critical in several illnesses
Physiotherapy is considered to be an allied field in terms of healthcare management but it helps in improving several serious conditions of the human body. This is done primarily by ‘maximising the quality of life and the movement potential’.
Conditions which require physiotherapy include: Respiratory problems such as asthma, pneumonia, chronic obstructive pulmonary disease; Neurological problems such as Parkinson’s disease, multiple sclerosis, stroke, congenital defects, deficiency diseases like Vitamin B12, neoplasm; Neuromusculoskeletal problems such as those received while playing sports (injuries related to bones, joints, tendons, ligaments and muscles), arthritis, accident injuries, back pain, whiplash-associated disorders; Cardiovascular issues such as chronic heart diseases and post heart attack rehabilitation.
Additionally, physiotherapy is important for patients of Type 2 diabetes, for which there is no cure. Treatment mainly includes managing lifestyle and incorporating lifestyle changes to maintain blood glucose levels.
A healthy lifestyle is critical in managing Type 2 diabetes as it minimises the risk of complications in such patients or if done at a prior stage, even prevent the onset of the disease in the first place. People with diabetes often have other health conditions such as high blood-pressure, stroke, obesity, heart disease, etc. These conditions are high risk factors and in such cases, exercise and lifestyle changes are needed for a healthy life.
Physiotherapists advice on exercises to prevent the onset of diabetes and incorporate changes to manage the other related conditions. The exercises aim to reduce body fat, improve how body processes glucose and maintain mobility and movement.
Therapeutic exercise programmes are a major part of diabetes management. Something as simple as proper foot care is an essential part of the physiotherapy programme for diabetic patients.
Geriatric physiotherapy important
Physiotherapy plays an important role in the rehabilitation of old patients, especially in individuals above 60 years of age when most suffer from several health issues including neurological problems, orthopaedics issues, etc. In such conditions, critical and specialised care is needed and physiotherapy provides that.
Most individuals at this age are unable to maintain balance that often leads to falls and other injuries in the process. Physiotherapy helps in muscle strengthening, balancing exercises, restoring full/maximum range of motion in limbs and joints, etc. Also, physiotherapists teach respiratory exercises to clear lungs and for cardiac rehabilitation in old patients.
The role of physiotherapy in health care and rehabilitation is highly understated. It is time the contribution of physiotherapy to global health is recognised and appreciated.