Physiotherapy recommendations for coronavirus disease 2019 in intensive care units_West China Medical Journal

Authors：

ZHU Chuanmei ¹ ,  YU Pengming ²

1. Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YU Pengming, Email: 13438201415@126.com

Keywords：

Coronavirus disease 2019; physiotherapy; intensive care unit; rehabilitation

DOI：

10.7507/1002-0179.202205030

Video：

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Since the outbreak of coronavirus disease 2019 (COVID-19), there have been numerous studies confirming that physiotherapy is an essential part of the comprehensive treatment during hospitalization and can facilitate recovery in COVID-19 patients. However, physiotherapy protocols for COVID-19 patients in intensive care units are still lacking. This article reviews the literature and incorporates practical experience around recommendations for the safe protection during physiotherapy, recommendations for evaluation criteria and intervention of physiotherapy, and future work for COVID-19 patients, so as to provide a standardized recommendation for physiotherapists working in intensive care units.

Citation： ZHU Chuanmei, YU Pengming. Physiotherapy recommendations for coronavirus disease 2019 in intensive care units. West China Medical Journal, 2023, 38(6): 914-918. doi: 10.7507/1002-0179.202205030 Copy

1.	Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep, 2020, 69(24): 759-765.
2.	Chang D, Mo G, Yuan X, et al. Time kinetics of viral clearance and resolution of symptoms in novel coronavirus infection. Am J Respir Crit Care Med, 2020, 201(9): 1150-1152.
3.	Wittmer VL, Paro FM, Duarte H, et al. Early mobilization and physical exercise in patients with COVID-19: a narrative literature review. Complement Ther Clin Pract, 2021, 43: 101364.
4.	Phelan S, Lin F, Mitchell M, et al. Implementing early mobilisation in the intensive care unit: an integrative review. Int J Nurs Stud, 2018, 77: 91-105.
5.	Bernal-Utrera C, Anarte-Lazo E, Gonzalez-Gerez JJ, et al. Could physical therapy interventions be adopted in the management of critically ill patients with COVID-19? A scoping review. Int J Environ Res Public Health, 2021, 18(4): 1627.
6.	Pascarella G, Strumia A, Piliego C, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med, 2020, 288(2): 192-206.
7.	Greenhalgh T, Jimenez JL, Prather KA, et al. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. Lancet, 2021, 397(10285): 1603-1605.
8.	Wilson NM, Marks GB, Eckhardt A, et al. The effect of respiratory activity, non-invasive respiratory support and facemasks on aerosol generation and its relevance to COVID-19. Anaesthesia, 2021, 76(11): 1465-1474.
9.	To KK, Sridhar S, Chiu KH, et al. Lessons learned 1 year after SARS-CoV-2 emergence leading to COVID-19 pandemic. Emerg Microbes Infect, 2021, 10(1): 507-535.
10.	Lee S, Meyler P, Mozel M, et al. Asymptomatic carriage and transmission of SARS-CoV-2: what do we know?. Can J Anaesth, 2020, 67(10): 1424-1430.
11.	Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet, 2009, 373(9678): 1874-1882.
12.	Ferreira CHJ, Driusso P, Haddad JM, et al. A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic. Int Urogynecol J, 2021, 32(1): 203-210.
13.	Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother, 2020, 66(2): 73-82.
14.	Lazzeri M, Lanza A, Bellini R, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a position paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis, 2020, 90(1): 1285.
15.	Helms J, Kremer S, Merdji H, et al. Neurologic features in severe SARS-CoV-2 infection. N Engl J Med, 2020, 382(23): 2268-2270.
16.	Ozyemisci Taskiran O, Turan Z, Tekin S, et al. Physical rehabilitation in intensive care unit in acute respiratory distress syndrome patients with COVID-19. Eur J Phys Rehabil Med, 2021, 57(3): 434-442.
17.	Vitacca M, Carone M, Clini EM, et al. Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian Position Paper. Respiration, 2020, 99(6): 493-499.
18.	Thomas P, Baldwin C, Beach L, et al. Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations. J Physiother, 2022, 68(1): 8-25.
19.	Silva C, Xavier DS, Lima E, et al. Evidence-based physiotherapy and functionality in adult and pediatric patients with COVID-19. J Hum Growth Dev, 2020, 30(1): 148-155.
20.	Abdullahi A. Safety and efficacy of chest physiotherapy in patients with COVID-19: a critical review. Front Med (Lausanne), 2020, 7: 454.
21.	Zaim S, Chong JH, Sankaranarayanan V, et al. COVID-19 and multiorgan response. Curr Probl Cardiol, 2020, 45(8): 100618.
22.	Negm AM, Salopek A, Zaide M, et al. Rehabilitation care at the time of coronavirus disease-19 (COVID-19) pandemic: a scoping review of health system recommendations. Front Aging Neurosci, 2022, 13: 781271.
23.	Thomas K, Harrison DA, Koelewyn A, et al. Critical care outcomes, for the first 200 patients with confirmed COVID-19, in England, Wales and Northern Ireland: a report from the ICNARC Case Mix Programme. J Intensive Care Soc, 2021, 22(4): 270-279.
24.	Dixit S, Borghi-Silva A, Bairapareddy KC. Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review. Rev Cardiovasc Med, 2021, 22(2): 315-327.
25.	Nasa P, Azoulay E, Khanna AK, et al. Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method. Crit Care, 2021, 25(1): 106.
26.	Wang Y, Zhang M, Yu Y, et al. Sputum characteristics and airway clearance methods in patients with severe COVID-19. Medicine (Baltimore), 2020, 99(46): e23257.
27.	Li L, Yu P, Yang M, et al. Physical therapist management of COVID-19 in the intensive care unit: the West China Hospital experience. Phys Ther, 2021, 101(1): pzaa198.
28.	Shafi AMA, Shaikh SA, Shirke MM, et al. Cardiac manifestations in COVID-19 patients: a systematic review. J Card Surg, 2020, 35(8): 1988-2008.
29.	Burgess LC, Venugopalan L, Badger J, et al. Effect of neuromuscular electrical stimulation on the recovery of people with COVID-19 admitted to the intensive care unit: a narrative review. J Rehabil Med, 2021, 53(3): jrm00164.
30.	Debeuf R, Swinnen E, Plattiau T, et al. The effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: a rapid review. J Rehabil Med, 2022, 54: jrm00242.
31.	The Lancet. Facing up to long COVID. Lancet, 2020, 396(10266): 1861.
32.	Negm AM, Salopek A, Zaide M, et al. Rehabilitation at the time of pandemic: patient journey recommendations. Front Aging Neurosci, 2022, 14: 781226.
33.	Holdoway A. Addressing nutrition in the road map of recovery for those with long COVID-19. Br J Community Nurs, 2021, 26(5): 218-222.

1. Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep, 2020, 69(24): 759-765.
2. Chang D, Mo G, Yuan X, et al. Time kinetics of viral clearance and resolution of symptoms in novel coronavirus infection. Am J Respir Crit Care Med, 2020, 201(9): 1150-1152.
3. Wittmer VL, Paro FM, Duarte H, et al. Early mobilization and physical exercise in patients with COVID-19: a narrative literature review. Complement Ther Clin Pract, 2021, 43: 101364.
4. Phelan S, Lin F, Mitchell M, et al. Implementing early mobilisation in the intensive care unit: an integrative review. Int J Nurs Stud, 2018, 77: 91-105.
5. Bernal-Utrera C, Anarte-Lazo E, Gonzalez-Gerez JJ, et al. Could physical therapy interventions be adopted in the management of critically ill patients with COVID-19? A scoping review. Int J Environ Res Public Health, 2021, 18(4): 1627.
6. Pascarella G, Strumia A, Piliego C, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med, 2020, 288(2): 192-206.
7. Greenhalgh T, Jimenez JL, Prather KA, et al. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. Lancet, 2021, 397(10285): 1603-1605.
8. Wilson NM, Marks GB, Eckhardt A, et al. The effect of respiratory activity, non-invasive respiratory support and facemasks on aerosol generation and its relevance to COVID-19. Anaesthesia, 2021, 76(11): 1465-1474.
9. To KK, Sridhar S, Chiu KH, et al. Lessons learned 1 year after SARS-CoV-2 emergence leading to COVID-19 pandemic. Emerg Microbes Infect, 2021, 10(1): 507-535.
10. Lee S, Meyler P, Mozel M, et al. Asymptomatic carriage and transmission of SARS-CoV-2: what do we know?. Can J Anaesth, 2020, 67(10): 1424-1430.
11. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet, 2009, 373(9678): 1874-1882.
12. Ferreira CHJ, Driusso P, Haddad JM, et al. A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic. Int Urogynecol J, 2021, 32(1): 203-210.
13. Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother, 2020, 66(2): 73-82.
14. Lazzeri M, Lanza A, Bellini R, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a position paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis, 2020, 90(1): 1285.
15. Helms J, Kremer S, Merdji H, et al. Neurologic features in severe SARS-CoV-2 infection. N Engl J Med, 2020, 382(23): 2268-2270.
16. Ozyemisci Taskiran O, Turan Z, Tekin S, et al. Physical rehabilitation in intensive care unit in acute respiratory distress syndrome patients with COVID-19. Eur J Phys Rehabil Med, 2021, 57(3): 434-442.
17. Vitacca M, Carone M, Clini EM, et al. Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian Position Paper. Respiration, 2020, 99(6): 493-499.
18. Thomas P, Baldwin C, Beach L, et al. Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations. J Physiother, 2022, 68(1): 8-25.
19. Silva C, Xavier DS, Lima E, et al. Evidence-based physiotherapy and functionality in adult and pediatric patients with COVID-19. J Hum Growth Dev, 2020, 30(1): 148-155.
20. Abdullahi A. Safety and efficacy of chest physiotherapy in patients with COVID-19: a critical review. Front Med (Lausanne), 2020, 7: 454.
21. Zaim S, Chong JH, Sankaranarayanan V, et al. COVID-19 and multiorgan response. Curr Probl Cardiol, 2020, 45(8): 100618.
22. Negm AM, Salopek A, Zaide M, et al. Rehabilitation care at the time of coronavirus disease-19 (COVID-19) pandemic: a scoping review of health system recommendations. Front Aging Neurosci, 2022, 13: 781271.
23. Thomas K, Harrison DA, Koelewyn A, et al. Critical care outcomes, for the first 200 patients with confirmed COVID-19, in England, Wales and Northern Ireland: a report from the ICNARC Case Mix Programme. J Intensive Care Soc, 2021, 22(4): 270-279.
24. Dixit S, Borghi-Silva A, Bairapareddy KC. Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review. Rev Cardiovasc Med, 2021, 22(2): 315-327.
25. Nasa P, Azoulay E, Khanna AK, et al. Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method. Crit Care, 2021, 25(1): 106.
26. Wang Y, Zhang M, Yu Y, et al. Sputum characteristics and airway clearance methods in patients with severe COVID-19. Medicine (Baltimore), 2020, 99(46): e23257.
27. Li L, Yu P, Yang M, et al. Physical therapist management of COVID-19 in the intensive care unit: the West China Hospital experience. Phys Ther, 2021, 101(1): pzaa198.
28. Shafi AMA, Shaikh SA, Shirke MM, et al. Cardiac manifestations in COVID-19 patients: a systematic review. J Card Surg, 2020, 35(8): 1988-2008.
29. Burgess LC, Venugopalan L, Badger J, et al. Effect of neuromuscular electrical stimulation on the recovery of people with COVID-19 admitted to the intensive care unit: a narrative review. J Rehabil Med, 2021, 53(3): jrm00164.
30. Debeuf R, Swinnen E, Plattiau T, et al. The effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: a rapid review. J Rehabil Med, 2022, 54: jrm00242.
31. The Lancet. Facing up to long COVID. Lancet, 2020, 396(10266): 1861.
32. Negm AM, Salopek A, Zaide M, et al. Rehabilitation at the time of pandemic: patient journey recommendations. Front Aging Neurosci, 2022, 14: 781226.
33. Holdoway A. Addressing nutrition in the road map of recovery for those with long COVID-19. Br J Community Nurs, 2021, 26(5): 218-222.

West China Medical Journal

Physiotherapy recommendations for coronavirus disease 2019 in intensive care units

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