Postcovid rehabilitation gives patients a chance to regain full he alth and physical fitness after contracting the SARS-CoV-2 coronavirus infection. As statistics show, up to a third of patients after COVID-19 infection may struggle with various types of complications, including those related to the respiratory system, which directly affects the body's efficiency. What are the indications for pulmonary rehabilitation and how to get a referral for rehabilitation treatment?

In order to improve the condition and he alth of patients, a specialprogram of postcovid pulmonary rehabilitationhas been developed. Complications related to COVID-19 disease can affect many systems of the body, including the cardiovascular, neurological and respiratory systems. Complications after COVID-19 very often affect the respiratory system and take the form of respiratory failure.

COVID-19 and respiratory complications

Respiratory complications after COVID-19 lead, among others, to to:

  • deterioration of exercise tolerance,
  • feeling short of breath - which may be related to pulmonary fibrosis, but also to developing heart failure (dyspnea, increasing in the supine position, indicates a cardiac cause),
  • problems with breathing, air intake,
  • depression and anxiety related to the above disorders.

Respiratory rehabilitation after COVID-19 - who is en titled to?

Patients who are convalescents are eligible for pulmonary rehabilitation if less than six months have passed since the end of the disease.

Symptoms that interfere with normal everyday functioning are also a condition. Such a symptom related to the respiratory system is primarilyshortness of breath .

Dyspnoea is assessed using a special scale called the Medical Research Council's Modified Scale (mMRC for short) . It is a five-point scale with 0 to 4 points.

A score of 4 means that breathlessness is preventing the patient from leaving the house or occurs while dressing or undressing. On the other hand, 0 points means that the patient suffers shortness of breath only during intense physical exertion.

To receive a referral topostcovid rehabilitation, it is enough to get 1 point on the mMRC scale described above. If you get 1 point, you are experiencing breathlessness when walking briskly across flat terrain or when climbing a slight hill.

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Referral for pulmonary rehabilitation - where to get it?

You must have a referral to start pulmonary rehabilitation. Such a referral can be obtained, among others, from your family doctor who, based on an interview with the patient, assesses whether a given person qualifies for this type of treatment.

If you have bothersome symptoms related to COVID-19, it is definitely worth asking your doctor about the possibility of rehabilitation treatment.

Respiratory rehabilitation after COVID-19 - how is it going?

Currently, pulmonary rehabilitation can take place in spas, in physiotherapy offices, but also at the patient's home.

Rehabilitation at home is possible thanks to the visits of physiotherapy specialists. In Poland, about 90 facilities have already joined the program, which will rehabilitate patients.

Patients who decide to undergo pulmonary rehabilitation at the clinic or at home can use it for up to six weeks. Pulmonary rehabilitation in the office or at home takes place in several stages.

Respiratory rehabilitation after COVID-19 - initial visit

The initial and necessary stage of pulmonary rehabilitation is the so-called initial visit. During this visit , the physiotherapy specialist conducts a detailed interview with the patient , thanks to which it is possible to identify the most bothersome symptoms.

The specialist can also conduct some breathing tests that will assess the condition and he alth of the patient. Moreover, the initial assessment of the patient's he alth gives a chance to compare the patient's efficiency after the completion of rehabilitation.

Initial tests give a chance to select the appropriate physiotherapy exercises and, importantly, to adjust their intensity.

Too much effort at the beginning of rehabilitation may be dangerous for the patient , incl. due to the presence of cardiovascular complications that arose as a result of COVID-19 infection.

The first visit lasts about 50 minutes in the case of rehabilitation in a physiotherapist's office, and in the case of home rehabilitation - about 90 minutes.

Respiratory rehabilitation after COVID-19 - therapeutic visit

After the initial visit, the physiotherapy specialist makes an appointment with the patient for further appointmentsappropriate pulmonary rehabilitation will be performed.The postcovid rehabilitation program involves three rehabilitation visits in each of the six weeks .

Respiratory therapy with a physiotherapist includes:

  • breathing exercises,
  • endurance exercise,
  • interval exercises - during which intense exercises are performed in rounds (intervals), between which lower intensity exercises are performed. These exercises help to improve the condition and endurance of the body,
  • learning expectoration techniques - allows for effective cleaning of the respiratory tract of secretions,
  • balance training - it is recommended primarily in the case of accompanying neurological complications.

Respiratory rehabilitation after COVID-19 - final visit

At the final visit, the physiotherapy specialist assesses the effects of the entire rehabilitation program by re-performing the tests that took place during the first visit. The breathing tests and fitness assessment exercises are accompanied bydyspnea scale assessment .

It is worth knowing that the postcovid rehabilitation program also provides for patient education, thanks to which he will be able to continue certain exercises on his own.

As part of their education, patients will receive from the physiotherapist special training plans for self-exercise at home.

Respiratory rehabilitation after COVID-19 at home - what exercises can we do on our own?

You should be aware that you can do the breathing exercises yourself at home. Such self-rehabilitation improves the body's efficiency and reduces the risk of respiratory failure in the event of contracting COVID-19. It also helps in dealing with the complications of this infection.

The breathing exercises are aimed at:

  • reduction of atelectasis areas in the lungs (atelectasis is a condition in which the lungs lose their aeration due to external pressure or bronchial obstruction),
  • increasing the strength of the respiratory muscles, including the diaphragm, which is the largest respiratory muscle,
  • increasing the mobility of the chest.

Performing breathing exercises at home requires some preparation. You should thoroughly ventilate the room in which you are staying and equip yourself with comfortable, non-compressive clothes for exercise.

Do not eat a heavy meal before exercising. If you are prescribed medications in the form of inhalations, you can take them before starting exercise.

  • COVID-19: symptoms, course, treatment, complications, prevention
  • Complications after COVID-19. What complications do people who recovered from COVID-19 have?
  • Convalescence after COVID-19. What does recovery look like from coronavirus infection?

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COVID 19