The second wave of COVID 19 has been an unpredictable catastrophe for the people of India. There was excessive acute of beds, medicines, healthcare professionals and most importantly there was immense mismanagement of the already available resources in India. Physiotherapy is one such branch of modern healthcare which is still underutilized even though enough awareness has been spread over past two years in this battle against COVID. Cardiorespiratory physiotherapists can play key role as part of a multidisciplinary team experienced in critical care. The government needs to understand that physiotherapy has been a powerful weapon in all times of need. The current pandemic scenario has made us realise that in spite of modern medicine, at the end it is one's immunity by fitness or exercises that is the ultimate medicine for any unknown disease in future. Exercise is the cheapest, safest & effective medicine that needs prescription by movement scientists.
Physiotherapy must be recognised as a frontline or essential health profession during a crisis like the COVID-19 pandemic. Physiotherapists play a critical role in the treatment for all phases of COVID-19.
New strategies will need to be developed and implemented to address issues related to people affected by Covid. Physiotherapists will have a key role in this process of rehabilitation, right from day one. If physiotherapy is incorporated, mobility is achieved way faster and this will definitely have an impact on bringing down mortality rates. Lack of physiotherapists involvement in public services has resulted in many people affected by COVID-19 not receiving
physiotherapy interventions. Certain [points need to be made in this regard.
People with non-Covid long-term conditions have been particularly affected by the disruption of physiotherapy services because they are more likely to develop complications secondary to their existing condition and this will further add to the existing demands of hospital admission.
In many public health systems, physiotherapists were redeployed into other healthcare roles to support emergency plans to inpatients with COVID-19.
There is lack of knowledge, not only on part of people affected by COVID-19 but also from different stakeholders involved in the healthcare process, about the importance of physiotherapy treatment and the role of physiotherapists as frontline workers in the response to the COVID-19 pandemic.
Overall healthcare load will be reduced as physiotherapy has multiple applications, from reducing pooling of secretions, improving air entry, reducing occurrence of ventilator associated pneumonia, improving aerobic endurance and muscular strength. It also plays a role in reducing hospital related depression and psychosis and critical illness neuropathy.
The very famous and trending proning position advised for management of COVID 19 is a component of physiotherapy. If a simple position can yield great results then using aid of qualified physiotherapists can do wonders. As experienced by Nitin Gadkari, physiotherapy has helped him recover at a faster rate and I believe taking inspiration from such great personalities shall help us all. From my own vast international experience, we have had successful stories with excellent patient outcome.
Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-reducing, psychosocial, and health economic benefits in multiple outcome areas for patients with chronic respiratory diseases.
The American Thoracic Society (ATS)/European Respiratory Society (ERS) Policy Statement provides policy recommendations with the principal objective of expanding the provision of PR to suitable individuals. This is exactly the need of hour right now in India as well,our goals are to:
1. Raise awareness of the value and specific benefits of PR
2. Trigger action by healthcare systems to provide adequate funding support for PR services and to include provision of PR in their strategic plans for care of respiratory diseases,
3. Increase healthcare professionals’ prescription of PR
4. Enhance delivery of PR through increased program access and capacity,
5. Raise awareness of patients’ experiences and barriers in accessing and attending PR
6. Engage patients with chronic respiratory diseases and their caregivers to request access to PR,
7. Facilitate the development and implementation of quality metrics for the inclusion of PR
We must develop media campaigns with governmental and professional societies’ support to increase the awareness of patients and the general public regarding the benefits of PR, exercise, and physical activity.
Some components of physiotherapy applicable at the moment are:
1. Breathing exercises & incentive spirometer to strengthen respiratory muscles.
2. Postural drainage, gravity assisted positions to be used after a clearance from the senior or experienced physio
3. Early mobilization which includes in bed, around bed and in hospital complete rehabilitation
4. Patient and family education on bronchial hygiene, home care management, improving aerobic endurance.
5. Positioning and secretion removing correct techniques.
It is strongly advised that the patients should only consult qualified senior or experienced physiotherapist for their rehabilitation and recovery, similar to seeking medical help for treating COVID 19. Half knowledge can do more harm than cure and self treatment has no benefit.
Dr. Suhail Ahmad Mir (PT) President J And K Physiotherapists Association