Long Covid/ Post Covid Syndrome – New Evidence supports Physio intervention

April 06, 2021

The latest research supports the multi- system impact of Long Covid (or increasingly in clinical settings known as  Post Covid Syndrome), requires an individualised approach as each person will present with differing symptoms. There is also immense pressure on the NHS to deal with the demand. If you would like advice on your recovery plan BWT are here to help. it may just need a one off assessment and advice session or maybe a programme of supervised, incremental goal setting, advice on restorative sleep or the input of a clinical psychologist or consultant cardiologist. We are here to point you in the right direction. www.bwtphysio.co.uk/services/long-covid-rehab/ 

The key findings from The Chartered Society of Physiotherapy are outlined below. The full article can be read here Post-covid syndrome | The Chartered Society of Physiotherapy (csp.org.uk)

The key messages for physiotherapists managing long Covid  by Jessica Bavinton – specialist fatigue physio, are fully amalgamated into the BWT Physio approach to managing this condition:

• Collaboration: all programmes need to be absolutely bespoke for that one patient – there really is no one-size-fits-all. They must be developed in collaboration with the patient
• Thorough screening and assessment: expect to assess and advise on medical factors, and to up-skill where needed to spot signs of medical deterioration (especially neuro, cardiac or respiratory). Some patients may not have been assessed medically, may still be medically unstable and require your ongoing monitoring, They may also have symptoms that we would see as ‘red flags’ (eg chest pain, oxygen desaturation, tachycardia) so we need confidence in assessing and knowing when to refer on. Expect to screen for malnutrition, anxiety, depression & PTSD
• Symptom assessment management: there may be a number of factors a patient is dealing with, including fatigue, breathlessness, chest pain, joint/muscle pain, loss of taste/smell, cough, brain fog (amongst a number of others). Some of these may be improving and spontaneously resolve, and others you will need to develop a plan to help manage
• Give hope: hearing a negative message at a vulnerable time can be devastating, so think carefully about the words you use. We are finding some people are very frightened by what they have been through, and worried about what might lie ahead. Let people know that most people are getting better, but that it could take some time. I tell them this is a new illness, so we don’t know for sure what the outcome will be. But that early evidence, and my own experience, says that most people are gradually getting better over time
• Work with others: because of the range of issues experienced by some people with long Covid, its important  to work as part of a team which would include occupational therapists, psychologists, dieticians, physicians and medical specialists, speech therapists and nurses
• Structure and routine: consider the importance of setting a sustainable daily routine to stabilise symptoms utilising non-incremental pacing strategies in the first instance. This would include addressing sleep, nutrition, and balancing different types of activities and rest
• A gentle incremental approach, over time: start low, go slow. Take an individualised and steady approach back to function, social, work, physical activity or exercise. Going back too soon or too fast is likely to lead to a setback and be very demoralising. There may be some contraindications to aerobic exercise, but we are finding most people are responding well to a gentle, carefully monitored approach using functional everyday physical activities like walking and exercises
• Emotional wellbeing and sleep: patients can understandably be sleeping badly and/or anxious for many reasons including health uncertainties, finances, family and social. Anxiety may make fatigue worse
• Be confident but steady and patient: physios are very well equipped with skills to assess and manage patients using our clinical reasoning skills. However, don’t be tempted to push too hard or go too fast. You will need to be patient

You can be sure that at BWT your recovery will be managed with care and respect for your personal symptoms and circumstances.