Recovery & Rehabilitation Post-Covid-19

We are now hesitantly entering a brave new world; but as we all navigate the easing of restrictions and a gradual return to our new ‘normal’, we cannot forget the many thousands of individuals still impacted by COVID-19.

Recent publications from the NHS and professional bodies, such as the Chartered Society of Physiotherapy and the Royal College of Occupational Therapists, make it clear that the pandemic will be affecting individuals recovering from the virus for a long time to come.

As COVID-19 is a new virus, evidence regarding its long term impact is limited, but we are continuing to learn and piece together new information every day. As more people continue to hopefully recover globally more evidence will become available.

Health Professionals are observing the following deficits during the acute stages, especially in those individuals receiving critical care, which may suggest a longer term impact:

• Musculoskeletal – muscle deconditioning and weakness, pain, overwhelming fatigue
• Cardiopulmonary – postural hypotension, breathlessness, limited exercise tolerance
• Neuro-cognitive – delirium, impaired consciousness, memory problems, sensory changes
• Psychological – fear, anxiety, low mood, post traumatic stress disorder
• Communication – speech difficulties, post-intubation swallowing difficulties

This list is certainly not exhaustive, but gives a strong indication of how individuals’ daily lives will be affected long after recovery. Of course some deficits may improve in the short term but some deficits not evident in the early stages may also become apparent. Such impairments in survivors of critical illness can understandably have a significant negative impact on quality of life.1

We must also consider those individuals impacted by an exacerbation of other health issues as a result of reduced access to health services and isolation during the pandemic.

Rehabilitation will be essential in enabling these individuals to reach their potential and live their lives to the full. Given the significant impact on quality life rehabilitation services will require the same consideration as critical care, and leaders and policymakers need to take urgent action to ensure this is delivered.2

The NHS has published its support of Health Professionals’ role in rehabilitation during and after COVID-19, and has identified four main population groups who will likely be in need of multi-disciplinary care:3

1. Individuals recovering from COVID-19; those still hospital and those discharged to community services.
2. Individuals at risk due to pauses in their planned care.
3. Individuals who avoided accessing health services during the pandemic and may now be at greater risk of ill-health due to delayed diagnosis and subsequent treatment.
4. Individuals dealing with the negative impact lockdown has had on their physical and mental health.

At CareFlex we fully support our health & care services and continue to be thankful for keyworkers’ hard work and dedication in fighting this cruel enemy, and for putting their lives at risk to save others. We want to play our part in the next step of the fight and raise awareness of the importance of postural management in rehabilitation.

Our next article will review in more detail the rehabilitation recommendations put forward by the NHS and professional bodies, and how specifically CareFlex and our specialist seating can help towards improving quality of life for those in recovery.

References:

1. Parker A, Sricharoenchai T, Needham DM (2013) Early rehabilitation in the intensive care unit: preventing physical and mental health impairments Curr Phys Med Rehabil Rep 1:307-314
2. Chartered Society of Physiotherapy (2020) Rehabilitation and Covid-19 – CSP policy statement Available from: https://www.csp.org.uk/professional-clinical/improvement-innovation/community-rehabilitation/rehab-covid-19-policy-statement
3. NHS (2020) Allied health professionals’ role in rehabilitation during and after COVID-19 Available from: https://www.england.nhs.uk/coronavirus/publication/allied-health-professionals-role-in-rehabilitation-during-and-after-covid-19/