What Interventions Do Physical Therapists Provide for Patients With Cardiorespiratory Conditions, Neurological Conditions, and Conditions Requiring Acute Hospital Care? A Systematic Review

Physical therapy for the treatment of respiratory issues using Systemic Manual Therapy protocols

BACKGROUND

The emergence of the Coronavirus (COVID-19) pandemic increased the need for an effective treatment for respiratory conditions exponentially. To meet this challenge, we reevaluated the effectiveness of our physical therapy protocols for respiratory conditions. Protocols of interest were categorized as decongestive, neurogenic, mechanical, and immune modulating.

OBJECTIVE

The objective of this study is to evaluate which of our existing treatment protocols or protocol combinations produce the best outcome. To do so, we analyzed which ones can meet the following criteria when compared to all other treatments: test statistic (>2.0) in parametric and non-parametric tests, [statistical significance (p < 0.05)], effect size larger than 0.2, difference in the Patient Identified Problem Scale (PIP) score above Minimal Clinically Important Difference (MCID), and sample size minimum 15 treatments.

DESIGN

Retrospective multivariate analysis using a modified adaptive platform design.

METHODS

A computerized sampling using respiratory related key words from a blinded dataset yielded 178 patients with respiratory complaints or pain in the chest area. Additional statistical analysis using parametric and non-parametric tests evaluated the difference between each treatment protocol and the rest of the treatments provided.

RESULTS

Several protocol combinations and one individual protocol passed the study criteria. Cardiac vascular venous thoracic (CVVT) protocol was used most frequently within these combinations (7), followed by Urinary Drainage (UD) (4). Other protocols in this group were Cardiac Cervical Cranial Vascular (CCCV), Venous Thoracic Cardiopulmonary (VTCP), and Diaphragm Cranial Sinus (DCS). Among the respiratory specific protocols, CVVT was significantly better than VTCP (0.40, p < 0.001).

DISCUSSION AND CONCLUSION

For the patient population studied, CVVT appears to be the primary protocol to consider, followed by UD, CCCV, VTCP, and DCS. Combining CVVT with Barral Abdominal Motility protocol (Barral) or VTCP with Lower Abdominal Urogenital (LAUG) on the same day might be required with acute patients.

Telerehabilitation for Post-Hospitalized COVID-19 Patients: A Proof-of-Concept Study During a Pandemic

Purpose

Telerehabilitation could prevent sequelae from COVID-19. We aimed to assess the feasibility of telerehabilitation; describe pulmonary and functional profiles of COVID-19 patients; and explore the effect of telerehabilitation on improving pulmonary symptoms and quality of life.

Methods

We conducted a pre-experimental, pre-post pilot study. We recruited COVID-19 patients who had returned home following hospitalization. The intervention included eight weeks of supervised physiotherapy sessions. We documented technological issues, success of recruitment strategies, and participants' attendance to supervised sessions. We measured the impact of pulmonary symptoms on quality of life and functional health.

Results

We scheduled 64 supervised sessions with seven participants with few technological issues. Initial scores showed that pulmonary symptoms moderately to highly impacted quality of life. At eight weeks, all patients had improved from 10 to 45 points on the EuroQol-Visual Analog Scale (EQ-VAS) instrument, indicating clinical significance.

Conclusion

We developed and administered a telerehabilitation intervention during a global pandemic that targets key symptoms of the relevant disease.