COVID-19 Pandemic: A Physiotherapy Update

Addressing post-COVID-19 musculoskeletal symptoms through pulmonary rehabilitation and telemedicine: A study protocol

Objective

The purpose of the study will be to evaluate the effect of pulmonary rehabilitation on the improvement of patients with post-COVID-19 musculoskeletal symptoms, as well as to quantify the impact of telemedicine that evaluates the evolution of pain, functionality, and quality of life.

Methods

We will carry out a case-control study in post-COVID-19 musculoskeletal symptoms patients who will undergo pulmonary rehabilitation, together with an intervention and a follow-up using programmed telemedicine sessions. Data will be collected on the improvement of functional capacity and quality of life, in addition to assessing the evolution of musculoskeletal symptomatology, as well as pain and psychological variables. The approaches of face-to-face rehabilitation and telerehabilitation will also be compared. The telemedicine sessions will improve user adherence and follow-up, and the results are expected to be disseminated to the scientific community during and after the end of the study.

Knowledge, Attitude, and Practice of Physiotherapists in COVID-19 ICUs: A National Survey

Background

COVID-19 belongs to the beta-corona cluster that spreads enormously via aerosols. Physiotherapists must be knowledgeable about the symptoms, mode of transmission, risk mitigation strategies, and practice guidelines for COVID-19.

Objective

This study aimed to assess physiotherapists' knowledge of COVID-19 guidelines, their attitude toward this new evolving field, and their practice routines in India's COVID-19 ICUs.

Methods

It was a cross-sectional study. A total of 600 questionnaires were distributed through e-mail and WhatsApp to physiotherapists using Google Forms between February 2022 and January 2023. The questionnaires consisted of demographics and 23 questions in three sections about the knowledge, attitude, and practice of physiotherapists working in the COVID-19 ICU. Data analysis was carried out using Jamovi.

Results

A total of 136 responses were obtained from 18 states of India. Of 136 participants, 89 were female (65.4%) and 47 were male (34.6%). The highest level of qualification was BPT (n = 69 (50.7%)), followed by MPT (n = 62 (45.6%)) and Ph.D. (3 (3.7%)). The knowledge about COVID-19 guidelines is fair. Only 21.3% of the physiotherapists received training before being deployed in COVID-19 ICUs, and the CARP protocol was well known by only as few as 10.3%. The criteria advised for close monitoring of patients during treatment was aware by 29.4%. Most physiotherapists have a good attitude toward treating COVID-19 patients; 70.63% strongly agree that physiotherapy is vital in these patients despite the risk of self-exposure, and 64.7% agree that physiotherapy should be initiated during all phases of COVID-19. Physiotherapists follow good practices for COVID-19 patients in the ICU, which is as per the guideline recommendation.

Conclusion

Physiotherapists working in COVID-19 ICUs have a fair knowledge of the existing physiotherapy guidelines for COVID-19, and they exhibit good attitudes and practice patterns.

Mental health patterns of physiotherapists in South Africa during COVID-19

Background

While attention has been drawn to the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers generally, little is known regarding mental health changes over time in frontline and non-frontline physiotherapists during this period.

Objectives

Our study aimed to investigate differences in mental health trends among frontline and non-frontline physiotherapists across three time periods during the pandemic.

Method

Survey-based data were collected from 366 practising physiotherapists across three time periods during the pandemic (Time 1: n = 171; Time 2: n = 101; Time 3: n = 94). Variations in reported mental health of frontline and non-frontline respondents generally and over time were analysed using comparative statistical techniques and trend analysis.

Results

Frontline physiotherapists reported significantly lower levels of general mental well-being and resilience, and significantly higher levels of burnout and maladaptive strategy use. Only frontline physiotherapists' general mental well-being and resilience decreased over time, whereas depression decreased over time for both groups. Anxiety decreased over time for non-frontline physiotherapists but initially decreased and then increased for frontline physiotherapists. Burnout increased initially and then decreased for non-frontline physiotherapists.

Conclusion

Varying mental health trends were found between frontline and non-frontline physiotherapists over time. Nuanced mental health interventions that consider the period of the pandemic and degree of exposure are needed.

Clinical implications

Understandings of the mental health trajectories experienced by physiotherapists across the pandemic can inform long-term, targeted interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system.