IJPR.2020.180

Type of Article:  Case Series

Volume 8; Issue 6 (December 2020)

Page No.: 3706-3714

DOI: https://dx.doi.org/10.16965/ijpr.2020.180

REVIEW OF PHYSIOLOGICAL RATIONALE OF PHYSIOTHERAPY IN COVID-19 PATIENTS: A CASE SERIES

Mohini N Kamat 1, Manali G Sonavane *2, Jaimala V Shetye 3, Dipti B Geete 4.

1,*2 PG Student, PT School & Centre, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.

3 Associate Professor, PT School & Centre, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.

4 Assistant Professor, PT School & Centre Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.

Address for Correspondence: Dr. Manali Sonavane, PT., PG Student, PT School & Centre, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India. E-Mail: sonavanemanali5@gmail.com

ABSTRACT

Physiotherapy interventions have been evidenced to assist early liberation from ICU in COVID-19 patients. This case series of three COVID patients admitted to the COVID ICU, explains the physiologic rationale of physiotherapy intervention in acute care of COVID patients. Early mobilization is seen to help early recovery.
Keywords: Physiologic rationale, COVID, physiotherapy, crocodile breathing.

REFERENCES

[1]. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020 May;109:102433.
https://doi.org/10.1016/j.jaut.2020.102433
PMid:32113704 PMCid:PMC7127067
[2]. Kashani KB. Hypoxia in COVID-19: Sign of Severity or Cause for Poor Outcomes. Mayo Clin Proc. 2020;95(6):1094-1096.
https://doi.org/10.1016/j.mayocp.2020.04.021
PMid:32498766 PMCid:PMC7177114
[3]. Torres Acosta MA, Singer BD. Pathogenesis of COVID-19-induced ARDS: implications for an aging population. Eur Respir J 2020; in press
https://doi.org/10.1183/13993003.02049-2020
PMid:32747391 PMCid:PMC7397945
[4]. Mason RJ. Pathogenesis of COVID-19 from a cell biology perspective. Eur Respir J 2020; 55: 2000607
https://doi.org/10.1183/13993003.00607-2020
PMid:32269085 PMCid:PMC7144260
[5]. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, Camporota L. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020 Jun;46(6):1099-1102.
https://doi.org/10.1007/s00134-020-06033-2
PMid:32291463 PMCid:PMC7154064
[6]. Dhont, S., Derom, E., Van Braeckel, Depudeyt P, Lambrecht B. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 2020;21:198.
https://doi.org/10.1186/s12931-020-01462-5
PMid:32723327 PMCid:PMC7385717
[7]. Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, Hodgson C, Jones AY, Kho ME, Moses R, Ntoumenopoulos G, Parry SM, Patman S, van der Lee L. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020 Apr;66(2):73-82.
https://doi.org/10.1016/j.jphys.2020.03.011
PMid:32312646 PMCid:PMC7165238
[8]. Hodgson CL, Tipping CJ. Physiotherapy management of intensive care unit-acquired weakness. J Physiother. 2017 Jan;63(1):4-10.
https://doi.org/10.1016/j.jphys.2016.10.011
PMid:27989729
[9]. Masiero S, Zampieri D, Del Felice A. The Place of Early Rehabilitation in Intensive Care Unit for COVID-19. Am J Phys Med Rehabil. 2020;99(8):677-678.
https://doi.org/10.1097/PHM.0000000000001478
PMid:32467490 PMCid:PMC7299104
[10]. Liu D, Baumeister RF, Veilleux JC, Chen C, Liu W, Yue Y, Zhang S. Risk factors associated with mental illness in hospital discharged patients infected with COVID-19 in Wuhan, China. Psychiatry Res. 2020 Oct;292:113297.
https://doi.org/10.1016/j.psychres.2020.113297
PMid:32707218 PMCid:PMC7355324
[11]. Hopkins SR, Henderson AC, Levin DL, Yamada K, Arai T, Buxton RB, Prisk GK. Vertical gradients in regional lung density and perfusion in the supine human lung: the Slinky effect. J Appl Physiol (1985). 2007 Jul;103(1):240-8.
https://doi.org/10.1152/japplphysiol.01289.2006
PMid:17395757 PMCid:PMC2399899
[12]. Mentzelopoulos SD, Roussos C, Zakynthinos SG. Prone position reduces lung stress and strain in severe acute respiratory distress syndrome. Eur Respir J. 2005 Mar;25(3):534-44.
https://doi.org/10.1183/09031936.05.00105804
PMid:15738300
[13]. Trifi A,Abdellatif S,Abdennebi C,Daly F,Touil Y,Ben Lakhal S. Ultrasound variations of diaphragm activity between prone position versus supine position in ventilated patients: a cross-sectional comparative study. Journal of Ultrasound. Sept 2020.
https://doi.org/10.1007/s40477-020-00514-2
PMid:32870470 PMCid:PMC7459156
[14]. Bein T, Bischoff M, Brückner U, Gebhardt K, Henzler D, Hermes C, et al. S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders : Revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Anaesthesist. 2015 Dec;64 Suppl 1:1-26.
https://doi.org/10.1007/s00101-015-0071-1
PMid:26335630 PMCid:PMC4712230
[15]. Mase K, Noguchi T, Tagami M, Imura S, Tomita K, Monma M, et al. Compression of the lungs by the heart in supine, side-lying, semi-prone positions. J Phys Ther Sci. 2016 Sep;28(9):2470-2473.
https://doi.org/10.1589/jpts.28.2470
PMid:27799672 PMCid:PMC5080154
[16]. Elharrar X, Trigui Y, Dols AM, Touchon F, Martinez S, Prud’homme E, et al. Use of Prone Positioning in Nonintubated Patients With COVID-19 and Hypoxemic Acute Respiratory Failure. JAMA. 2020 Jun 9;323(22):2336-2338.
https://doi.org/10.1001/jama.2020.8255
PMid:32412581 PMCid:PMC7229532
[17]. Gupta P, Nambi G, Gupta G, Nagar R, Mehta P, Makwana A. Effect of Intercostal Stretch Technique and Anterior Basal Lift Technique on Respiratory Rate, Saturation of Peripheral Oxygen and Heart Rate among ICU Patients. International journal of health sciences and research. 2014; 4:26-31.
[18]. Tom Schepens, Ewan C. Goligher; Lung- and Diaphragm-protective Ventilation in Acute Respiratory Distress Syndrome: Rationale and Challenges. Anesthesiology 2019; 130:620-633.
https://doi.org/10.1097/ALN.0000000000002605
PMid:30844950
[19]. Ali SS, O’Connell C, Kass L, Graff G. Single-breath counting: a pilot study of a novel technique for measuring pulmonary function in children. Am J Emerg Med. 2011 Jan;29(1):33-6.
https://doi.org/10.1016/j.ajem.2009.07.006
PMid:20825771
[20]. Cantor-Quimson , M. B., Gaerlan-Enojado , A. , Saenz , M. , Agtarap , V. P., & Gonzales , M. Single breath counting: a simple alternative to pulmonary function assessment. The Filipino Family Physician, 1998;36(2):39-44.
[21]. Arul Kumaran Palaniyandi. “Even A Single Breath Counts.” IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2017; 16.9:70-72.
[22]. Escóssio A, Araújo R, Oliver N, Costa E, Rizzo J, Sarinho E et al. Accuracy of single-breath counting test to determine slow vital capacity in hospitalized patients. Revista CEFAC. 2019; 21.
https://doi.org/10.1590/1982-0216/20192122119
[23]. Basso JC, Suzuki WA. The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Brain Plast. 2017;2(2):127-152.
https://doi.org/10.3233/BPL-160040
PMid:29765853 PMCid:PMC5928534
[24]. Mohamed AA, Alawna M. Role of increasing the aerobic capacity on improving the function of immune and respiratory systems in patients with coronavirus (COVID-19): A review. Diabetes Metab Syndr. 2020;14(4):489-496.
https://doi.org/10.1016/j.dsx.2020.04.038
PMid:32388326 PMCid:PMC7186129
[25]. Al-Bilbeisi F, McCOOL FD. Diaphragm recruitment during nonrespiratory activities. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):456-9.
https://doi.org/10.1164/ajrccm.162.2.9908059
PMid:10934070
[26]. Singh MV, Chapleau MW, Harwani SC, Abboud FM. The immune system and hypertension. Immunol Res. 2014;59(1-3):243-253.
https://doi.org/10.1007/s12026-014-8548-6
PMid:24847766 PMCid:PMC4313884
[27]. Apicella M,Campopiano M, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet Diabetes & Endocrinology. Sept 2020;8(9):782-92.
https://doi.org/10.1016/S2213-8587(20)30238-2
[28]. Patel BK, Pohlman AS, Hall JB, Kress JP. Impact of early mobilization on glycemic control and ICU-acquired weakness in critically ill patients who are mechanically ventilated. Chest. 2014 Sep;146(3):583-589.
https://doi.org/10.1378/chest.13-2046
PMid:25180722 PMCid:PMC5831570
[29]. Hegde SM, Solomon SD. Influence of Physical Activity on Hypertension and Cardiac Structure and Function. Curr Hypertens Rep. 2015;17(10):77.
https://doi.org/10.1007/s11906-015-0588-3
PMid:26277725 PMCid:PMC4624627
[30]. Gaffar A, Waghray S, Balne NK. Efficacy of Balance Scales in Fall Risk Identification in Elderly with Breathing Pattern Dysfunction-An Observational Study. 2019;9(2):101-107.
[31]. Hillegass E, Fick A, Pawlik A, Crouch R, Perme C, Chandrashekar R, McNamara S, Cahalin L. Supplemental Oxygen Utilization During Physical Therapy Interventions, Cardiopulmonary Physical Therapy Journal: June 2014 ; 25 (2): 38-49
https://doi.org/10.1097/01823246-201406000-00002
[32]. Russo MA, Santarelli DM, O’Rourke D. The physiological effects of slow breathing in the healthy human. Breathe (Sheff). 2017 Dec;13(4):298-309
https://doi.org/10.1183/20734735.009817
PMid:29209423 PMCid:PMC5709795
[33]. Gerritsen RJS, Band GPH. Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Front Hum Neurosci. 2018 Oct 9;12:397.
https://doi.org/10.3389/fnhum.2018.00397
PMid:30356789 PMCid:PMC6189422
[34]. Garcia AJ 3rd, Koschnitzky JE, Dashevskiy T, Ramirez JM. Cardiorespiratory coupling in health and disease. Auton Neurosci. 2013 Apr;175(1-2):26-37.
https://doi.org/10.1016/j.autneu.2013.02.006
PMid:23497744 PMCid:PMC3683976

Cite this article: Mohini N Kamat, Manali G Sonavane, Jaimala V Shetye, Dipti B Geete. REVIEW OF PHYSIOLOGICAL RATIONALE OF PHYSIOTHERAPY IN COVID-19 PATIENTS: A CASE SERIES. Int J Physiother Res 2020;8(6):3706-3714. DOI: 10.16965/ijpr.2020.180