How to Improve the Physical Fitness in COVID-19 Recovered Patients?

Covid-19 being mainly a respiratory infection, has a major effect on the lungs and breathing muscles along with other systems. Understanding respiratory symptoms, its treatment and management has thus become a crucial part of post COVID care.

Most patients either with mild or severe COVID-19 symptoms invariably experience some amount of breathlessness and fatigue on the path to recovery. Taking into account how breathless you are, it is also important to know how to deal with it. Physiotherapy, especially respiratory therapy focussing mainly on improving the lung function plays a major role in this.

Here are a few physiotherapy guidelines to help COVID patients on their path to recovery:

Proper positioning: _{Breathlessness is one of the most common symptoms among patients both during COVID infection as well as post recovery which in turn hampers their day to day activities. Some positions like high side-lying, forward bending, and backward lean standing are useful in relieving the breathlessness and thus improving the general symptoms.}

Breathing Exercises: Controlled paced breathing has shown to improve the lung expansion and oxygen saturation of patients recovering from COVID. Phased breathing exercises [assisting diaphragm and minimizing work of accessory muscles] are thus important to be included in the recovery plan.

Oxygen monitoring: One of the most common and often missed effects of corona virus is a drop in oxygen saturation. This in turn causes fatigue and breathlessness leading to further complications. Hence it's very important to monitor the oxygen saturation with a pulse oximeter in COVID patients. Drop-in SpO2 <90 [at rest or during exercises] should be immediately reported to the healthcare provider.

Improve the Functional mobility: Reduction in SpO2 levels and breathlessness often lead to a reduction in functional capacity and overall endurance of patients. Hence it's important to maintain and improve the mobility by simple on bed exercises of hands and legs with gradual progression as per patient tolerance [under the guidance of a physiotherapist]. These exercises are started in the immediate phase of infection itself [including ICU care depending on patient condition].

 
Strengthening: Prolonged hospitalization and general fatigue frequently result in loss of muscle strength of patients recovering from COVID. So it is important to incorporate exercises that improve the functional strength of muscle groups in the final stage of rehabilitation. Aerobic exercises are one of the most effective exercises that improve the endurance and strength in these patients.

Apart from improving the lung function, physical activity in general has certain other benefits as well, such as:

• Physical activity improves the overall immunity in the patients.
• Some amount of regular exercises helps to keep comorbidities such as diabetes, blood pressure, obesity under control.
• COVID-19 has shown to have an impact on not only the physical status but also to some extent on the emotional well-being of patients. Exercises in general release happy hormones and cortisol, thus keeping stress levels under control which in turn keeps anxiety and depression at bay.

 These are some of the points to be followed for patients affected with and recovering from COVID. All these taken into consideration along with the general safety measures accelerate the path to recovery.