Your Guide to The Essential COVID-19 Physiotherapy Resources

With the information and evidence surrounding the coronavirus pandemic constantly changing it can cause confusion and misinformation. This is why we have put together a simple easy-to-use guide to ensure you stay on top of what you need to know.

Contents of The Guide

  1. Free Physiopedia COVID-19 e-book
  2. The Essential Physiopedia Pages
  3. Free COVID-19 Courses
  4. Youtube Playlist
  5. Covid-19 Rehabilitation
  6. Long COVID
  7. COVID-19 and Frailty
  8. Social Media Top Follows
  9. World Physiotherapy
  10. Myth Busters

Free COVID-19 e-books Powered By Physiopedia

These are Physiopedia’s first ever eBooks. The PP team is quite a lot smaller than most people realise so putting something like this together alongside our usual jobs and PP tasks is no mean feat. Kim Jackson is the content manager at Physiopedia and she has been the driving force behind the eBooks creation.

“2020 has been a year to remember, the COVID-19 pandemic brought many changes to the delivery of Physiotherapy and a steep learning curve for many.  With social distancing and the temporary closure of many services we had to find another way to deliver services, mainly through platforms such as Telehealth.”

“For others it meant adapting their skills and knowledge to cope with this new respiratory disorder, whilst there where others who spent time re-skilling to help out in areas that were completely overwhelmed and understaffed. But one thing 2020 did show us was the resilience of Physiotherapists, their ability to adapt their skills and also their willingness to work as a part of a team, both within our discipline and as part of multi-disciplinary teams. COVID-19 really has been a challenge both on a personal and professional level.”

Kim says that everyone at Physiopedia has recognised the importance of keeping abreast of all the new developments and many interventions that COVID-19 has demanded of us. The PP team have created many new pages to guide clinicians and these complement the Physioplus courses to ensure a well rounded learning experience for clinicians. The fact that all of these resources are available for free is even better and something the whole team is proud of.

The first ebook is An Introduction to COVID-19 and the second is COVID-19 Rehabilitation Programme. Access these two eBooks by completing the form below, to make sure you have all the knowledge you need about COVID-19, wherever you are. Even without an internet connection.

Get 2 free COVID eBooks

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You will be able to download the eBooks shortly to make sure you have all the knowledge you need about COVID-19, wherever you are. Even without an internet connection.

The Essential Physiopedia Pages

Kim has also selected her top Physiopedia COVID-19 resources for you. These pages are continually updated by the Physiopedia Team to ensure you have the best evidence based content available to you.

These are the top pages for a reason. They contain evidence based facts and information written in an easy to digest way for you to implement in clinical practice. These pages cover everything you need to know from pathophysiology, lung x-ray changes and rehabilitation to PPE, your role as a physiotherapist and ventilation settings. These are your go-to resources to remain on top of the newest changes in the evidence.

Don’t forget you can download the Physiopedia App to access these pages quickly on and offline .

Get it on Google Play

Download on the App Store

Free COVID-19 Courses on Physioplus

Currently there are 21 Physioplus courses related to COVID-19. All created by topic experts with each sharing with you how the coronavirus has affected their speciality and disseminating the information to you via high quality video and testing your knowledge with quizzes and articles. Many of these courses have been translated into different languages too!

The courses are available for free until the end of 2020.

The courses are free until the end of 2020 and then they will be available to all full paying members of Physioplus. Undoubtedly the Physioplus Team will continue to update the courses and upload new courses as the evidence changes.

To get access to the courses all you have to do is sign up for a trial account. Be quick as time is running out!

Covid-19 Youtube Playlist

Physiopedia’s mission is to improve global health through universal access to physiotherapy knowledge. COVID-19 hasn’t put a stop to that – it’s strengthened our resolve to make sure we keep our community up to date with everything they need to know through every channel we can. This includes Youtube.

These Youtube videos are a mixture of interviews and presentations covering a wide range of topics from leadership and crisis management to clinical management of respiratory patients. Thank you to all of the clinicians who gave up their time to create the content. The whole #GlobalPT community are thankful for your time but remember, these videos aren’t just for us so make sure you share them to your colleagues.

The videos in the playlist include:

  • Leadership during times of COVID-19 with Emma Stokes
  • Crisis management with Jason Giesbrecht
  • COVID respiratory treatment considerations with Rachel Moses and Deborah Dent
  • Nutritional considerations with Joe Tatta
  • Treating tendinopathy during lockdown with Ebonie Rio
  • Staying safe with handwashing techinque and cleaning with Liezl Naude

We will have new and original Youtube content coming out in 2021 so make sure you don’t miss out. Subscribe and hit the alarm button to get notified when we release our new content. The Physiopedia team is super excited with what we are working on so don’t miss out! We’d love you to be a part.

COVID-19 Rehabilitation

There are two distinct patient groups affected by the pandemic: those who need rehab because of the virus and those whose services are affected because of the virus. Any rehabilitation strategy in the time of COVID must therefore address both COVID-specific rehabilitation needs and the needs of those who require rehabilitation for reasons other than COVID infection.

Failure to do so risks inequity of access to rehab for large numbers of people, and a failure to deliver effective rehabilitation to those deconditioned or otherwise in need risks worse outcomes for those who become unwell with COVID-19 in future pandemic waves. It is therefore essential that rehabilitation programmes and proactive management resume as soon as possible. This will minimise adverse outcomes for people living with long term conditions, those with gradual functional decline and those requiring rehabilitation after elective or emergency hospitalisation.

Below is a list of the best resources and guidelines from around the world to help you make sure your services are covid safe as far as possible.

COVID-19 Post-Acute Rehabilitation
People with severe COVID-19 infection have rehabilitation needs in the acute, post-acute and long-term phases of the disease. Many people who have suffered from COVID-19 may now be at risk of long-term impairment or disability. Physiotherapists are critical to the rehabilitation efforts in all phases of this disease. Rehabilitation has a positive effect on health and functioning outcomes, it improves recovery and can reduce disability, it may facilitate early discharge and reduce the risk of readmission. Physiotherapists also play a key role in supporting and empowering people through rehabilitation process.

Rehabilitation is Key to Long Term Recovery

Long COVID

The persistent chronic symptoms of coronavirus is still something the world is figuring out. As new information emerges you can be sure we will be updating our Physiopedia pages. But for now, below is a run down of what we know now.

What You Need To Know

  • Current management after first 3 weeks is unknown
  • ~10% of people with a COVID infection develop chronic symptoms
  • Many people with Long COVID recover spontaneously, others need MDT care with graded exercise and exposure to their usual pre-covid routine
  • If you are concerned about persistent clinical concern then refer for specialist assessment. This includes respiratory, neurological or cardiac symptoms

Most patients who have COVID-19 recover and return to normal health. Approximately 10% of patients have persistent symptoms that can be wide-ranging and last weeks to months after the initial infection. This isn’t only reserved for those who have been severely affected, those with mild or minimal symptoms can go on to develop chronic symptoms. Many multi-year studies are underway to investigate Long COVID fully but for now we have to mange with what we know so far.

The most common symptoms are

  • Fatigue
  • Shortness of breath
  • Cough
  • Myalgia
  • Chest pain

Others include brain fog, low mood, headache and  heart palpitations.

The best way to prevent these symptoms is to prevent getting COVID-19 in the first place. This means adhering to social distancing and wearing PPE whenever possible. There is some evidence to suggest that persistent viraemia due to weak immunity, deconditioning and PTSD are all contributing factors to developing long covid.

This infographic is taken from the BMJ which has some excellent COVID-19 resources available.
Long COVID infographic

World Physiotherapy and The COVIDPhysio Registry

World PT Day took place on the 8th of September and the theme for this year was COVID-19 rehabilitation, something which will continue to be at the forefront of our minds for months and years to come. On the World Physiotherapy website there is a COVID-19 information hub which contains all of the PT day outputs and materials in the COVIDPhysio Registry.

Our profession is uniquely placed to step up and contribute to the challenge and help our most vulnerable people regain independence and quality of life in ways we have never seen before. Although it is easy at this stage to have COVID-19 fatigue and the thought of seeing and creating more resources is exhausting, this is our time to rise to the challenge. Make sure you check the COVIDPhysio Registry to promote collaboration and avoid duplication in effort.

Additionally there are high quality educational resources for both staff and patients all of which are available for free.

Frailty & COVID-19

Older people who are living with frailty don’t respond to coronavirus in the same way as younger people. This is partly why many older people who are admitted to hospital go on to become asymptomatic postive cases and inadvertedly spead the disease to others on the wards.

Key Points

  • Older patients have a higher risk of mortality and may present with delirium, postural instability or diarrhoea and without fever
  • Social distancing and isolation may have negative concequences for older people unrelated to COVID-19
  • Older people are relatively excluded from clinical trials relating to COVID-19
  • In addition to age, male gender and presence of comorbidities, specific laboratory and radiology findings are important prognostic factors

At this stage we all know that the typical symptoms of COVID-19 are predominantly respiratory symptoms (cough, sputum, sore throat, runny nose, ear pain, wheeze and chest pain), systemic manifestations (myalgia, joint pain and fatigue) and enteric presentation (abdominal pain, vomiting and diarrhoea). Due to frailty and age-related physiological and immunological changes older people often present without these typical / classic symptoms.

Immune scenecence is one of the key drivers for atypical presentations along with the multi system dysregulation involved in the frailty process. If your body systems aren’t working together properly you don’t have a typical response to homeostasis or infection. It makes the situation unpredictable.

Deep Dive into Frailty with Scott Buxton

A recent study published in Age and Ageing has shed some light on atypical presentations in the elderly who are living with higher levels of frailty or live in care settings. Of the patients included within the study the most common COVID-19 symptoms were hypoactive delirium, falls, anorexia and fatigue. Mortality for fully atypical presentation was 65% and median LoS was 11 days for those that survived.

For more information on how COVID-19 affects people living with Frailty the British Geriatric Society has a  a COVID-19 resource hub.

COVID-19 Post-Acute Rehabilitation
Frailty is a clinical state that is associated with many negative outcomes, including falls, harm events and disability or death. It is estimated that 25-50% of the population aged 85 years and over can be classified as frail and, as such, most physiotherapists will encounter frail patients. This course will introduce frailty and provide you with key insights on how it impacts patients and their quality of life.

People Living with Frailty Often Present Atypically with COVID

News and Social Media Top Follows

The evidence around COVID-19 is constantly changing and that’s why Physiopedia recommends keeping up to date with the latest developments via Physiospot and reputable news outlets and experts on social media.

We asked our Physiopedia community to tell us where they go to find out about the latest coronavirus developments where they are in the world.

Our community’s top follows include:

  • The BMJ Twitter account for the latest articles on COVID-19
  • The CDC Twitter account is a great follow for the latest breaking news
  • The European Medicines Agency for vaccine updates in the Northern Hemisphere
  • The Lancet for developments in Latin America
  • The New Scientist for topical and politcal analysis of COVID-19 developments

Coronavirus Myth Busters

Myth busting at a time like this is crucial and there are some excellent articles out there on the internet. Always make sure it is from a trusted source and author and seek evidence to back up people’s claims. Instagram and Twitter are excellent sources of quick and up-to-date evidence and infographics however the good is interspersed with misinformation.  Make sure you are vigilant and if it sounds sensationalist or too good to be true, then it probably is. Below is a list of truths and the resources they have come from. Make sure you know all you need to know as a physiotherapist.

Does alcohol gel kill COVID-19? – Yes.

Are surgical face masks useful? – The leading thought at the moment is that COVID is transmitted via droplets which means masks are useful at collecting these droplets. Clearly this isn’t infallible because droplets can still be transmitted through eyes and onto your skin and transferred to your face later. Also it’s worth pointing out surgical masks are useful in close proximity to people only.

There is also lots of misinformation about the size of the virus and the filtering ability of masks. An infographic allegedly from Unicef has been doing the rounds on WhatsApp and Twitter which claims the coronavirus is 400-500nm wide and therefore enough to be stopped by masks. This is actually untrue and the virus is 50-200nm wide. Either way as explained above, a mask won’t always stop the virus.

What’s The Incubation Period for COVID-19? – The WHO report this being somewhere between 1 and 14 days with symptoms most commonly emerging after 5 days. This is where the 14 days of self-isolation comes from.

How Long Does The Virus Live On Surfaces – There is no exact answer to this question. The current thought is that COVID-19 behaves like other corona viruses and will persist on surfaces for a few hours up to several days but there is some evidence to say up to 28 days on surfaces like your phone. This is a broad timespan but this is because it is all dependant on environmental conditions which vary massively even within a persons home. The sensible advice is to disinfect surfaces regularly if you think they may be contaminated.

The WHO have some awesome Infographics available which you should definitely share amongst patients, colleagues and friends. Here is one busting the myth that dousing your body in chlorine or alcohol will kill the coronavirus.