World Physiotherapy Day celebrates the unity and solidarity of the global physiotherapy community and the work physiotherapists do for their patients and the community.

The theme for 2021 is ‘Long COVID and rehabilitation’.

Global guidance has been developed to support physiotherapists to manage safe and effective rehabilitation approaches for people living with long COVID.

Physiotherapy Board Chair Kim Gibson says that despite Australia’s success in limiting and controlling the spread of COVID-19, physiotherapists need to remain vigilant and keep abreast of the latest international guidance on COVID-19 and how this disease may continue to affect our communities in the future.

‘We need to know how to manage patients who have had COVID-19, particularly those who have longer term complications from this virus, and how as physiotherapists we can help them in their recovery.’

What is long COVID?

COVID-19 can cause persistent ill health.

Global data shows that one-quarter of people who have had the virus may experience symptoms that continue for at least a month, more than one in 10 may remain unwell after 12 weeks and others may have ongoing symptoms for longer than six months.

Long COVID may be experienced as episodic and unpredictable in nature, with symptoms fluctuating and changing over time.

Safe rehabilitation

Long COVID is an emerging condition that is not yet well understood but can be severely disabling.

It is currently unknown when and what amount of physical activity is safe or beneficial.

Among a sample of 3762 people living with long COVID across 56 countries, 72 per cent reported post-exertional symptom exacerbation.

A World Physiotherapy briefing paper, Safe rehabilitation approaches for people living with Long COVID: physical activity and exercise, outlines the global consensus on safe rehabilitation specific to physical activity, including exercise or sport, for people living with long COVID.

Four specific statements consider the impact of post-exertional symptom exacerbation, cardiac impairment, exertional oxygen desaturation and autonomic nervous system dysfunction on the safe prescription of rehabilitation, including physical activity.

‘Physiotherapists can play an important role in the rehabilitation of people living with long COVID, to balance physical activity with rest for the best outcomes for long-term recovery,’ says Kim.

Managing COVID-19 in Australia

The authors of a Deeble Institute for Health Policy Research paper, Managing the long-term health consequences of COVID-19 in Australia, consider that Australia’s response to long COVID needs to be proportionate—suitable for dealing with today’s relatively small numbers, yet capable of rapid scaling up if circumstances require it.

This calls for healthcare professionals to be supported to work at the top of their scope of practice, including through the development of regular, updated clinical guidelines that reflect evolving evidence on the long-term management of post-COVID care.

Even in Australia, where effective control measures have avoided the burden of acute and long-term illness from COVID-19 seen in other countries, many of these potential long-term effects are still likely to be felt in the healthcare system, particularly the effects on healthcare professionals.

Direct impacts of COVID-19 on the healthcare workforce

The COVID-19 pandemic has directly impacted healthcare staff, with health practitioners at increased risk of infection.

Health practitioners have also experienced considerable emotional distress during the pandemic.

An Australian study of hospital clinical staff found approximately a quarter of the nurses, midwives, doctors and allied health staff surveyed during the first wave of the pandemic reported symptoms of psychological distress (Holton et al 2020).

In a separate study, approximately 30 per cent of 320 Australian healthcare workers surveyed screened positively for burnout symptoms (Dobson et al 2021).

Healthcare systems will be further challenged with the reduced healthcare capacity resulting from the events caused by COVID-19, including workload and work-related stress.

The World Health Organization has released a charter dedicated to healthcare worker safety in recognition of the burden of COVID-19 for healthcare providers (WHO 2020).

Click here for more information and here for updates relevant to all health professions under the National Scheme.

References

Dobson, H., Malpas, C.B., Burrell, A.J., Gurvich, C., Chen, L., Kulkarni, J. & Winton-Brown, T. 2021, 'Burnout and psychological distress amongst Australian healthcare workers during the COVID-19 pandemic', Australas Psychiatry, vol. 29, no. 1, pp. 26-30.

 

Holton, S., Wynter, K., Trueman, M., Bruce, S., Sweeney, S., Crowe, S., Dabscheck, A., Eleftheriou, P., Booth, S. & Hitch, D. 2020, 'Psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic', Australian Health Review.

 

World Health Organization (WHO). 2020. Health worker safety: a priority for patient safety, https://www.who.int/publications/i/item/9789240011595