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Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19

OBJECTIVE: The COVID-19 pandemic is rapidly evolving and has led to increased numbers of hospitalizations worldwide. Hospitalized patients with COVID-19 experience a variety of symptoms, including fever, muscle pain, tiredness, cough, and difficulty breathing. Elderly people and those with underlyin...

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Autores principales: Felten-Barentsz, Karin M, van Oorsouw, Roel, Klooster, Emily, Koenders, Niek, Driehuis, Femke, Hulzebos, Erik H J, van der Schaaf, Marike, Hoogeboom, Thomas J, van der Wees, Philip J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337861/
https://www.ncbi.nlm.nih.gov/pubmed/32556323
http://dx.doi.org/10.1093/ptj/pzaa114
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author Felten-Barentsz, Karin M
van Oorsouw, Roel
Klooster, Emily
Koenders, Niek
Driehuis, Femke
Hulzebos, Erik H J
van der Schaaf, Marike
Hoogeboom, Thomas J
van der Wees, Philip J
author_facet Felten-Barentsz, Karin M
van Oorsouw, Roel
Klooster, Emily
Koenders, Niek
Driehuis, Femke
Hulzebos, Erik H J
van der Schaaf, Marike
Hoogeboom, Thomas J
van der Wees, Philip J
author_sort Felten-Barentsz, Karin M
collection PubMed
description OBJECTIVE: The COVID-19 pandemic is rapidly evolving and has led to increased numbers of hospitalizations worldwide. Hospitalized patients with COVID-19 experience a variety of symptoms, including fever, muscle pain, tiredness, cough, and difficulty breathing. Elderly people and those with underlying health conditions are considered to be more at risk of developing severe symptoms and have a higher risk of physical deconditioning during their hospital stay. Physical therapists have an important role in supporting hospitalized patients with COVID-19 but also need to be aware of challenges when treating these patients. In line with international initiatives, this article aims to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands. METHODS: A pragmatic approach was used. A working group conducted a purposive scan of the literature and drafted initial recommendations based on the knowledge of symptoms in patients with COVID-19 and current practice for physical therapist management for patients hospitalized with lung disease and patients admitted to the intensive care unit. An expert group of hospital-based physical therapists in the Netherlands provided feedback on the recommendations, which were finalized when consensus was reached among the members of the working group. RESULTS: The recommendations include safety recommendations, treatment recommendations, discharge recommendations, and staffing recommendations. Treatment recommendations address 2 phases of hospitalization: when patients are critically ill and admitted to the intensive care unit, and when patients are severely ill and admitted to the COVID ward. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization. Respiratory support includes breathing control, thoracic expansion exercises, airway clearance techniques, and respiratory muscle strength training. Recommendations toward active mobilization include bed mobility activities, active range-of-motion exercises, active (assisted) limb exercises, activities-of-daily-living training, transfer training, cycle ergometer, pre-gait exercises, and ambulation.
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spelling pubmed-73378612020-07-08 Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19 Felten-Barentsz, Karin M van Oorsouw, Roel Klooster, Emily Koenders, Niek Driehuis, Femke Hulzebos, Erik H J van der Schaaf, Marike Hoogeboom, Thomas J van der Wees, Philip J Phys Ther Clinical Practice Guidelines OBJECTIVE: The COVID-19 pandemic is rapidly evolving and has led to increased numbers of hospitalizations worldwide. Hospitalized patients with COVID-19 experience a variety of symptoms, including fever, muscle pain, tiredness, cough, and difficulty breathing. Elderly people and those with underlying health conditions are considered to be more at risk of developing severe symptoms and have a higher risk of physical deconditioning during their hospital stay. Physical therapists have an important role in supporting hospitalized patients with COVID-19 but also need to be aware of challenges when treating these patients. In line with international initiatives, this article aims to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands. METHODS: A pragmatic approach was used. A working group conducted a purposive scan of the literature and drafted initial recommendations based on the knowledge of symptoms in patients with COVID-19 and current practice for physical therapist management for patients hospitalized with lung disease and patients admitted to the intensive care unit. An expert group of hospital-based physical therapists in the Netherlands provided feedback on the recommendations, which were finalized when consensus was reached among the members of the working group. RESULTS: The recommendations include safety recommendations, treatment recommendations, discharge recommendations, and staffing recommendations. Treatment recommendations address 2 phases of hospitalization: when patients are critically ill and admitted to the intensive care unit, and when patients are severely ill and admitted to the COVID ward. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization. Respiratory support includes breathing control, thoracic expansion exercises, airway clearance techniques, and respiratory muscle strength training. Recommendations toward active mobilization include bed mobility activities, active range-of-motion exercises, active (assisted) limb exercises, activities-of-daily-living training, transfer training, cycle ergometer, pre-gait exercises, and ambulation. Oxford University Press 2020-08 2020-06-18 /pmc/articles/PMC7337861/ /pubmed/32556323 http://dx.doi.org/10.1093/ptj/pzaa114 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Practice Guidelines
Felten-Barentsz, Karin M
van Oorsouw, Roel
Klooster, Emily
Koenders, Niek
Driehuis, Femke
Hulzebos, Erik H J
van der Schaaf, Marike
Hoogeboom, Thomas J
van der Wees, Philip J
Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title_full Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title_fullStr Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title_full_unstemmed Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title_short Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
title_sort recommendations for hospital-based physical therapists managing patients with covid-19
topic Clinical Practice Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337861/
https://www.ncbi.nlm.nih.gov/pubmed/32556323
http://dx.doi.org/10.1093/ptj/pzaa114
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