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Respiratory rehabilitation is an important phase for patients affected by the coronavirus disease.
While the majority of patients have no post COVID-19 sequelae, those suffering from preexisting pathologies or age-related vulnerability require broad-spectrum rehabilitation or a targeted therapeutic program. Indeed, diverse sequelae may appear, or even persist, following hospitalization in an intensive care unit, with or without respiratory assistance (oxygen therapy), linked to the treatment of COVID-19, such as pulmonary deconditioning, musculoskeletal disorders, cachexia, brain damage, peripheral polyneuropathies (damage to peripheral nerves) and fatigue.
Our rehabilitation programs last 3 to 6 weeks, depending on the therapeutic objectives and the clinical condition of the patient. The key target is to recover respiratory, motor and cognitive capacities.
Our multidisciplinary team made up of medical specialists, physiotherapists, occupational therapists, speech therapists, neuropsychologists and nurses work together to define the therapeutic objectives. Each personalized rehabilitation program offers adapted training focused on the patient's clinical condition, taking into account specific needs and autonomy levels prior to the disease.
Physiotherapy plays a fundamental role in pulmonary rehabilitation and its management is based on the evaluation of the patient's existing condition.
• In the case of non-congested breathing difficulties, we use breathing techniques to work lung volume capacity. In more rare cases with secretions, decongesting techniques such as cough stimulation are used.
• In the case of cardio-respiratory difficulties that affect endurance, we recommend early mobilization with wide-ranging mobility and strengthening exercises, such as: sitting on the edge of the bed, standing, walking, going up and down stairs, cycling, conveyor belt… If other comorbidities exist, we rely on standard orthopedic and neurological rehabilitation protocols.
Occupational therapy is aimed at enabling patients to gradually restore autonomy in daily life activities.
The primary phase consists of assessing the patient's abilities and difficulties. Then, taking into account a high level of fatigability, a personalized program focused on exercises and daily activities is defined to work and improve the areas of difficulty.
Occupational therapy enables patients to:
• Regain optimal autonomy in day-to-day activities: washing, dressing, cooking, shopping, administrative and financial management
• Restore autonomy in self-directed bed, toilet and car transfers
• Recover sensitivity loss or diminution
• Improve balance (Wii Balance Board)
After a final evaluation, the occupational therapist is able to put into place the necessary healthcare assistance and material aids to ensure a successful return-home transition.
Following long-term hospitalization, some patients may suffer from cognitive disorders such as memory loss or concentration and language troubles, etc. We offer a neuropsychological assessment as well as personalized management aimed at optimally restoring impaired cognitive functions to resume daily activities once back at home.
Some severe Covid-19 cases require intubation that may, for example, cause swallowing or voice problem sequelae. We recommend speech therapy for these patients in order to return to a normal voice and food diet as quickly as possible.
Furthermore, we have also observed other neurological damage such as facial or tongue paralysis. In these specific cases, speech therapy is particularly relevant to recover facial motor function.