Physiotherapy-assisted prone or modified prone positioning in ward-based patients with COVID-19: a retrospective cohort study.
Claudia Tatlow, Sophie Heywood, Carol Hodgson and 5 others
PMID 35091328WHAT IT FOUND
In 13 frail ward patients with COVID-19, physiotherapy-assisted prone or side-lying positioning raised oxygen saturation by 4% and lowered oxygen flow needs after 15 minutes.
Modified positions enabled participation for those unable to lie fully flat.
Key findings
01Mean oxygen saturation increased from 90% to 94% (mean difference 4%) and mean oxygen usage decreased from 8 l/minute to 7 l/minute (mean difference 2 l/minute) after 15 minutes of positioning.
02Six of the 13 patients required assistance from two physiotherapists to achieve position, while only four could independently assume prone; modified positions (side-lying or three-quarter prone) were used in 62% of patients.
03Three patients were able to wean from a mask to nasal prongs during seven sessions, but seven of the 13 patients did not survive hospital admission.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only 13 patients, making the results preliminary and not generalisable. It was retrospective, so exact duration of tolerance and body mass index data were missing. One author was a treating physiotherapist, introducing potential observer bias. The cohort was highly frail with high mortality, so long-term outcomes were not captured. The study did not include a control group, so natural variation in oxygenation cannot be ruled out as a cause for the improvements.
Declared interests
None declared. The study was unfunded and investigator-initiated.
The easy way to misread this
Do not interpret the 4% oxygen saturation increase as proof of long-term survival benefit or efficacy. The study was small, retrospective, and uncontrolled, with a high mortality rate in the cohort, meaning the observed short-term physiological changes did not translate to improved discharge rates for most patients.