Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations.
Peter Thomas, Claire Baldwin, Bernie Bissett and 11 others
PMID 32312646WHAT IT FOUND
Expert recommendations advise physiotherapists not to enter isolation rooms routinely for screening, and not to provide respiratory physiotherapy for a dry, non-productive cough.
Provide airway clearance only when secretions are problematic, use airborne precautions, and mobilise early when safe.
Key findings
01Respiratory physiotherapy is not indicated for a dry, non-productive cough without exudative consolidation or secretion-clearance difficulty, but may be indicated when exudative consolidation, mucous hypersecretion, or difficulty clearing secretions develops.
02Many respiratory physiotherapy interventions are considered potentially aerosol-generating, so airborne precautions are strongly recommended during respiratory physiotherapy.
03Direct mobilisation and rehabilitation should be considered for significant functional limitations, frailty, multiple comorbidities, advanced age, or risk of ICU-acquired weakness, and early mobilisation is encouraged when safe.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The paper reports consensus recommendations, not a study of patient outcomes. The recommendations were developed rapidly and extrapolated from existing critical-care guidance, so they may change as knowledge develops. No patient was included in the author group. The guidance is for adult acute hospital and ICU settings, and local scope of practice, resources, and infection control rules must be considered. It does not report how much benefit or harm each recommendation produces.
The easy way to misread this
Do not read these recommendations as evidence that physiotherapy improves patient outcomes. The paper reports recommendations, not patient outcomes.