Over a year has passed since COVID-19 first arrived in the U.S. As we learn more about the virus’s impact on the body, we’re also learning more about the unique role physical, speech, and occupational therapists play in post-COVID-19 recovery.
For both long-haul patients and those who experience prolonged ICU hospital stays, PTs, SLPs, and OTs help patients return to a state of well-being. Looking at first-hand accounts from those on the frontlines of the pandemic, we’re highlighting the efforts being made across the country by outpatient rehab therapists and how your clinic can help.
Challenges Faced by Post-COVID-19 or “Long-Haul” Patients
For many COVID-19 patients, symptoms remain mild and only last 14-21 days. But an estimated 10% (according to a UK study) to 35% of patients (according to a US study) report experiencing COVID-19 symptoms like shortness of breath and muscle weakness persisting for months. As for the patients who underwent the worst symptoms, their post-ICU hospitalization and recovery takes time and requires continued medical rehabilitation.
At our Elevate Conference in December, physical therapists Michael Kamme (MBA, PT, Cert MDT) and Dr. Brian Krebs (PT, DPT, OCS, COMT) with STARS Northwell shared their story of creating a specialized COVID-19 recovery program named the INSPIRE Program. Their New York clinic was able to take in post-ICU patients early into the pandemic, and the two shared their observations on common symptoms they witnessed, including:
- Muscle disuse, atrophy, and weakness
- Joint contracture
- Increased deep vein thrombosis (DVT) risk
- Tachycardia (other doctors have reported signs of postural orthostatic tachycardia syndrome (POTS))
- Orthostatic hypotension
- Decreased aerobic capacity
Patients also described struggling to perform everyday tasks like washing dishes, transitioning from sitting to standing, and brushing teeth. The patient’s ages ranged from 13 to 90, with an average age of 56. For the STARS team, partnering with their hospital’s pulmonary specialist was the first step, and training staff on the unique needs of COVID-19 patients was next. With close observation from both teams, continued assessment of cardiological and physical activity, and time, they’ve been able to help over 60 patients since the program first began in late March 2020.
How Outpatient Rehab Therapists Are Helping Patients Recover
Along with the STARS Northwell team, PTs, OTs, and SLPs have shared their stories on how they help patients recover during and after prolonged COVID-19.
In Minnesota, patient Reggie McAllister shared his COVID-19 story with the local news. After being hospitalized for two months, including intubation and facing kidney failure, McAllister has spent the past nine months in intensive occupational therapy. He can now drive short distances and is beginning to regain muscle strength. His therapy team at Hennepin Healthcare described the recovery plan as akin to brain injury patients.
Additionally, SLPs at Hennepin Healthcare have been on the frontlines of the pandemic. They assessed swallowing conditions, conducted speaking evaluations for intubated patients, and offered post-intubation swallowing and speaking therapy for recovered patients. Some patients have also experienced cognitive changes, which require further neurological rehabilitation therapy before the patient can be released.
Another inspiring PT story comes from Provo, UT, where PTs with Community Rehabilitation Clinic (CRC) were able to provide pro-bono physical therapy services to uninsured, underinsured, and low-income patients recovering from COVID-19. Thanks to an approved grant through the CARES Act, the CRC team was able to fully equip their clinic with the tools and PPE needed to treat COVID-19 patients. With time, their team began learning new methodologies to tackle COVID-19 long-haul and post-ICU patients’ unique circumstances.
Feeling Inspired to Get Involved?
Across the country, PTs, OTs, and SLPs will be needed to help patients return to normal life. While not every clinic will have the necessary resources to create a COVID-19 specialty program, outpatient rehab therapists’ skills and abilities can still be of use. Here are three ways your clinic can get involved in helping patients recover from COVID-19.
Create a Specialized COVID-19 Recovery Program
As the STARS team described at Elevate, their INSPIRE Program required diving into new territory. Here are some of the steps they took to create their program, which may inspire your clinic to create your own.
- Partner with specialists: STARS partnered with pulmonary specialists to clear, evaluate, and monitor patients throughout their care plan.
- Create clear but flexible program goals: STARS created program goals that focused on traditional PT work, like strength and endurance building, and incorporated EKG monitoring, assessing breath capacity, and other post-COVID-19 patient concerns.
- Create pandemic safety protocols: The STARS team learned COVID-19 safety protocols, including routine temperature checks on patients and staff, regular testing, necessary PPE, following CDC recommended guidelines, and requiring patients to be asymptomatic or have a negative test at least 14 days before their start date.
- Train staff on the unique needs of COVID-19 recovering patients: They also trained their team on using the new equipment, including how to monitor oxygen saturation, blood pressure during exercises, etc.
- Adapt and learn as you go: As STARS began to take on patients, they continued to modify their program as needed, including adjusting patient goals to align with prolonged symptoms and gradual recovery. The more patients they took in, the more they learned about the virus and how they could tackle each patient’s unique situation and needs.
Communicate and Market Your Services with Referring Physicians and Past Patients
If you’re working in a small clinic or private practice, you can still help COVID-19 patients even if you don’t have the funds to create a whole program. But first, you’ll need to get the word out about how your therapy services can help.
To create new referral networks, target family or general practitioners, urgent care facilities, and local hospitals that are likely to see many COVID-19 patients. However, if you already have referral systems set up with general practitioners and specialists, notify them of your ability to help long-haul patients.
You can also email your patient network or market via social media your team’s ability to assist in COVID-19 recovery. While the service may not be relevant to all past patients, they may know someone who has struggled with COVID-19 recently and may serve as a new referral source for your practice.
In your communication, be detailed about how your physical, occupational, or speech therapy can be of service to recovering patients. Mention exercises or activities that you can offer patients to help them recover their strength, endurance, speech, or breath capacity. With the right details, doctors and practices will be better equipped to assess which patients they can refer for therapy.
Stay Educated on COVID-19 and Therapist Roles in Recovery
New information is still being released regularly around COVID-19, and as more therapists get involved in recovery, more information will become available on how your services can help. Continue to follow the news and stay informed. And if you have tips from your own experience in helping COVID-19 patients, please share them in the comments!