Developing physiotherapy recommendations for COVID-19

Michelle Kho is an associate professor at McMaster’s School of Rehabilitation Science and a physiotherapist St. Joseph’s Healthcare Hamilton.

A McMaster clinician-scientist is among an international group of cardiorespiratory physiotherapy experts that has mobilized quickly to release recommendations on physiotherapy management for COVID-19 for adult patients in acute care hospitals.

Michelle Kho is the Canadian representative on the guide. She is an associate professor at McMaster’s School of Rehabilitation Science, a physiotherapist at St. Joseph’s Healthcare Hamilton, and the Canada Research Chair in Critical Care Rehabilitation and Knowledge Translation.

The recommendations were led by Peter Thomas, physiotherapist from the Royal Brisbane and Women’s Hospital, Australia.  They are for physiotherapists and related health-care professionals working in an acute care setting with adult patients who are suspected or confirmed to have COVID-19.

Available online as a peer reviewed pre-proof, the recommendations have been endorsed by a number of associations around the world, such as the World Confederation for Physical Therapy, the Canadian Physiotherapy Association, the Australian Physiotherapy Association, and the American Physical Therapy Association.

“We responded to an urgent need for clinical guidance for acute care physiotherapists worldwide in this unprecedented situation,” said Kho.

“Physiotherapists are playing an important role in patient care during the COVID-19 pandemic, from early rehabilitation to help patients maintain or improve muscle strength and physical function to airway clearance techniques to help patients clear sputum from their lungs,” said Kho. “In fact, for patients with COVID-19, the World Health Organization recommends active mobilization early in the course of disease when safe to do so to reduce intensive care unit-related weakness.” 

The international team consisted of expert researchers and clinicians within the intensive care and

acute cardiorespiratory fields. Authors came from Australia, Belgium, Canada and the United Kingdom. They based their guidance on the most recent, relevant COVID-19 clinical practice guidelines from highly respected organizations, national physiotherapy organizations, and from peer-reviewed studies.

Dina Brooks, vice-dean of the Faculty of Health Sciences and executive director of McMaster’s School of Rehabilitation Science who worked in Toronto until 2018, said: “Personally, I have been inundated with colleagues and previous students asking for guidance on how to treat COVID patients in Toronto hospitals. These guidelines are needed now in the community.”

The pre-proof has open access in the Journal of Physiotherapy.

The recommendations are being translated into a number of languages, including French, Portuguese, Spanish, Dutch, Greek and Chinese.

Further iterations of the guidelines will be published as new information arises.

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