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Year : 2020  |  Volume : 20  |  Issue : 2  |  Page : 57-58

Physiotherapy in COVID times: Hybrid care is the new norm

1 Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
2 Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
3 Department of Burns and Plastic Surgery, AIIMS, New Delhi, India
4 Department of Orthopeadics, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India

Date of Submission19-Oct-2020
Date of Acceptance07-Dec-2020
Date of Web Publication20-Jan-2021

Correspondence Address:
Prof. Sushma Sagar
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjsm.sjsm_30_20

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How to cite this article:
Mir N, Hussain A, Mishra P, Maurya M, Sharma V, Sagar S. Physiotherapy in COVID times: Hybrid care is the new norm. Saudi J Sports Med 2020;20:57-8

How to cite this URL:
Mir N, Hussain A, Mishra P, Maurya M, Sharma V, Sagar S. Physiotherapy in COVID times: Hybrid care is the new norm. Saudi J Sports Med [serial online] 2020 [cited 2023 Sep 29];20:57-8. Available from: https://www.sjosm.org/text.asp?2020/20/2/57/307522

Dear Editor,

Severe acute respiratory syndrome-coronavirus-2, a new coronavirus, emerged in December 2019 and led to COVID-19. This pandemic had taken a heavy toll on the existing health care systems of the world, which was never seen before.[1] Physiotherapy, a well-established discipline worldwide, shared its burden like other specialties too. Physiotherapists responsible for providing rehabilitation tasks had to adapt to the new normal of compromising the human touch. In particular, cardiorespiratory physiotherapy which always emphasized on the hands on treatment of patients with critical respiratory problems and helped in facilitating post acute physical rehabilitation.[2]

The pandemic, involving physiotherapists, has an immense influence on the society and health-care providers. Today, the discipline of physiotherapy is dealing with the ongoing challenges and consequences related to the pandemic.[3] Physical distancing and isolation measures entail the cessation of physical therapy services, which adversely affects patients' quality of life and well-being, hence hindering physiotherapists' potential to manage the spectrum of treatment of patients with chronic illnesses.[4]

Covid positive patients with trauma or without trauma admitted to the Covid facility of AIIMS Delhi received physiotherapy advisable particularly for feeble/ productive cough, or in patients having signs of pneumonia on imagery and/ or retained secretion. Physiotherapists continue to assist with exercise, mobilization, and rehabilitation measures to the responders of the serious disease to enable early discharge.[5]

Airborne precautions are followed during respiratory physiotherapy interventions. Cough etiquette and hygiene is practiced by patients and staff. Physiotherapists always position themselves more than 2 m from the patient and out of the expected direction of dissipation. Equipment used are thoroughly analyzed and discussed with the hospital's infection control team (HIC) before being used on patients to ensure proper decontamination.

Digital physiotherapy is practiced as a new normal, which is providing an extension of access to health-care professionals, fostering self-management and increase of versatility for delivery of health care. Use of tele-appointment, teleconsultation and tele-connecting and attempting telerehabilitation for treating patients have become a part of routine physiotherapy care.

On the other hand, there are still challenges facing the adoption of digital practice, especially in a developing country like India. These challenges range from infrastructure barriers, socioeconomic issues, lack of training and relevant guidance for practitioners, and poor access as well as level of computer knowledge of patients. There is a high prevalence of illiteracy in India, and computer accessibility for many low-income Indians struggling hard to make a living is also not realistic.[4] Patient factors which are responsible for delayed recovery of patients especially amputee during a pandemic are lack of dedicated transport facility, need of an accompanying person to bring the patient to the hospital for follow-up, traveling in between containment zones, and above all financial issues.

Finally, this perspective on the hurdles and obstacles encountered by physiotherapists during the pandemic needs innovative approaches to deal with India's diverse population and varied geographical boundaries. To compensate for the loss of human touch, physiotherapists at our center emphasize on spending quality time on each visit, more of digital communication and sharing of exercise regimes through tailor-made video modules and encourage regular phone calls.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization, Corona Virus Disease 2019 (COVID-19) Situation Report 46; 2020.  Back to cited text no. 1
Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: Clinical practice recommendations. J Physiother 2020;66:73-82.  Back to cited text no. 2
Pegorari MS, Ohara DG, Matos AP, Iosimuta NC, Ferreira VT, Pinto AC, et al. Barriers and challenges faced by Brazilian physiotherapists during the COVID-19 pandemic and innovative solutions: Lessons learned and to be shared with other countries. Physiother Theory Pract 2020;36:1069-76.  Back to cited text no. 3
Dantas LO, Barreto RPG, Ferreira CHJ. Digital physical therapy in the COVID-19 pandemic. Braz J Phys Ther 2020;24:381-3.  Back to cited text no. 4
ANZICS COVID-19 Working Group. The Australian and New Zealand Intensive Care Society (ANZICS)-COVID-19 Guidelines (Version 1). Melbourne, Victoria: Australian and New Zealand Intensive Care Society; 2020.  Back to cited text no. 5


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