Rehabilitation during the pandemic - FAQs 

Access to high quality community rehabilitation for those affected by Covid-19 is critical. We face a significant increase in demand for physiotherapy for those recovering from acute Covid-19 infection and for those people living with Long Covid. 

Physiotherapy services already face major disruption due to the redeployment of the workforce during the first and second waves. We answer some of your frequently asked questions about what all this means for rehabilitation during the Covid-19 pandemic.

What are the rehabilitation needs of people recovering from Covid-19?  

We are learning all the time about rehabilitation after Covid-19. Much of what we know about people’s acute rehabilitation need is based upon what we know about acute respiratory distress syndrome (ARDS), post intensive treatment unit (ITU) and severe influenza. The Long Covid picture is also starting to emerge.

What we know so far:

  • People coming out of acute hospitals have significant rehabilitation needs.
  • Up to 25%of hospitalised Covid-19 patients require intensive care, often for prolonged periods. Most of them (67%) will have acute respiratory distress syndrome (ARDS).
  • A prolonged stay in the ICU, mostly including prolonged mechanical ventilation, has significant impact on lung function, physical functioning and emotional wellbeing.
  • Long Covid prevalence and severity is not linked to hospitalisation.

 CSP members report that rehabilitation needs are extremely complex, both in the acute and Long Covid cohorts.

People present with a range of needs – primarily fatigue, dyspnoea (breathlessness), breathing pattern disorder, musculoskeletal disorders, neurological dysfunction and deconditioning. Some people are at risk of developing ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).

People with pre-existing long term conditions may be more severely affected, and their rehabilitation needs are likely to be more complex.

The longer term impact of Covid-19 is not yet known and the global physiotherapy community is playing an important role in developing the evidence base and keeping informed of the latest developments.

(Last reviewed :  28 July 2021)


How does rehabilitation of people with Covid-19 save lives? 

Many people with Covid-19 and subsequent Long COVID will need rehabilitation to support their recovery.

Rehabilitation is a critical part of the whole care pathway including community based rehabilitation.

During any new significant waves of the virus, it will be essential to keep the flow of people moving through hospital, freeing up beds and capacity to treat the critically ill.

If rehabilitation isn’t provided at all steps of the pathway then this will lead to bottlenecks in the system or people being readmitted.

The impact of Long Covid on community rehabilitation services is predicted to be highly significant. The profession will need to be flexible, adaptable and develop new ways of working to meet this challenge.

(Last reviewed : 28 July 2021)


What forms of rehabilitation are likely to be needed by people recovering from Covid-19?

The CSP has produced standards to support service delivery for people recovering from Covid-19 and Long Covid.

The physiotherapeutic principles of person-centred, evidence-based rehabilitation apply for people recovering from Covid-19 and for those experiencing  Long Covid.  All decisions about care for people with or recovering from Covid-19 must be based on individual clinical need, presenting signs and symptoms, and local risk assessments. 

An individual assessment of rehabilitation needs is essential. This should include but is not limited to:

  • safe mobility
  • symptom control (dyspnoea, fatigue, and pain)
  • respiratory care
  • adequate nutrition
  • psychological/social support

Rehabilitation plans need to address the assessment findings, with a focus on supporting people to reduce breathlessness, reduce fatigue, manage pain and provide psychological support.

'Return to work' conversations should form part of the plan where it is appropriate.

Physiotherapists have a key role in empowering people to recover and build up resilience at their own pace, with specific support to self-manage.  This will be an important part of any rehabilitation and recovery plan.

(Last reviewed : 28 July 2021) 


Should rehabilitation for non Covid-19 patients continue in the period of the pandemic? 

Yes. Rehabilitation services are essential to keep people out of hospital and reduce pressures on all parts of the health and care system. If rehabilitation does not continue then people’s needs will become more urgent, placing greater demands on the system.

Local risk assessments should be made in order that careful consideration is given as to whether this is through face-to-face contact or other means.   Throughout the Covid-19 emergency, the physiotherapy workforce must be compliant with UK government advice and follow NHS guidance for healthcare professionals.

Wherever you are working face to face with patients you must ensure that you use the appropriate PPE. See our PPE FAQs and guidance.

(Last reviewed: 28 July 2021)


How are we going to meet people’s rehabilitation needs after the pandemic is over? 

It is clear that there will be a substantial increase in rehabilitation needs across the UK population.  These groups are likely to be (but not limited to):

  • those with rehabilitation needs associated with recovery from Covid-19 illness, including Long Covid
  • service disruption for those with pre-existing rehabilitation needs
  • people whose physical function has deteriorated due to the requirements of social distancing and / or shielding
  • people who felt unable to seek help for new symptoms during the pandemic

Community rehabilitation provision has been historically patchy and inconsistent, thanks to decades of lack of development and investment. This is why, in 2019, the CSP brought together a Community Rehabilitation Alliance of professional bodies and charities with a shared concern in this area to work together.

This is also why now, along with our alliance partners, we are calling for the Government and the NHS to be preparing to meet people's rehabilitation needs by radically overhauling and expanding community rehabilitation services. 

See Community rehabilitation and Covid-19 policy statement and our Community rehabilitation content for more details.
 
(Last reviewed : 28 July 2021)


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