India is grappling with the double challenge of the second wave as well as repeated mutating strains of the Covid-19 virus. The incidence of hospitalizations is estimated to be higher in the over 65 age group and the percentage of affected individuals requiring hospitalization in this group is 28.17% compared to 6.04% of hospitalizations in the 0 to 64 age group, mentioned Dr Akshata Rao, Rehabilitation Manager, Bengaluru, Nightingales Home Health Services.
Covid-19 significantly affects lung functions. Shortness of breath and low oxygen levels are its hallmarks. These symptoms are a sign of distress and a risk factor for a more severe impact of the disease and therefore justify hospitalization. Unfortunately, leaving the hospital is not the end of the ordeal for most patients with Covid-19. One in 10 people experience “long-Covid or post-Covid health conditions ”even after 12 weeks.
Therefore, rehabilitation by physiotherapists is a key strategy to ensure that the condition of these patients does not deteriorate further or require readmissions, Dr Rao said. “We have seen the impact firsthand with our post-Covid patients. There was an improvement in oxygen saturation after exercise sessions and less reliance on external oxygen requirements, ”said Dr Rao.
How does that help?
Improves shortness of breath
*Leaning forward position: While sitting in a chair, keep a pillow on your knees and rest your elbows or just rest your elbows on your knees. This can also be done while standing by leaning forward on a wall.
*Ventilation while lying down: Lying on your stomach – also called ‘inclined‘position – has been highly recommended for critical Covid patients to improve lung dynamics and improve oxygenation.
*Belly breathing: Involves breathing using the diaphragm muscle. Sit with some support or in a lying position, place your hand on the stomach and as you breathe in, the stomach rises, and slowly exhale, the stomach goes down.
Cough and pulmonary sputum clearance
When the lungs are affected due to Covid, they produce more sputum than normal that must be cleaned out to make breathing easier and prevent new infections.
In situations like this, the Active Cycle of Breathing Techniques (ACBT), a set of breathing exercises best taught by a physical therapist, can help clear the lungs of sputum by loosening it and helping it cough. . Here is how it can be done:
Respiratory control: Run in a seated or semi-recumbent position. This relieves the secondary muscles involved in inspiration and relaxes them, especially in the neck. Inhale slowly through your nose, count to two, then exhale very slowly through your mouth – while pursing your lips as if you are blowing out a candle – and exhale to three. Try to release all tension with each exhale. Also, try to close your eyes to focus on the breathing.
Deep breathing exercises: Take long, slow breaths through your nose, keep your chest and shoulders relaxed, and like a sigh – breathe out relaxed and smooth. About three to five deep breaths can be taken. A physiotherapist can advise you if an apnea is needed and also the correct number of breaths based on your current lung capacity and other vital parameters.
Blowing: Huffing involves exhaling with your mouth and throat open, it helps move sputum through the pulmonary airways and helps flush it out in a more controlled manner. In order to “breathe” out, quickly remove air from the lungs through your open mouth and throat, as if you were cleaning your glasses. Use your belly muscles, but avoid any effort that may cause wheezing. The breath should always be followed by a breath control.
When done correctly, the movement / growl of sputum in the chest can be heard. Wheezing means you are blowing too hard. Your physiotherapist can help you adjust ACBT to suit your individual needs.
A therapy plan that takes into consideration your current state of health, Lung capacity and overall activity levels can help you recover from long symptoms of Covid effectively. If you are afraid to go out, you can opt for home assessment and therapy sessions to recover in the comfort of your home.