Respiratory Rehabilitation: Managing COVID-19 with PT
- July 15, 2020
Physical Therapy could make a difference in preventing or recovering from COVID-19
The Role of Physical Therapy in COVID-19 Management
As many of you know, COVID-19 is a virus that affects the respiratory system. A COVID-19 infection can prevent us from breathing deeply, and can cause shortness of breath; if it progresses far enough, it can cause pneumonia, persistent chest pain, and hypoxia (1,2). It’s important that our body has a strong enough immune system to attack foreign bodies like COVID-19, but our body also needs to be able to adequately expel debris from the lungs caused by the immune response. Sometimes, our respiratory system isn’t strong enough to do this effectively…That’s where physical therapy comes in!
Physical therapists are experts of the musculoskeletal system; this includes the muscles that we use to breathe. Just like other muscles in the body, it is important to regularly strengthen your “breathing muscles” to allow you to breathe more efficiently, and prepare the body for any unexpected stressors, such as a respiratory virus. It is especially important for individuals with preexisting respiratory conditions such as asthma, COPD, allergies, etc. to strengthen their breathing muscles, as their respiratory system is already compromised. Many physical therapists agree that exercising in moderation, as well as performing intentional breathing exercises could be helpful for strengthening respiratory muscles and combatting a COVID-19 infection (2,3).
Effective Breathing
At baseline, many of us do not breathe as effectively as we could. Simply put, we can take in more air, and exhale completely, ONLY if we use our respiratory muscles in the correct way.
Diaphragmatic breathing allows for full oxygen exchange and carbon dioxide release. Many of us have experienced increased stress and anxiety in recent weeks because of COVID-19. Intentional breathing can stimulate the parasympathetic nervous system, which encourages relaxation, helps slow your heartbeat, and can lower or stabilize blood pressure (4).
The diaphragm is a large muscle at the base of the lungs. When we inhale, the diaphragm moves down, creating a larger space and therefore, a negative pressure inside the lungs, causing them to fill with air. When we exhale, the diaphragm relaxes and returns to its starting position, which decreases lung space and pushes air out of our lungs. When performing proper diaphragmatic breathing, your belly should rise as you inhale, and fall as you exhale. Follow these steps to perform diaphragmatic breathing:
Diaphragmatic Breathing
- Sit upright in a chair or on the floor, or lie on your back on a flat surface with your knees bent.
- Place one hand on your upper chest and the other hand on your belly.
- Breathe in slowly, allowing your belly to fill, and the hand on your belly to rise as you inhale. The hand on your chest should remain still
- Tighten your abdominal muscles, and allow the hand on your belly to fall as you exhale through pursed lips.
Here is a great video demonstration of how to perform diaphragmatic breathing:
Breathing Exercises
In the early weeks of the pandemic, COVID-19 positive individuals were isolated and encouraged to remain in their homes and rest. However, physical therapists that specialize in respiratory rehabilitation believe that many more patients could have successfully recovered if they kept exercising (3). Strong respiratory muscles could be beneficial for prevention of COVID-19, and physical therapists have found that light physical exercise and breathing exercises are vital for recovery of COVID-19 positive patients (2,3,5). There are several breathing exercises you can perform on your own to strengthen your respiratory muscles. Here are a few simple ones to try at home:
Cup Blowing
- Place a paper/Styrofoam cup open end down on a table.
- Exhale, then place a straw in your mouth.
- Inhale deeply through your nose.
- Blow on the cup, pushing it across the table.
- Blow for 3-5 seconds, repeat 10-15x
Tissue Blowing
- Hold a tissue in one hand in front of your face
- Exhale, then place a straw in your mouth.
- Inhale deeply through your nose.
- Blow on the tissue, causing it to move.
- Blow for 3-5 seconds, repeat 10-15x
Huffing Exercise
- Hold a small mirror in front of your face.
- Perform a “huffing” motion to create fog on the mirror.
- Repeat 10-15x using varying levels of force.
*Video demonstration for the above exercises (3)
REMINDER: Due to current health guidelines, the above exercises are intended to be performed at home. If you have been directly exposed to an individual positive for COVID-19 please cancel your in-person appointment immediately. Until further notice, masks are required while traveling to/from our clinic within the building, and at ALL TIMES during treatment. Stay safe!
References:
- https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
- http://www.one2onephysicaltherapy.com/blog/lunghealthlymphaticflowcovid19breathingexercise/
- https://komonews.com/news/coronavirus/physical-therapy-could-protect-covid-19-patients-from-pneumonia-researchers-find
- https://www.health.harvard.edu/lung-health-and-disease/learning-diaphragmatic-breathing
- https://www.genengnews.com/news/coronavirus-early-pathology-examined-in-lung-tissue-of-symptomless-patients/
- Image: https://parksportspt.com/2020/05/19/physical-therapy-can-help-you-to-breathe-better/
