1. This document discusses the responsibilities of physiotherapists during the COVID-19 pandemic. It provides an overview of the current global situation, common symptoms of COVID-19, treatment options, and rehabilitation protocols for patients with varying illness severities. 2. The responsibilities of physiotherapists involve providing chest physiotherapy and exercises tailored to patients' conditions, from self-quarantine to hospitalization and critical care. Positioning techniques and breathing exercises are emphasized. 3. A multidisciplinary team approach is stressed to ensure best care and quick recovery for patients from all aspects. Physiotherapists must work collaboratively with other departments while applying their professional expertise.

1. COVID19 &
Professional
Responsibilities of
Physiotherapist
Dr. SANA KOMAL
DPT, MS-OMPT, PhD Control science & Rehabilitation

2. Agenda
COVID19 Current Situation
01
Rehabilitation and COVID19
02
Responsibilities of PT
03
Team Work
04

3. World Health Organization
◆United States of America
◆Canada
◆Brazil
24 June 2020
9,129,146 confirmed cases
473,797 deaths
188,926 confirmed
3,755 deaths
1,106,470 confirmed
51,271 deaths
101,637 confirmed
8,436 deaths.
2,295,272 confirmed
120,171 deaths.
◆Pakistan

4. Pakistan
3,892
Per day Cases
3,337
Critical
60% ratio of recovery mild conditions
40% ratio of recovery in critical conditions
188,926
Confirmed cases
A number of 1,150,141 tests has been
done till date 22/June/2020 and the
gap between recovery and death ratio
is getting closer.
3,755 deaths

5. Common Symptoms
Most common symptoms
Cough Fever Difficulty Breathing Sore Throat
Less common symptoms
➢ Aches and pains
➢ Sore throat
➢ Diarrhea
➢ Conjunctivitis
➢ Headache
➢ Loss of taste or smell
➢ A rash on skin
➢ Discoloration of fingers
or toes
Chest pain or pressure Shortness of breathLoss of speech or movement
Serious
Symptoms

6. Available Solution
PREVENTION
How To Prevent An Outbreak
2m
SELF MEDICATION

7. Treatment
A normal blood oxygen level varies between 75
and 100 millimeters of mercury (mm Hg). A blood
oxygen level below 60 mm Hg is considered low
and may require oxygen support.
Plasma transfusions are used for patients with liver
failure, severe infections, and serious burns.
Ventilation is required when RR is below
Adults: 12–18 breaths per minute
3 years: 20–30 breaths per minute
6 years: 18–25 breaths per minute
10 years: 17–23 breaths per minute
Oxygen Therapy
Plasma
Transfusion
Life Support
Devices
1. Physical
2. Emotional
3. Psychological
4. Nutritional
5. Educational
Rehabilitation

8. Rehabilitation
Pre-Infection
Aerobics, Strengthening, Balance and
stretching exercises. Education, psychiatry
session.
Critical condition
Chest Physiotherapy is strongly recommended
along with positioning and ankle movement in
CU.
Post Infection
WHO recommends 150 minutes of moderate-
intensity or 75 minutes of vigorous-intensity
physical activity per week for adults, or a
combination of both. The guidance is intended
for people in self-quarantine without any
symptoms or diagnosis of acute respiratory
illness. Emotional support and nutritional
balance.
Mild condition
For hospitalized people with normal heart
blood tests they should rest without exercise
until symptoms resolve -- then have a medical
evaluation after an additional two weeks of
recovery without exercise. Low intensity
exercises are recommended with controlled HR
and RR.

9. Physiotherapy Protocol
Mild /Quarantine
1. Mackenzie stretch
2. Breathing Exercises
3. No Aerobics
4. Hook position
5. Balance & Cognition
02
Hospitalized
1. Chest Physio Vibration
technique
2. Ankle knee and back
stretches
3. Positioning regarding
lobes of the lungs
4. Pursed breathing
o Relax shoulder & neck
o Nasal breath for 2 seconds
o Breath out for 4 seconds
03
Critical Unit
1. Positioning for drainage
/15 min each
2. Ankle stretch & knee
positioning
3. Back support
4. Vibration technique for
specified lung lobes
(auscultation)
04
Pre Infection
1. 1000 steps/day
2. Stretching 20/day
3. Breathing exercises
4. Balance & Cognition
5. Aerobics 30 min/day
01

10. Positioning and
basic guideline
for lung support
and drainage
regarding lobes.

11. 1. 1000 Steps daily
2. Breathing enhancement (Pursed breathing)
3. Mackenzie stretch (20 repetition, 2 sets)
4. Hooked sitting position (15 min, 2 sets)
5. Supported lying (supported hip flexion, knee 30*)
6. Calf muscles strengthening
PANDEMIC
COVID-19
Self Quarantine

12. Hospitalized
Chest Clearance, Body ache recovery>stretches
& Breathing education
Ward
Supported hook sitting position, Knee & ankle
stretches, Pursed breathing
Isolation
Passive Stretches, Passive positioning, Monitored
chest clearance technique
Critical Illness Unit
Low intensity medium endurance work, 500-1000 steps
daily, full body stretches, deep breathing exercises,
endurance training.
Recovery

13. Team Work
COVID-19
Multidisciplinary
Approach
Team work
Multidisciplinary Approach
Respect and collaboration between departments to
ensure best quality and quick recovery of the patient from
every single aspect
Technical Support &
Excellence
Domain
Explain the plan for patient treatment and create a mutual
understanding while remaining within the concerned field
of work
Education
Patient & Attendee
First and most important step is to educate the patient to
avoid mental stress and to gain confidence and
encouragement.
Professional
Expertise
Staff & Doctor
Basic techniques and technical equipment.

14. Humanity & Muhammad (PBUH)
A Muslim shall
never leave
another Muslim
helpless, in the
time of need.

15. A multidisciplinary approach is a whole method of recovery. No team
ever be seen on failing to achieve their goals. In a world hard
condition lets join hands to make a differences in life. Chin up and
walk with confidence. You! Yes you are a health care provider be
proud of that.
God bless you and increase you in knowledge and respect.
HOD Rehabilitation Medicine, PIHMS Peshawar,
Pakistan
DPT, MS-OMPT, PhD control science & Rehabilitation
Dr. Sana Komal

16. THANK YOU