Physical Therapy in the Hospital Improves Outcomes After COVID-19

Man with COVID-19 in a hospital bed talking to nurse

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If you have been hospitalized due to COVID-19, then you understand how difficult it may be to return to your previous level of functioning. You may feel fatigued, have trouble breathing, or have difficulty with basic tasks like walking or climbing stairs.

But what if there was a way to improve your function while in the hospital and enjoy improved outcomes, like a lower risk of mortality, after being hospitalized for COVID-19? There is.

Research indicates that patients who are hospitalized due to COVID-19 and who received physical therapy while hospitalized enjoyed improved outcomes upon discharge. These include a lower risk of dying.

Physical therapy services provided while in the hospital may be the difference between a rapid return to functional normalcy and long-term functional limitations. It may also be the difference between life and death.

Functional Limitations Due to COVID-19

When hospitalized with COVID-19, many people experience various impairments and functional limitations. These may be exacerbated by your inability to move around.

If you are intubated or have various tubes and wires connected to your body, it is difficult to get up and walk. Bed rest typically has deleterious effects on functional mobility.

Common limitations due to COVID-19 in the hospital may include:

  • Difficulty catching your breath or breathing
  • Pain with taking a deep breath
  • Difficulty with bed mobility
  • Difficulty rising from a seated position
  • Difficulty walking without assistance
  • Decreased overall endurance or intense fatigue with basic functional tasks

Physical therapists work to improve breathing, bed mobility, transfers from sitting to standing, and walking. While in the hospital, working on these activities with a skilled healthcare professional, like a physical therapist, may improve your ability to perform these activities after discharge.

Research also shows that working with a physical therapist in the hospital may decrease your risk of dying.

The Research

Research presented at the 2021 Physiatry Conference included a retrospective study of 1,314 patients admitted to a suburban hospital between March 1 and May 2020 with a diagnosis of COVID-19. Patients were identified as those who had received physical therapy in the hospital and those who did not.

The demographics of the patients in the two groups were different: patients receiving physical therapy tended to be older and had a greater number of comorbidities than the patients who did not receive therapy.

The therapy patients also had a lower level of functional mobility compared to the non-therapy group. In essence, the patients who received physical therapy in the hospital for COVID-19 tended to be older, sicker, and have less overall mobility.

When the researchers examined mortality rates between the groups, they found that the patients who received physical therapy in the hospital for COVID-19 had a lower rate of mortality, 12%, than the non-therapy group, which had a mortality rate of 25%.

Despite being older and having greater comorbidities and less mobility, the patients who received physical therapy were more likely to survive their hospital stay for COVID-19 than the patients who did not participate in physical therapy.

While many different factors could be at play here, it appears that receiving physical therapy in the hospital for COVID-19 improves your possible outcome. Physical therapy has proven to be a low-cost, safe, and effective treatment modality for hospitalized patients. It should be considered an essential component of the treatment regimen for patients with COVID-19.

Physical Therapy in the Hospital for COVID-19

What can you expect your physical therapy experience to be like while hospitalized with COVID-19? Your first encounter with a therapist in the hospital will be an initial evaluation.

Your physical therapist will speak with you about your condition and your past medical history, and ask questions about your previous level of function and mobility. They will also ask about your current living situation and home setup.

Your physical therapist will also perform a bedside evaluation. They likely will assess:

  • Bed mobility
  • Transfer ability from bed to chair
  • Ability to transfer from sitting to standing
  • Walking ability

Your therapist will also measure your strength, respiratory rate, and heart rate to get an idea of your current endurance level and to ensure you are safe while moving around.

Physical therapy treatment in the hospital for COVID-19 will center around improving your endurance and breathing, and improving your safe functional mobility. Exercises may be done at the bedside, and continual measurements of heart rate and breathing will be taken while working with your therapist.

The ultimate goal of physical therapy in the hospital for COVID-19 (or for any other breathing-related diagnoses) is to help you gain endurance and functional mobility, and be ready to be discharged home.

A Word From Verywell

If you or a loved one is hospitalized with COVID-19, you should focus on regaining normal functional mobility and endurance. One way is to engage in an active course of physical therapy, which has been shown to improve outcomes at hospital discharge for patients with COVID-19. Those outcomes include a lower risk of mortality while hospitalized with COVID-19.

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  2. Yerra S. Impact of physical therapy on the mortality rate among COVID-19 patients. Association of Academic Physiatrists Annual Meeting Physiatry '21, February 2021.

  3. Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendationsJournal of Physiotherapy. 2020;66(2):73-82. doi:10.1016/j.jphys.2020.03.011