Title: A Scoping Review of the Unique Role of Physical Therapy in Cardiovascular COVID-19 Management
Name: Chloe Couves
Primary Presenters: Chloe Couves, Amy Sutheimer, Madison Glunn
College of Health Sciences
Clinical Doctorate
Faculty Sponsor(s): Dr. Caitlyn Anderson
A Scoping Review of the Unique Role of Physical Therapy in Cardiovascular COVID-19 Management
INTRODUCTION: In December 2019, COVID-19 began to spread rapidly.1 Despite studies outlining the effects of COVID-19 on the cardiovascular (CV) system, there are no studies pertaining to physical therapy (PT) treatment (tx) aimed at the CV system. Research has found PT tx and patient (pt) education improves recovery, decreases hospital readmission, and prevents dangerous secondary complications.2 PURPOSE: This scoping review aimed to identify gaps in research related to COVID-19 complications and the CV system in order to make recommendations for the treating PT and interdisciplinary team. METHODS: Two electronic database searches were conducted to gather studies between October 2019 and February 2021. Publications following 2019 were included to ensure research was specific to COVID-19 strain. Publications evaluating PT modalities for CV complications were limited to research that discussed sequelae similar to complications seen due to COVID-19. Articles following 2015 were included to ensure up-to-date research. RESULTS: COVID-19 can lead to thrombosis, myocarditis, myocardial infarction, and structural damage, among other CV sequelae.1 Hypertension, diabetes mellitus, and heart disease are comorbidities associated with poor outcomes.1 DISCUSSION: Conventional PT CV tx is beneficial; however, given the unique pathophysiology of COVID-19 with hyperinflammatory state, conventional tx may require modification. Early mobilization and moderate to high intensity exercise may be detrimental to those in acute to subacute stages. Formalized exercise testing may be indicated long term. CONCLUSIONS: COVID-19 can cause multiple CV complications.1 PTs play a role in management of pts with COVID-19 across treatment settings and must take the viral pathophysiology into account to avoid exacerbation of symptoms and promote safe mobility. PT also plays a role in prevention of mentioned comorbidities through skilled exercise progression and health promotion.2 Further research is warranted.
References:
1. Mansueto G, Niola M, Napoli C. Can COVID 2019 induce a specific cardiovascular damage or it exacerbates pre-existing cardiovascular diseases? Pathology – Research and Practice. 2020;216(9):153086.
2. Shoemaker MJ, Dias KJ, Lefebvre KM, Heick JD, Collins SM. Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure. Physical Therapy. 2020;100(1):14-43. doi:10.1093/ptj/pzz127
https://sites.uwm.edu/healthresearchsymposium/files/formidable/2/References_-A-Scoping-Review-of-the-Unique-Role-of-Physical-Therapy-in-Cardiovascular-COVID-19-Management.pdf
Quite an undertaking, to inform the practice of Physical Therapy in an area that has no direct evidence to guide practice! It will be interesting to see if clinicians publish about their experiences with these patients to help direct further research pertaining to Physical Therapy Cardiovascular Interventions in patients with COVID 19.
Awesome work, team!!!! This was a great synthesis of emerging research and highlights the scope of physical therapy management in our Covid populations!
Awesome job! You did a really good job synthesizing so much information and making it clear that PT has a vital and unique role in COVID rehab. I was particularly intrigued at the recommendation for intermittent and more moderate physical activity during the hyper-inflammatory stage. It is good to know that even during this “most sick” stage of the disease, that patients can still reap the many benefits of physical activity.
Great job, Amy, Chloe and Maddie! A very thorough scoping review on a very timely topic! PTs clearly have a role in the early and late rehabilitation of patients with COVID.
Great job, Amy, Maddie and Chloe! What a thorough job navigating the literature on such a timely topic. PTs definitely have a role in early and late rehabilitation of patient with COVID. So interesting!