Long COVID is not only new to those suffering from it directly – it’s also a challenge for therapists and doctors. Everyone, therefore, needs to learn how to deal with the syndrome and its many sides. Qualified physiotherapist Petra Gmünder felt the same way. The 34-year-old first came into contact with acutely ill COVID-19 patients in autumn 2020. Even then, she noticed how multifaceted the illness is and how differently physiotherapy could have an impact on the symptoms.
The need to be taken seriously
It soon became clear that COVID-19 can also take a protracted course, which can have a significant impact on the performance and quality of life of those suffering from it. “Some patients report that they don’t feel that their symptoms are taken seriously. In some cases, the restrictions are so severe that those affected – even very young people – are no longer able to pursue their jobs and leisure activities to the desired extent,” explains Gmünder. This prompted her to launch the Post-COVID Group together with the colleagues in her team at the Kantonsspital Olten (KSO).
“It shocks me to see how previously healthy, dynamic people are pulled out of their usual daily lives overnight.”
The post-COVID group aims to offer those affected comprehensive and targeted rehabilitation. The aim is to restore independence in day-to-day life and resilience. As this is a new clinical picture, there is still little knowledge about which forms of physiotherapy are helpful and safe. “That’s why we rely heavily on personal reports,” says Gmünder. “It takes a lot of initiative to gather information and always stay up to date with the latest knowledge and science.”
Listen to your body – not your head
For everyone involved, it is essential that doctors from different disciplines, physiotherapists and other healthcare professionals work closely together and exchange information on a regular basis. Patients are examined by doctors before being admitted to the group and screened for risk factors. The next step involves a one-on-one physiotherapy session to make the initial findings. There, persistent physical limitations (physical resilience) and impairment of quality of life are recorded. “It’s important to listen to your body and not your head,” says Gmünder, “even though that doesn’t come naturally to everyone.”
Petra Gmünder presents the exercises from the Post-COVID Group’s home program (Picture: Petra Gmünder)
A problem shared is a problem halved
The post-COVID group actually started on 6 April 2021. “Currently, the group includes people between the ages of 18 and 65, around 60% of whom are women,” explains Gmünder. This alone shows just how heterogeneous the group is. From working people to those who are unable to work to those who are under great pressure in their private lives, there is a mix of everyone.
Participation in the post-COVID group is initially scheduled for 12 weeks, with two group sessions per week. One of them focuses on endurance training, the other on strength training. If patients tolerate the strain, it is important that, in addition to group training, they also carry out a regular home program and incorporate activity into their daily routine. Those affected also have time to discuss self-management strategies. “These discussions are highly valued by those affected and boost their motivation,” says Gmünder. An activity diary should also help them to see their progress and identify any factors that could lead to a worsening of symptoms. “What improves symptoms in some people can even have a negative impact on symptoms in others. Detecting possible triggers together with patients is very important in order to avoid exhaustion due to overexertion. In some cases, this also means supporting group members in dividing their day-to-day activities into manageable sub-activities in order to increase their resilience in a measured and individual manner over the longer term,” adds Petra Gmünder.
The exchange of self-management strategies is very important for those affected. (Symbol picture: Adobe Stock)
“The best thing so far? Laughing in the group with those affected.”
Pulling together
For patients as well as doctors and therapists, it is important not to want too much at once. These are small steps that I hope will lead to success. One moment during the therapy session is particularly memorable for Petra Gmünder: “When the group came back from the changing room, giggling, my heart warmed. I think moments like this are a huge contribution to recovery.”
Gmünder advises other therapists not to shy away from the currently relatively small data base, to always follow a holistic approach, to promote exchange and to respond to individual needs. Probably the most important thing is for those affected to feel that they are taken seriously, that they are heard and that they are not left alone. This is also essential if we are to work with the patients to define the appropriate dosage for each patient in order to build up their resilience.
