The closer a person can initiate rehabilitation into the care plan of a person after returning from the hospital especially with severe respiratory associated with pneumonia or issues such as seen with COVID positive patients the better chance we have of putting the person on the road to full recovery. The earlier intervention has the greatest therapeutic effect compared to waiting until a person can be seen in an outpatient clinical situation especially with the shutdowns that have occurred these days.

I myself as a practicing Physical Therapist feel it scandalous that medical offices have closed or stopped seeing people in need out of fear. I have treated Post COVID Positive patients using this protocol and seen wonderful and rapid success, patients returning to full pre-infection strength, and even reaching levels of performance that exceed the pre-existing functional levels.

Protocol for COVID 19 Rehabilitation 

Physical therapy home health evaluation and subsequent treatment for post pneumatic infection and or COVID 19; 

Full viral infection precautions upon entry into the home;

* Gloves, Mask, Bag technique, Disinfect testing apparatus prior, and post-use. Barriers to be used if in doubt to the cleanliness of the environment. Wash hands thoroughly before and after any contacts.

* Vitals specifically important temp and pulse ox. Use patients equipment if available. Pulse Ox recheck throughout the session. Clean with alcohol or Betadine after.  

* In addition to any general physical therapy impairments commonly seen in Home Health referrals, test for upper and lower breathing strength. (Particular interest in Upper body, chest, and Breathing Assistant muscle groups; back, chest, and abdominal muscle strength)

* Bring the patient to the understanding they will get better. Better; means better than they were prior to the injury. Have them verbalize their agreement, discarding doubt or negative speech.

* Patients are de-conditioned, weakened, short of breath. Increase with conditioning exercises, functional enhancing especially activities that use the entire body, high repetition/low weight strengthening, full and deep breathing strengthening exercises. Performed in front of a mirror for posture and visual encouragement. 

* Rapid progression from sitting to standing therapeutic exercise program. 

* Immediately incorporate breathing enhancing and breathing facilitating exercises into any exercises given. Check with Pulse Oximeter between and during sets, rest if O2 sat approaches 92 or below.

* Implement Breathing exercises between to increase O2 exchange and reduce shortness of breath status.

* Increase into exercise routine outside in sunlight at least 15-20 daily. 

* High volume water consumption minimal one gallon/day. White tea is also good. Best if the water is kept in a glass container, (better if you write the word “God” or any other blessing on the container).

* Neck and shoulders tension relief Manual Therapy and or Massage Therapy. Self-stretching, Heat or Cold pack application on self for tension reduction.

* Frequent flushing of mouth with warm very slightly natural sea salt saline water, every hour. 

* For optimal effect add-in “Intermittent Fasting.”

* Progress into active functional enhancing therapeutic exercise program the person can perform at home or with a friend such as Tai-Chi, Pilates, or Yoga, all with enhanced breathing added. 

* Add in “Chi Energy” engaging instruction and demonstrate its uses as well as importance. 

* As O2 blood sats remain above 95 patients can progress to more concentrated, combined, and difficult exercises. Remember to incorporate breathing into exercises.

* Swimming is the ultimate end goal target for a full recovery. 

* Finally and most importantly; “Fear Not,” we are called to be overcomers and not fear, “what doesn’t kill us makes us stronger!”

** Anticipated full recovery from post pneumatic symptoms.

By Peter Colla PT

“Dear Lord help us remember that you overcame all sicknesses with your sufferings, we as your children have the right to claim this power and overcome. You said; We have not because we ask not? So I am asking; this little bully of a virus will have no power over me or the people I happen to see before me, and if it has already attacked them it must, and will flee! In the name of our Lord Jesus.”