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Cited by 79COVID-19 Clinical Research StudiesRespiratory Support and MechanismsLong-Term Effects of COVID-19

Safety and Efficacy of Chest Physiotherapy in Patients With COVID-19: A Critical Review

Open access
Abdullahi, Auwal·2020·Frontiers in Medicine
DOI 10.3389/fmed.2020.00454PMC PMC7385182
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Abstract

The present global pandemic of COVID-19 has brought the whole world to a standstill, causing morbidity, death, and changes in personal roles. The more common causes of morbidity and death in these patients include pneumonia and respiratory failure, which cause the patients to require artificial ventilation and other techniques that can improve respiratory function. One of these techniques is chest physiotherapy, and this has been shown to improve gas exchange, reverse pathological progression, and reduce or avoid the need for artificial ventilation when it is provided very early in other respiratory conditions. For patients with COVID-19, there is limited evidence on its effect, especially in the acute stage and in patients on ventilators. In contrast, in patients after discharge, chest physiotherapy in the form of respiratory muscle training, cough exercise, diaphragmatic training, stretching exercise, and home exercise have resulted in improved FEV1 (L), FVC (L), FEV1/FVC%, diffusing lung capacity for carbon monoxide (DLCO%), endurance, and quality of life, and a reduction in anxiety and depression symptoms. However, there are still controversies on whether chest physiotherapy can disperse aerosols and accelerate the rate of spread of the infection, especially since COVID-19 is highly contagious. While some authors believe it is possible, others believe the aerosol generated by chest physiotherapy is not within respirable range. Therefore, measures such as the use of surgical masks, tele-rehabilitation, and self-management tools can be used to limit cross-infection.

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  • Respiratory rehabilitation was recommended only for patients with moderate to severe COVID-19-related respiratory symptoms.

    “The study included only the patients with moderate to severe COVID-19-related respiratory symptoms because respiratory rehabilitation was recommended only for these patients according to previous literature [15–18].”

    From Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study (2022) · cites this paper as [18]

    The Introduction says chest physiotherapy can be used for patients with mild to moderate symptoms. The ‘Chest Physiotherapy During the Acute Period’ section also discusses its case-by-case use for patients with exudation and mild to moderate symptoms. This contradicts the claim that respiratory rehabilitation was recommended only for those with moderate to severe symptoms. Page numbers were not supplied. (LLM, conf=0.90)

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  • At the time of writing, there is limited evidence about the effects of respiratory rehabilitation in the acute stage of COVID-19 treatment and cardio-respiratory recovery in patients with COVID-19.

    “At the time of writing, there is limited evidence about the effects of respiratory rehabilitation in the acute stage of COVID-19 treatment and cardio-respiratory recovery in patients with COVID-19 [15–18].”

    From Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study (2022) · cites this paper as [18]

    The Effects and Safety section says evidence for chest physiotherapy in COVID-19 was lacking, especially during the acute stage. The Post-Extubation and After Discharge section reports improvements in respiratory measures and endurance after rehabilitation, but does not establish a general lack of evidence about cardio-respiratory recovery. (LLM, conf=0.84)

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  • Both scientific and anecdotal reports have highlighted the importance of breathing exercises for maintaining respiratory function [15-18].

    “Both scientific and anecdotal reports have highlighted the importance of breathing exercises for maintaining respiratory function [15–18].”

    From Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study (2022) · cites this paper as [18]

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Authors
Abdullahi, A.
Affiliations
University of Antwerp (BE)
Corresponding author
Abdullahi, Auwal
ORCID
Abdullahi, Auwal
Venue
Frontiers in Medicine
Publisher
Frontiers Media SA
Published
2020-07-21
Volume
7
Pages
454-454
ISSN
2296-858X (ISSN-L)
DOI
10.3389/fmed.2020.00454
PMC
PMC7385182
OpenAlex
W3044320887
Cited by
79
References
3
Citations by year
2026: 2 · 2025: 7 · 2024: 9 · 2023: 14 · 2022: 22 · 2021: 24 · 2020: 1
FWCI
0.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Keywords
chest physiotherapy, COVID-19 pandemic, airborne transmission, respiratory muscle training, home-based exercise, post-discharge rehabilitation, mechanical ventilation, respiratory failure, pneumonia, telerehabilitation, surgical masks, anxiety and depression, quality of life

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