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Post Covid Rehabilitation

Covid 19 is an infectious disease caused by a newly discovered corona virus. This virus mainly affect lungs and it is spread by droplet infection. During 1st wave It gives symptoms like cough, cold, fever, loss of taste and smell , further leads to pneumonia and even death .

But the 2nd wave is more disaster where people found to be asymptomatic and when infection increases it effect major parts of lungs and then recovery rate fall down immensely and death rate increases. Even this time this virus affects infants and small children as well.

During this pandemic lots of people loss their family members, whole family member suddenly disappear. People who recover from covid 19 felt immense amount of weakness there aerobic capacity degrades which hampers their day today activity and leads to physical as well as mental trauma.

Patients who have ongoing symptoms or who had severe COVID-19 or a history of heart complications would need further assessment but otherwise, exercise can generally begin with at least 2 weeks with minimal exertion. While you are recovering, rehabilitation will improve your exercise tolerance and muscle strength, help manage your breathlessness and fatigue.

So to get proper recovery here are some exercises which guides you to recover in a proper way:

Light Intensity for First 2 Weeks

Using the Borg Rating of Perceived Exertion (RPE) scale patients monitor how hard they’re working and help them choose activities. Patients rate shortness of breath and fatigue on a scale from 6 (no exertion at all) to 20 (maximum exertion).

 Phase 1 of “extremely light intensity activity (RPE 6-8),” with flexibility and breathing exercises. Activities might include household tasks and light gardening, walking, light strengthening, stretching, and balance or yoga exercises and most important is Active Cycle of Breathing Technique (ACBT), is one way to help you to clear your sputum from your chest. ACBT is a set of breathing exercises that loosens and moves the sputum from your airways.  Further which will help you to improve your lung capacity and reduce your anxiety.

Phase 2 should include 7 days of light intensity activities (RPE 6-11) such as

walking and light yoga, increasing 10-15 minutes per day at the same RPE level as tolerance allows. At these two levels a person should be able to hold a full conversation without difficulty during the exercises

Phase 3 may include intervals of two 5-minute blocks of brisk walking, going up and down stairs, jogging, swimming, or cycling — separated by a block of recovery.

RPE of 12-14 is recommended in this phase and patients should be able to hold a conversation during the activities. Patients should add an interval per day as tolerance allows.

Last Phase Works Coordination, Strength

Phase 4 movement should challenge coordination, strength, and balance — activities such as running but with varied directions (eg, shuffling sideways). This phase could also include body weight exercises or circuit training, but exercises should not feel hard.

In any of the phases patients ” should monitor for any inability to feel recovered at 1 hour after exercise and on the day after, abnormal breathlessness, abnormal heart rate, excessive fatigue or lethargy, and markers of mental ill health.”

In order to improve your physical strength and function, we recommend you do not stay in bed all day, try to sit in a chair for meals and activities and go on short walks. Try to complete between five and twenty repetitions of each exercise daily. You can increase or decrease the number of repetitions depending on how you are feeling that day but try to progress the number of repetitions each week.

You can start this exercises from phase 2 as we have mentioned earlier:

  1. Seated knee extension :

  1. Sit upright on a chair.

· Start with your knee bent.

· Lift your foot in the air and straighten your knee.

If you find it too easy -· hold the leg up for 10 seconds.

  1. Seated hip flexion :

  1. Sit upright on a chair.

· Start with both your feet on the floor.

March your legs by lifting one knee up and down – alternate between your right and left legs.

  1. Sit-to-stand :

  1. Stand up and sit down from a chair without using your arms to help.

If you find it too easy -· lower the height of the chair or bend your legs until your bottom just touch the seat and then stand back up.

If you find it too hard -· increase the height of the chair.

  1. Shoulder press

  1. Sitting or standing, start with your elbow bent and your fist facing up. Punch to the ceiling, straightening your elbow.

If you find it too easy –· hold a weight in your hands, such as a tin of beans or peas.

If this exercise is too· hard – just bend and straighten your elbows.

  1. Shoulder Abduction:

  1. Sit upright on a chair or stand with your arms by your side. Lift your arm sideways to shoulder height and slowly back to your side.

If you find it too easy –· hold a weight in your hands, such as a tin of bens or peas.

  1. Seated tricep dips :

  1. Sit upright on a chair with your hands on the arm rest.

Push through your hands· to straighten your elbows and then slowly return to the starting position. If you find it too easy –· move your feet further away.

  1. Bridging:

  1. Lie on a bed on your back with your knees bent. Squeeze and lift your bottom off the bed.

If you find it too easy –· perform the exercise using one leg.

  1. Sideways leg lift

  1. Lie on a bed on your side. Bend your bottom leg and keep your top leg straight. Lift the straight leg up towards the ceiling. Slowly lower the leg down towards the bed.

If you find it too easy –· hold the leg up for 10 seconds.

  1. Straight leg raise:

  1. Lie on a bed on your back.· Keep one leg straight and· lift it off the bed. Repeat on both sides. · If you find it too easy

–· hold the leg up for 10 seconds.

  1. Standing leg exercises:

  1. Stand with your feet together holding onto a firm chair for support. Lift your outer leg out to the side. Slowly return back to the starting position. Repeat the exercise by lifting the leg backwards or lifting the knee up forwards.

  2. If you find it too easy –· repeat the movements without holding onto the chair.

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