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Review
. 2021 Oct 12;4(1):100139.
doi: 10.1016/j.opresp.2021.100139. eCollection 2022 Jan-Mar.

[Respiratory physiotherapy in post-COVID-19: a decision-making algorithm for clinical practice]

[Article in Spanish]
Ane Arbillaga-Etxarri  1 , Ana Lista-Paz  2 , Victoria Alcaraz-Serrano  3   4   5 , Raúl Escudero-Romero  6 , Beatriz Herrero-Cortina  7   8 , Ana Balañá Corberó  9   5 , Raquel Sebio-García  10   11 , Jordi Vilaró  5   12 , Elena Gimeno-Santos  4   5   10
Affiliations
Review

[Respiratory physiotherapy in post-COVID-19: a decision-making algorithm for clinical practice]

[Article in Spanish]
Ane Arbillaga-Etxarri et al. Open Respir Arch. .

Abstract
in English, Spanish

The outbreak of COVID-19 has posed a great challenge for the healthcare system which has been later aggravated by the need of managing clinical manifestations and potential sequelae in COVID-19 survivors. In this context, respiratory Physiotherapy emerges as a cornerstone in the interdisciplinary management warranted in this population. Given that the implementation and resources available for the interdisciplinary therapeutic interventions in Spain is scarce, it is essential to perform a comprehensive, exhaustive and personalised assessment. This will allow us to establish more accurate selection criteria in order to optimise the use of existing human and material resources. To this end, we propose here a decision-making algorithm for clinical practice to assess the clinical manifestations in people recovered from COVID-19 based on well-established, validated tests and assessment tools. This algorithm can be used at any clinical practice environment (primary care/community or hospital-based), combined with a patient-centered model and the use of community and e-Health resources and its application to improve the Physiotherapy care of these patients in the COVID-19 era.

La pandemia causada por la enfermedad de la COVID-19 ha supuesto un gran reto para los profesionales del sistema sociosanitario, intensificándose con el manejo y atención de las manifestaciones clínicas que potencialmente pueden presentarse de manera persistente en las personas que han superado la enfermedad. Para ello, la fisioterapia respiratoria se presenta como piedra angular dentro del modelo de abordaje interdisciplinar que requiere esta población. Dado que la implementación de esta opción terapéutica continúa siendo limitada en España, es imprescindible realizar una evaluación integral y exhaustiva de la persona que nos permita establecer criterios de selección a fin de optimizar el uso de los recursos humanos y materiales existentes. Para ello, se propone un algoritmo de decisión terapéutica basado en pruebas de evaluación validadas y objetivas de las posibles manifestaciones clínicas del paciente. La aplicación de este algoritmo, en cualquier nivel asistencial (atención especializada y atención primaria/comunitaria) junto con la atención centrada en la persona, el impulso del uso de los espacios comunitarios verdes y azules de las ciudades y un adecuado uso de las tecnologías de la comunicación y la información, nos permitirá optimizar el modelo de atención de fisioterapia respiratoria en el contexto actual, marcado por la COVID-19.

Keywords: COVID-19; Physical Therapy Modalities; Post-acute COVID-19 syndrome.

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Figures

Figura 1
Figura 1
Algoritmo de decisión terapéutica de fisioterapia respiratoria AVD: actividades de la vida diaria; DAUCI: debilidad adquirida en unidad de cuidados intensivos; FC: frecuencia cardíaca; FCR: frecuencia cardíaca de recuperación; GS: gait speed o velocidad de marcha; lpm: latidos por minuto; Mmrc: Medical Research Council modificada; PE: prueba de esfuerzo; PM6 M: prueba de marcha de 6 minutos; RM: repeticiones máximas; SNA: sistema nervioso autónomo; SPPB: short physical performance battery; SpO2: saturación de oxígeno; STS: sit-to-stand test; TEP: tromboembolismo pulmonar; TUG: timed-up and go test.
See this image and copyright information in PMC

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