Physiotherapy interventions facilitating recovery in COVID-19 patient on immunosuppressive therapy and with multiple comorbidities: a case report


  • Sayali S. Rasal Department of Physiotherapy, PT School and Centre, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Sushama A. Bhandare Department of Physiotherapy, PT School and Centre, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Saraswati K. Iyer Department of Physiotherapy, PT School and Centre, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India



COVID-19, Physiotherapy, Immunosuppressive therapy, Comorbidities


The global pandemic of the Coronavirus disease 2019 (COVID-19) has increasingly emerged as a multisystem infection with a wide spectrum of patient presentation, clinical severity and eventual outcomes. Physiotherapy treatment is pivotal to combat the consequences of the viral infection assisting timely functional recovery. Early intervention, routine assessments and tailormade rehabilitation programs aid in the comprehensive management of the patient and reduce further debilitating long COVID sequelae.  This case report describes the course of a COVID-19 patient admitted in a COVID dedicated ICU, on immunosuppressive therapy and with multiple comorbidities, receiving daily physiotherapy treatment from admission to discharge. The change in the functional status was assessed using various outcome measures namely single breath count, breath holding time, Medical Research Council sum score, 30 sec sit to stand, timed up and go and 6 min walk test demonstrating a positive effect of physiotherapy interventions in facilitating recovery in the patient.  


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Chatterjee P, Nagi N, Agarwal A, Das B, Banerjee S, Sarkar S, et al. The 2019 novel coronavirus disease (COVID-19) pandemic: A review of the current evidence. Indian J Med Res. 2020;151(2):147-59.

Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.

Ou X, Liu Y, Lei X, Li P, Mi D, Ren L, et al. Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nat Commun. 2020;11(1):1620.

Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020;39(7):2085-94.

Bohn MK, Hall A, Sepiashvili L, Jung B, Steele S, Adeli K. Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression. Physiology (Bethesda). 2020;35(5):288-301.

Kalirathinam D, Guruchandran R, Subramani P. Comprehensive physiotherapy management in covid-19–a narrative review. Scientia Medica. 2020;30(1):38030.

Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020;66(2):73-82.

Shakerian N, Mofateh R, Saghazadeh A, Rezaei N, Rezaei N. Potential Prophylactic and Therapeutic Effects of Respiratory Physiotherapy for COVID-19. Acta Biomed. 2020;92(1):2021020.

Maharashtra State Coucnil For Occupational Therapy And Physiotherapy. 9. Guidelines for Chest Physiotherapy Management of COVID 19 in Indian Setup, 2020. Available at: https://mahaotand Accessed on 01 September 2021.

Janus General Medicine Resuscitation & Acute Critical Care. COVID Awake Repositioning/Proning Protocol (CARP), 2020. Available at: https://emcrit. org/wp-content/uploads/2020/04/ COVID-CARP-Protocol-postable.pdf. Accessed on 01 September 2021.

Guérin C, Albert RK, Beitler J, Gattinoni L, Jaber S, Marini JJ, Munshi L, Papazian L, Pesenti A, Baron A, Mancebo J. Prone position in ARDS patients: why, when, how and for whom. Intensive Care Med. 2020;46(12):2385-96.

Tucker B, Jenkins S. The effect of breathing exercises with body positioning on regional lung ventilation. Aust J Physiother. 1996;42(3):219-27.

Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014;370(17):1626-35.

Bhandare SA, Rasal SS, Iyer SK. Correlation of peak expiratory flow rate and single breath count in normal adults. Int J Res Med Sci. 2021;9(7):1960.

Turan Z, Topaloglu M, Ozyemisci Taskiran O. Medical Research Council-sumscore: a tool for evaluating muscle weakness in patients with post-intensive care syndrome. Crit Care. 2020;24(1):562.

Ozcan KB, Ozsoy I, Akdeniz B, Ozpelit E, Sevinc C, Acar S, et al. Test-retest reliability and validity of the timed up and go test and 30-second sit to stand test in patients with pulmonary hypertension. Int J Cardiol. 2020;304:159-63.

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.






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