Post – Isolation Rehabilitation

Dr. Mohammed Aljeaidi, Specialist Family Medicine, Medcare Medical Centre - Al Rashidiya

Long-periods of isolation can have a serious impact on a patient’s mental health and if the patient had been in critical care then it can take a major toll on his/her physical health as well. Post recovery or isolation rehabilitation is a topic that is being discussed globally by medical practitioners.

Post-isolation disorders:

Previous studies on COVID-19 mainly focused on epidemiological and clinical features of patients with confirmed infection.  Little attention has been paid to the follow-up of recovered patients.

There are patients who stayed on ventilators for 1 to 4 weeks. This prolonged immobility leads to patients becoming physically weak.

ICU patients need to have humans around to orient them, to calibrate them, to touch them, to look in their eyes, and make them understand what's happening. But that's exactly what the COVID patients won't get because they're all being isolated.

They may suffer from long-term physical, cognitive and emotional effects of being sedated for longer durations, which can be symptoms of the "post-intensive care syndrome." Some physicians call it post-ICU delirium.

Often when patients are discharged from the ICU, they struggle to think as clearly as they did before. Some patients may continue to struggle with shortness of breath, with a drop by 20 to 30 percent in lung function.

Physical Rehabilitation:

Cognitive and physical rehab can take as long as six months. Patients with prolonged inactivity lose a great deal of muscle mass and exhibit lack of energy.

These patients are suggested exercises aimed at improving lung function by strengthening the respiratory muscles, coughing up phlegm more effectively and breathing more deeply, thereby improving the ventilation of the lungs.

The type and amount of exercise you will do will depend on what you can do and as you get stronger, your exercises will increase. Exercise sessions begin with stretching exercises or warm ups, followed by exercises for your arms and legs. Both are required to build strength and endurance (stamina). To build your strength, generally weights and lifting devices are used. For endurance activities, one might include walking on a treadmill or in a corridor and/or using a stationary cycle.

Exercises help the lungs and heart work better, improving circulation and reduce the heart rate.

Area specific exercises:

• Lower body:  Legs workouts vary from simply walking on a treadmill or around a track to more intense exercises such as climbing the stairs.
• Upper body: The muscles in the upper body are important for breathing, as well as for daily activities. Arm and chest exercises might include turning a plank against resistance or just lifting your arms against gravity.
• Breathing: Blowing through a mouthpiece against resistance may increase the strength of your breathing muscles. These exercises may be helpful for people with very weak breathing muscles.
• Strength training: Most pulmonary rehab exercises focus on building endurance. Adding strength training, such as lifting weights, has been shown to be helpful as well.

 

Psychological rehabilitation:

The challenge is how to find a balance in our way of thinking, especially when we come out of isolation. Will we allow our kids to closely play with their friends, will we go back to shaking hands, are some questions that people tend to worry about.

If social distancing orders go on for many months, integrating back to normal life may become even more difficult for people.

Reducing stress and anxiety can help the body fight better against this pandemic. Experts say, while there is no right or wrong way to cope during self-isolation, one of the biggest things one can do is create or maintain a daily routine that allows for interactions, so that social isolation doesn’t become your default habit.

Engage yourself socially while you maintain distant interactions with others. Based on current data available, the IgM and IgG antibodies to SARS-CoV-2 develop between 6-15 days post-disease onset, but disease protection is still to be defined. Activities can include active social engagements, phone calls and video conferencing.

Take some time to sit down and talk with those you are isolated with, set up a schedule to talk to a friend via video call.

Aster’s Serenity App can also help you cope up with some of the anxiety and stress that you might be facing.