H E A LT H . . .
T R A I N YO U R R E S P I R ATO RY M U S C L E S BY RACHEL GARROD
These past few weeks I have been seeing patients with post COVID-19 sequelae, which refers to longer term complications following the initial infection. Imagine, a long period of bed rest and inactivity, weeks or possibly months of breathing dependent on a ventilator, fibrotic damage to the lungs as a result of the infection, muscle problems and other organ damage... You can see that, for these patients, rehabilitation post discharge from hospital is essential. With inactivity, muscles waste and become weakened. This might be the heart muscle as well as respiratory muscles. Is there anything we can do? Well the good news is that muscles can be strengthened, and since I am a respiratory physiotherapist I focus on the muscles of breathing. The diaphragm, the intercostal muscles (muscles in between the ribs that help expand the chest) and accessory muscles of breathing can all be specifically trained. We do this using gadgets that are designed to target the inspiratory/ expiratory muscles – this is called respiratory muscle training (RMT). In one study by Abodonya and colleagues. 42 patients who had been weaned from mechanical ventilation were given either RMT or usual care. This was not a randomised trial so results should be interpreted with caution. However, the RMT group showed significant benefits on pulmonary function tests and a six-minute walk test, compared with their counterparts. In a randomised study presented at a recent conference, Professor McNarry shared data on 87 patients recovering from COVID-19 with persistent shortness of breath. An eight-week Zoom-monitored programme of RMT led to improvements in breathlessness and fatigue. The control arm, who did not receive the training, also showed improvements over time but the change in the trained group was two to 14 times greater than in the untrained patients. If you are having persistent problems post COVID-19 please get in touch and find help. 162
JANUARY & FEBRUARY 2022
Rachel Garrod (Ph.D. Physiotherapist) specialises in physiotherapy for older people with chronic respiratory disease. Tel. (+34) 699 501 190 rachelgarrod1@gmail.com www.betterbreathingphysio.com
