Physical Symptoms of COVID-19 originate in the lungs and affect other areas of the body. The mental strain and physical inactivity of recovering from physical symptoms can ripple into every area of wellbeing. The tools for COVID recovery thus range from physical therapy and strength training to deep breathing meditation practice and self-talk strategies.
As a respiratory illness, COVID-19 affects the lungs and breathing most directly; lung damage is one of the most common long-term effects from COVID-19.
Typical lung-related symptoms such as shortness of breath or difficulty breathing are often present even in mild cases. Some adults then can develop pneumonia or acute respiratory distress syndrome, which complicates breathing longer-term.
In severe cases or with long-haulers, COVID causes lung tissue damage that has to be addressed even after the body has expelled the virus itself (i.e. no longer testing positive for coronavirus). This damage may be related to inflammation, clots, and interstitial lung disease.
When you can’t seem to fully bounce back from COVID-19, shortness of breath is usually part of the problem. Your lungs can recover their function, and breathing better is within your reach with stepwise physical therapy, breathing exercises, and skills strengthened from occupational therapy or even yoga. Most of all, staying active to the extent possible will help you maintain cardiovascular health to recover.
The Role of Physical Therapy in Lung Recovery
Physical therapy is an important aspect of long-term lung tissue recovery. Recovery can take anywhere from a few months to a year or more as the tissues in your lungs heal with the help of a targeted treatment program.
A physical therapist makes an initial assessment by taking baseline measurements such as capacity testing and musculoskeletal evaluations. Then, they build an individualized plan based on your limitations to help you make stepwise improvements.
Core exercises, cardiovascular activity on machines or treadmills, and breathing techniques can address both muscle loss and lung efficiency. Diaphragmatic breathing, specifically, has a far-reaching effect on wellbeing.
Physical therapy over time improves lung capacity via cardiovascular endurance, muscle strength, breathing, and posture. Your therapist is critical to helping you find appropriate levels of fatigue and judge progress as you gradually resume normal activities.
Muscle Fatigue and Weakness
Muscle weakness and fatigue emulate from the pulmonary strain as well as the sedentary initial recovery process. As you know, when it’s hard to breathe, you have less energy; when you move less, you lose muscle tone. And being sick always seems to require slogging through fatigue during recovery. As rehabilitation experts, we know these mutually compounding issues well. Even after the root causes have been addressed, we pursue the far-reaching effects of COVID.
The weeks of bedrest around COVID-19 can cause significant muscle loss, especially for the elderly. The elderly can lose 10% of muscle strength in one week of bed rest. Further, it seems COVID-19 may also cause actual damage to the muscles. A study published by the Centers for Disease Control and Prevention (CDC) suggests that rhabdomyolysis, the breakdown of muscle tissue, may be a side effect of COVID-19 in some patients. Learn more about our approach to maintaining muscular fitness.
The Role of Therapies in Muscle Recovery
During rehab, your physical therapists will develop a customized program of exercises that will help you rebuild your muscle strength, flexibility, and tone where you need it most. Often, this prioritizes core and postural muscles in the abs, lower back, glutes, and hamstrings. The focus of occupational therapy will be on performing basic daily activities to help you get back to normal life after COVID as quickly as possible, finding workarounds for difficult activities, and helping with better specific patterns of movement. Therapists will employ mobility training and strength work using bodyweight, bands, machines, and simulating common activities.
Brain fog describes the feeling of having sluggish and fuzzy thinking. Brain fog can be a symptom of flu, jet lag, or sleep deprivation. It seems especially common for COVID long-haulers. Encountering a well-publicized, life-threatening virus is unnerving; the COVID infection itself is no easier physically; isolation and lack of normal social routines increase the disassociation. Thinking and memory do usually recover from brain fog. Our rehabilitation approach helps spark clearer thinking and a better mood.
Symptoms and Causes
Researchers believe the underlying inflammatory conditions, silent strokes, and persistent lack of oxygen may contribute to brain fog directly. They are certain that ICU stays can cause anxiety, depression, and post-traumatic stress disorder. Further, sleep deprivation is common amongst the stress and discomfort of COVID. Researchers found that sleep deprivation disrupts our brain cells’ ability to communicate with each other, causing temporary mental lapses and affect memory. So, if you are finding it harder to think, reason, and focus, after coronavirus, it is not your imagination. Lifestyle changes and a combination of occupational and cognitive therapies can help cut through the fog.
Lifestyle Changes for Brain Fog Checklist
- Any aerobic exercise or combination that you can perform consistently is good for recovery: walking, running, dancing, cycling, swimming. Improving circulation combats many of the long-term effects of COVID; specifically, blood and nutrients flowing to the brain helps memory, and scheduling activity helps those suffering from brain fog to gain a sense of control and confidence.
- Eating for vitamins and essential oils as well as calories can improve brain function. Incorporate more "brain foods," such as salmon, olive oil, avocados, and dark leafy green vegetables, into your meals. Choose fibrous, slower digesting foods to prevent carb crashes, which can enhance the feeling of brain fog.
- Cut out bad diet habits that might exacerbate brain fog: drugs and alcohol, excessive caffeine, processed foods, MSG, and trans fats.
- Start practicing "sleep hygiene:" create a pre-bedtime routine; organize a sleep-inducing bedroom environment; optimize your sleep schedule; and establish pro-sleep habits (getting morning sun, cutting off bright lights after dinner) during the day to help you sleep longer and better at night.
- Use other stress management techniques that appeal to you: yoga, meditation, contrast showers, massage, daily affirmations. Common stressors can be blunted with a self-care routine.
Therapies for Brain Fog
Cognitive Rehabilitation Therapy is part of our solution to brain fog. Our speech and language pathologists help identify exercises to improve memory processes and rebuild neural pathways. This could include memory training exercises and methods, mental exercises, and speech therapy. Speech and language pathologists follow the flow of communication processes from the brain to the production of speech to help you maintain clarity in thinking and responding to the world.
An occupational therapist can provide you with mental training tools and exercises to optimize your thinking abilities as you work through the physical, mental, and cognitive challenges caused by COVID. They will also provide tools and suggestions for specific difficulties, whether it’s making a more organized grocery list or designing your office to better maintain focus.
Further counseling can be necessary for long haulers who may be highly discouraged by such a daunting recovery process versus what they expected.
Depression and Anxiety
Anyone who contracts the virus is at risk for some COVID anxiety and depression, but long-haulers are more vulnerable. According to a recent CDC study conducted between August 2020 and February 2021, the percentage of adults with symptoms of anxiety or depression rose from 36.4 percent to 41.5 percent.
Even those who have never been depressed might feel downtrodden after thinking they should be better just to find that real recovery seems to stretch out indefinitely. According to a Lancet article published November 2020, nearly 20 percent of those who had COVID-19 also developed a mental health issue within three months of diagnosis. Those who had COVID-19 were twice as likely as those who had not to develop issues such as covid depression, anxiety, or dementia.
Therapies and techniques that help with brain fog also help with depression and anxiety because the same factors contribute to both: sleep deprivation, isolation, lack of blood flow, fatigue, etc. Countering the effects of extended isolation is a major focus of our occupational therapists and speech and language pathologists, both of whom offer invaluable help in reclaiming normalcy by working around difficulties. We have all been somewhat disconnected for over a year, and regaining the confidence to communicate and participate in social life is a critical part of mental health.
Psychological counseling helps patients see the world in a more optimistic way. Developing patience and self-confidence is key to getting the most out of the COVID recovery program. We offer patients the chance to participate virtually or in person.
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