A comprehensive systematic scoping review for physiotherapy interventions for people living with long COVID

Abstract

Background: A diverse spectrum of long COVID symptoms (LCS) have the scope of physical rehabilitation. Due to limited resources, very little is known about the physiotherapy and rehabilitation interventions for LCS and their clinical application. This study aims to explore the role of physiotherapy and rehabilitation interventions in the management of musculoskeletal, neurological, cognitive, cardiorespiratory, mental health, and functional impairments of LCS. Methods: The study was a systematic scoping review of the literature published between April 2020 and July 2022. Results: 87 articles were extracted followed by a standard process of The Preferred Reporting Items for Systematic reviews and meta-analysis (PRISMA) extension for Scoping reviews (PRISMA-ScR). The included studies had a 3223 LCS population. All types of primary and secondary articles were retrieved except for qualitative studies. The evidence was evaluated by an appraisal scoring tool followed by the guidelines of the “Enhancing the Quality and Transparency of Health Research ( EQUATOR) network”. The included papers had a mean appraisal score of 0.7807 on a 0 to 1 scale (SD 0.08), the minimum score was for study protocols (0.5870), and the maximum score was for Cohort studies (.8977). Sixty seven (67) evidence-based interventions were documented from 17 clinical categories. The most weighted interventions were treating underlying symptoms of long COVID (Adjusted score 1/1), management of fatigue (Adjusted score 0.963/1), aerobic exercise and balance training (Adjusted score 0.951/1), multidisciplinary rehabilitation (Adjusted score 0.926/1), and low resistance training and aerobic exercise (Adjusted score 0.889/1). Conclusion: We recommend Long COVID rehabilitation in a multidisciplinary approach by treating the individual symptoms, especially fatigue. Physiotherapy interventions play a significant role as most of the recommended interventions were exercise, modalities, patient education, respiratory rehabilitation, and telerehabilitation Scoping reviews do not require protocol registration from PROSPERO.