Online exercise rehabilitation to stable COPD patients during the second COVID wave: are physiotherapists able to help?

Dear Editor,

A significant cause of morbidity and mortality worldwide is a chronic obstructive pulmonary disease (COPD). It is a chronic lung condition characterized by gradual restriction of airflow and symptomatic respiratory complaints, such as worsening dyspnea, chronic cough, and sputum. Besides the frequent symptomatic exacerbations (that need hospitalization), COPD may contribute to the gradual intolerance of exercise that eventually reduces the quality of life (QoL) of patients [1]. Reduced QoL in COPD patients may be related to the gradual dysfunction of peripheral limb and respiratory muscles that restrict the daily activities [2].

With a relatively-mild first wave from March to July 2020, the outbreak of the corona virus disease 2019 (COVID-19) spread to all countries around the world. The strong specter of the second wave began to appear from August 2020 till now [3] with the return of precautionary measures such as social distancing enforced by some governments, especially in Europe, reaching to some Arab countries including Egypt, which is on the threshold of the second wave of COVID-19, but more fiercely than the first wave, especially with the arrival of winter which represents a great opportunity for COVID-19 transmission.

During the endless incurable COVID pandemic, continuous stable-COPD assessment, treatment, and follow-up from the whole medical team (including chest physicians, psychologists, nutritionists, and physiotherapists) are recommended utilizing the telemedicine technologies away from the traditional face-to-face meetings to lower the high risk of COVID-19 contamination [4].Maintaining a moderate reasonable level of physical activity is a very important factor to decline the infection risk to the respiratory tract in addition to overcoming the expected physical and psychological adverse effects [5] of intentional/forced social distance even in patients with stable chronic long-standing chest diseases who are more vulnerable to high rate of deaths due to the cross-COVID risk infection. With the repeated calls to physiotherapists - during the first wave of COVID-19 crisis - to participate in the online home-centered rehabilitation sessions to avoid the expected high rate of patients –especially the elder ones – who will (un)intentionally cancel the continuity of their rehabilitation sessions in the private and/or governmental physiotherapy units that may be locked down due to the formal...


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