September 8, 2020, marks World Physiotherapy Day, a global event that recognises the importance of physiotherapists in the community. This year’s theme, ‘rehabilitation after severe respiratory illness’, is crucial to shedding light on the essential care that only physiotherapists can provide.

Survivors of COVID-19, especially those restricted to a ventilator, often suffer permanent damage to the lungs, which can result in a 20 to 30 per cent reduction in normal lung function.

This damage is a result of scarring of the small air sacs and blood vessel damage in the small blood vessels in the lungs.1

Melbourne Physiotherapist Michael Dermansky says the role of physiotherapy in the recovery and management of this reduced lung function will be extensive. 

“Our role will involve helping people cope with the effects of breathlessness, fatigue and reduced capacity to cope with previously normal activities by firstly helping people learn to breathe again, which takes work.” 

It will also be crucial for people to learn to pace these activities to cope with everyday life, explains Mr Dermansky.

“This won’t be as easy as before, so tasks will need to be broken down into parts and slowly completed, rather than all at once. 

“It may also mean that people require extra help with activities that they were able to do independently before that may be unrealistic for the short to medium term. 

“Finally, it will be extremely important to maximise and improve lung fitness. 

“Regular exercise to improve fitness is extremely important and will need to become a regular part of life.

“But it will need to be paced slowly, unfortunately, slower than before, keeping a very close eye on lung function rather than heart rate as a guide.”

The other associated problems with recovering from COVID-19 is post-viral fatigue, which is similar to chronic fatigue. 

“It’s tough to pinpoint the exact cause but seems to be the result of inactivity during ventilation and the recovery period, which results in muscle loss and reduced strength capacity.”

As COVID-19 survivors begin to resume normal activities, muscle strength and endurance is lacking, which also causes fatigue. 

“Trying to ‘just push through it’, causes severe fatigue.  Therefore, it is extremely important to learn to pace activities to avoid the ‘boom-bust’ cycle of activities that leads to frustration and more fatigue. 

“Our role as physiotherapists is to guide clients through this process. However, there are specialist centres in chronic fatigue that can provide a structured process to manage this fatigue. 

“Finally, heart damage, usually a result of myocarditis, will need to be closely monitored by a doctor or cardiologist and taken into account in exercise and recovery programs.”


1. Lewin, E. (n.d.). RACGP - What are the long-term health risks following COVID-19?