Understanding Long Covid April 2021 Information and Guidance for Soft Tissue Therapists

by Anna Maria Mazzieri - Jan 13th, 2022
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<p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">This document has been written as guidance for Soft Tissue Therapists on how to support and potentially treat clients who continue to suffer from the effects of COVID after the acute stage of the infection. The guidance has been developed by the ISRM via a Working Group of Soft Tissue Therapist members. The document will be updated from time to time as new information around COVID becomes available.</span></p> <div class="page" title="Page 3"> <div class="layoutArea"> <div class="column"> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Sufferers of Long-COVID symptoms should be identified through a thorough consultation process. The usual red flags and contraindications apply, of course.</span><br /><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">In addition, the following symptoms require referral to the GP before any treatment of any nature can commence:</span></p> <ul> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Acute breathlessness</span></p> </li> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Chest pain</span></p> </li> </ul> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Hands-on work should proceed with appropriate considerations, for example:</span></p> <ul> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Positioning to improve their comfort and ease of breathing.</span></p> </li> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Reducing treatment time to avoid exacerbating some symptoms.</span></p> </li> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Allowing additional time for getting dressed.</span></p> </li> <li> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Extra support when getting off the couch to keep the client safe in the event of dizziness or weakness.</span></p> </li> </ul> <p></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Hands-on treatment should be seen as one tool, used judiciously, during a session of person- centred support, rather than the sole objective. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">The complexity and unknown nature of many of the conditions should be borne in mind, and we should not mistakenly associate familiar symptoms with known musculoskeletal conditions. We should be looking to support and reassure the client if appropriate and relieve the symptoms. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Where our role involves supporting a client through exercise, we should be aware that the rehabilitative pathway is unknown and unpredictable. Standard repetitions and sets, even when graded, may not be desirable, and progress may be non-linear with relapse and remission being common. Let the treatment be led by the client. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Finally, we should bear in mind our scope of practice as Soft Tissue Therapists which involves the assessment, treatment and rehabilitation of minor and chronic MSK injuries and pain. Where we are unsure, we should refer back to the GP or a qualified medical professional. Where the GP cannot offer further support, this is the opportunity for Soft Tissue Therapists to utilise their own networks of healthcare practitioners (physiotherapists, osteopaths, etc.). </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Through adherence to this guidance, the community of Soft Tissue Therapists will not only ensure it supports those in need effectively and safely, but also shows itself to be a trustworthy and dependable ally in the provision of healthcare. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">This guidance has been developed from a review of current literature and research undertaken by the ISRM Long-COVID working group. Due to the nature of COVID and the unknown nature of Long-COVID progression, the longer-term response of the NHS, we will continue to monitor developments closely to ensure that Soft Tissue Therapy will continue to play a role in supporting people with Long-COVID. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Emerging evidence will be reviewed and any new evidence that influences our practice as Soft Tissue Therapists supporting people with Long-COVID symptoms will be reflected in updated guidance. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Palpitations</span></p> <div class="page" title="Page 3"> <div class="layoutArea"> <div class="column"></div> </div> <div class="layoutArea"> <div class="column"> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">For other symptoms, or where a client has been seen by the GP and no objection to treatment has been raised, the following key considerations apply:</span></p> </div> </div> </div> <ul> <li> <div class="page" title="Page 4"> <div class="layoutArea"> <div class="column"> <ul></ul> </div> </div> </div> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">The client needs to be treated as a person, not a collection of symptoms. This need for Person-Centred Care is, of course, always there, but it is particularly important for Long-COVID clients.</span><br /><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"> This is because the client’s own perception of their condition and what they find helpful becomes one of the most useful guides for how to support them.</span></p> </li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">For More Info: </span></li> <li><a title="Understanding Long- COVID Information and Guidance for Soft Tissue Therapists April 2021" target="_blank" href="https://www.dropbox.com/s/yufyvbssyvf5q8a/LC_GUIDE_FINAL.pdf?dl=0&fbclid=IwAR24C7Co8shf1LxNEOfsvkkDOgcVLo3nEJTJQFsyLT4AGcJZOyOELl9XSJ4">https://www.dropbox.com/s/yufyvbssyvf5q8a/LC_GUIDE_FINAL.pdf?dl=0&fbclid=IwAR24C7Co8shf1LxNEOfsvkkDOgcVLo3nEJTJQFsyLT4AGcJZOyOELl9XSJ4</a></li> </ul> </div> </div> </div>

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