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Education andtraining of current andfuturephysiotherapists: Physiotherapists should integrate Long COVID-specific education into physiotherapy entry-level-to-practice curricula and continuing education. Curricula should address the importance of screening for PESE or PEM, and potential harm physiotherapists may cause to patients with Long COVID through traditional exercise-based interventions |
It starts with school curriculum … we have these waves of students coming into practice … if we can educate them well on Long COVID, that’s huge … the next step is the colleges and associations of physiotherapy, they need to be I think doing a bit more proactive a job of being abreast of the literature and providing talks or courses, things that are well validated not necessarily just things that are popular. (P8) We need to educate physios because I think physios can do a lot of damage when they don’t know what’s going on, and I saw this initially in the concussion program, which is why I started to teach courses. (P6)
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Engage asactive andopen-mindedlisteners: Physiotherapists should engage as active and open-minded listeners to foster communication and mitigate testimonial injustice (gaslighting) patients with Long COVID |
…listen to the patient and being patient with them. Be patient with your expectations, it’s going to take a lot longer than you think. And that’s okay, that’s part of the recovery … we’re so focused on outcomes that we kind of say you know, if somebody presents within two weeks with a worse outcome that means I’m doing something wrong, but with Long COVID sometimes that’s just you evaluating them at the wrong time because they might have done something that was too much for them a couple of days ago and now they’re presenting with worse outcomes, so it’s not necessarily reflective of how well they’re responding to your treatment. (P5) Slow down and listen. And learn … put aside your expectations of functional baseline, which is what we’re really geared towards as, as physios, right. We’re really motivated to get people back to where they came from, from a functional perspective … it’s really tapping into those listening skills, those counseling skills, and slowing down. (P9)
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Interdisciplinarymodels ofcare: Long COVID rehabilitation should involve an interdisciplinary team to address the complexity of symptoms experienced by persons living with Long COVID |
The ideal situation is that you’ve got all of these players that are working together to help support these clients as best as possible … what needs to be offered needs to be a multidisciplinary approach … these patients need everybody … we need each other … we do come to the table with limitations and areas that we’re just not comfortable with. (P7) It should be … a multidisciplinary approach … psychologists [are] very, very important … because most [patients] are going through a lot of emotional distress and we don’t have [psychology] here, unfortunately. Nutrition is also very important because a lot of [patients] have GI issues and … some of my patients after they eat and they have malaise … it should be really very, very multidisciplinary. (P13)
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Interdisciplinarymodels ofcare: Physiotherapists should foster learning and regular check-ins with clinicians from other disciplines |
I would love interdisciplinary learning … more opportunities to connect, as clinicians… treating Long COVID. ‘Cause I know there are COVID clinics elsewhere in Canada, but just have never been connected to them … having regular check-ins like once a month like a meeting and somebody does a topic … based on clinical knowledge and it would be great to kind of get that all together in the same place. (P10) In my opinion, especially with my experience … it’d be multidisciplinary, it would have a, a variety … you’d have available virtual platforms for people who [need it] … definitely it would have to be interactive. just digesting, pre-recorded PowerPoint, we’ve found that not useful at all … it has to be multidisciplinary … I critically think that we need to involve our other clinical allied health partners. (P9)
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Organisationalandsystemlevelimprovements: Healthcare system models should enhance publicly funded access to rehabilitation care for persons living with Long COVID across Canada. For instance, using virtual methods such as video-based consulting to allow for accessible sharing of expertise and delivery of care between provinces. Additionally, increasing funding to Long COVID programmes would improve patient access to appropriate care |
There are some things that maybe, and Long COVID being one of them, has, an across-the-board standard of care, because I think right now what you sometimes hear is, “Well, if you live there, you’re getting x, y, and z, but if you live there, you’re only getting x”. So, I think that creating some sort of national standard of care of–hey, this is what we’re going to do with people, and allow some of that interprovincial–some of it can be video consulting, because I’m sure that there are provinces that don’t have access to perhaps the specialists that are in other provinces, right … if we can create an easier accessible system, you know, Canada-wide is gonna be beneficial. (P2) It’s important to establish some guidelines … it’s such a shame that we don’t have any major association in Canada having a framework for saying here’s what we learned so far from all the providers across our country, and here’s kind of a conference that we or means that we established those particular guidelines for how to treat COVID, and not just for physios, but for physicians, primary caregivers in different areas, they might not even have dealt with somebody with Long COVID … having those resources is going to be really important. (P5) Typing up the criteria would be helpful, so that we were clear about what Long COVID symptoms are best treated with physical therapy. Like we started this kind of … whatever you’ve got and we’ll figure it out. But if we have research now to say, physio helps with XYZ, then I would say that future directions of these programs should really consider that that should be part of the eligibility criteria. (P3) It’s creating access … no matter what somebody’s socioeconomic status, they should have access to care, and timely access to care is probably more specific and appropriate. Whether there’s even just … a screening … to make sure you’re educated, and you can make sure that you’re not overdoing it so [the] main thing is [access] and … knowledge translation from the research into practice. (P12)
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