Personal protective equipment

4.1

Droplet precautions should be appropriate for the provision of mobilisation, exercise and rehabilitation in most circumstances. However, physiotherapists are likely to be in close contact with the patient (e.g., for mobilisation, exercise or rehabilitation interventions that require assistance). In these cases, consider use of a high filtration mask (e.g., P2/N95). Mobilisation and exercise may also result in the patient coughing or expectorating mucus, and there may be circuit disconnections with ventilated patients.

Screening

4.2

Physiotherapists will actively screen and/or accept referrals for mobilisation, exercise and rehabilitation.

When screening, discussion with physician or family is recommended before deciding to enter the patient’s isolation room. For example, to try to minimise staff who come in to contact with patients with COVID-19, physiotherapists may screen to determine an appropriate aid to trial.

4.3

Direct physiotherapy interventions should only be considered when there are significant functional limitations, such as (risk for) ICU-acquired weakness, frailty, multiple comorbidities and advanced age.

Early Mobilisation

4.4

Early mobilisation is encouraged. Actively mobilise the patient early in the course of illness when safe to do so.

4.5

Patients should be encouraged to maintain function, as able within their rooms.

· Sit out of bed

· Perform simple exercises and activities of daily living

Mobilisation and exercise prescription

4.6

Mobilisation and exercise prescription should involve careful consideration of the patient’s state (e.g., stable clinical presentation with stable respiratory and haemodynamic function).