24 June 2020

In the journal Physical Therapy, Karin Felten-Barentsz and colleagues from the department of Rehabilitation and IQ healthcare described detailed recommendations and intervention descriptions for hospital-based physical therapists managing patients hospitalized with COVID-19 in the Netherlands.


The COVID-19 pandemic is rapidly evolving and has led to increased numbers of hospitalizations worldwide. Hospitalized patients with COVID-19 experience a variety of symptoms, including fever, muscle pain, tiredness, cough, and difficulty breathing. Elderly people and those with underlying health conditions are considered to be more at risk of developing severe symptoms and have a higher risk of physical deconditioning during their hospital stay. Physical therapists have an important role in supporting hospitalized patients with COVID-19 but also need to be aware of challenges when treating these patients. In line with international initiatives, this article aims to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands.

A pragmatic approach was used. A working group conducted a purposive scan of the literature and drafted initial recommendations based on the knowledge of symptoms in patients with COVID-19, and current practice for physical therapist management for patients hospitalized with lung disease and patients admitted to the intensive care unit (ICU). An expert group of hospital-based physical therapists in the Netherlands provided feedback on the recommendations, which were finalized when consensus was reached among the members of the working group.

The recommendations include safety recommendations, treatment recommendations, discharge recommendations, and staffing recommendations. Treatment recommendations address 2 phases of hospitalization: when patients are critically ill and admitted to the ICU, and when patients are severely ill and admitted to the COVID ward. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization. Respiratory support includes breathing control, thoracic expansion exercises, airway clearance techniques, and respiratory muscle strength training. Recommendations toward active mobilization include bed mobility activities, active range-of-motion exercises, active (-assisted) limb exercises, activities-of-daily-living training, transfer training, cycle ergometer, pre-gait exercises, and ambulation.

Recommendations for Hospital-Based Physical Therapists Managing Patients With COVID-19
Karin M Felten-Barentsz, Roel van Oorsouw, Emily Klooster, Niek Koenders, Femke Driehuis, Erik H J Hulzebos, Marike van der Schaaf, Thomas J Hoogeboom, Philip J van der Wees 

Related news items

Over 800k euro for Primary and Community Care study cardiovascular risk management

26 October 2020

The research group led by Primary and Community Care researcher and general practitioner Erik Bischoff has received a ZonMw grant from the call Goed Gebruik Geneesmiddelen.

read more

Radboudumc research into the effects of COVID-19 measures on migrant workers

22 October 2020

Within the Radboud University Network on Migrant Inclusion (RUNOMI), the Radboudumc researches the position and vulnerability of labour migrants within the (Dutch) labor market during the COVID-19 pandemic.

read more

Largest study ever on research integrity Aimed at all researchers in the Netherlands

15 October 2020

Radboudumc participates in the National Survey on Research Integrity (NSRI), which is being distributed to nearly 40,000 researchers in the Netherlands starting today. The survey seeks to sketch a picture of the issues that can foster or hinder research integrity. Please fill out the survey!

read more

Exoskeleton home and community use in people with complete spinal cord injury

15 October 2020

Radboudumc researchers are first to study actual exoskeleton use in the home and community environment in people with motor complete spinal cord injury.

read more

Making bones is less difficult than was previously thought Ten-year controversy settled with publication in Nature Communications

15 October 2020

The way in which bone formation occurs need to be redefined. This was revealed in a publication in Nature Communications by Nico Sommerdijk, theme Reconstructive and Regenerative Medicine, and his colleagues.

read more

Online care concept Luchtbrug improves monitoring and supervision of children with asthma

14 October 2020

The online care concept Luchtbrug, an initiative of Radboudumc, is an effective way to monitor and supervise children with asthma. Following the use of Luchtbrug, children need to visit the hospital less often.

read more