The cardiorespiratory physiotherapist is often under-acknowledged as a health care professional, yet they are a critical cog in the health care wheel in the current crisis, writes Dr Sarah Rhodes 

The Covid-19 pandemic has quite rightly brought to the forefront the vital work undertaken by doctors and nursing staff in critical care. However, at least one profession appears to have been overlooked in this space.

The work of the cardiorespiratory physiotherapist is just as essential in the management of the acutely unwell Covid-19 patient. These physiotherapists specialise in optimisation of the respiratory and cardiovascular systems, the heart and lungs, and this is never more relevant than in the intensive care unit.

An extensive knowledge of respiratory anatomy and pathophysiology ensures they are a vital part of the team, alongside the aforementioned doctors and nurses.  


They play a key role in the management of the ventilated patient and in ventilator weaning, helping the patient to build up enough strength to breathe without the ventilator, whilst ensuring the integrity of the musculoskeletal system throughout this period, to support early rehabilitation.

Not only that, but it will also be a cardiorespiratory physiotherapist who provides the ongoing essential rehabilitation to post Covid-19 patients once they are discharged from hospital.

Having Covid-19 can have longer-term health consequences. For some, the post-Covid symptoms last beyond 12 weeks.

These persistent symptoms, termed long Covid, typically include breathlessness, muscle weakness, cardiovascular compromise, brain fog and fatigue.  

Safe and effective rehabilitation is an important part of a patient’s recovery. Without input from a knowledgeable health professional, these symptoms can worsen. It is becoming increasingly clear that some aspects of long Covid present in a similar way to ME/chronic fatigue syndrome, in particular, the response to exercise.

For example, it remains uncertain what level of physical activity is appropriate in long Covid and at what stage in the recovery process it should be introduced for optimal benefit. For some with long Covid, exercise may further aggravate symptoms rather than relieve them.

Therefore, appropriate screening and assessment is vital to ensure rehabilitation recommendations offer the best outcome for the individual. Years of training and experience ensure physiotherapists are well placed to provide this support to patients at every stage of their Covid journey.

If you are experiencing the symptoms of long Covid, ask your GP to refer you to a local cardio-respiratory physiotherapist. 

Public perception of physiotherapy has typically been associated with clinic visits for sprained ankles and low back pain.

Yet, the cardiorespiratory physiotherapist has long existed. Unseen by many, they work tirelessly in the provision of acute on-call physiotherapy services, primarily for a cardio-respiratory related reason, which happens after hours, at any time of day or night, all year round.

Those who know of them will likely have had a previous hospital admission involving surgery or trauma or be managing with a long-term heart and/or lung condition.

Many patients can testify to the benefits of pulmonary rehabilitation programmes in terms of increasing their functional ability and quality of life, and the evidence is incontrovertible.

These essential workers are little seen or acknowledged but their role is a vital one. Their responsibilities span the critical care unit, community and home-based rehabilitation and private practice. From admission to discharge they are there for you.

At unprecedented times like these, we begin to appreciate the value that others provide, even if they are not usually acknowledged for it. Those who fall into the current definition of essential worker include cleaners, delivery drivers and supermarket workers.

The cardiorespiratory physiotherapist is often under-acknowledged as a health care professional, yet they are a critical cog in the health care wheel in the current crisis.

At a time when many are physically distancing, they are the ones getting up close, helping patients with Covid-19 to manage the burden of their increased effort to breathe, encouraging patients to clear secretions from their lungs and liaising with the wider team to ensure patients’ oxygen demands are met.

Additionally, they are central to managing fatigue and assisting these patients to get back on their feet again. Early identification of rehabilitation targets ensures that, for those patients who pull through, cardiorespiratory physiotherapists will be an important support on their way to full recovery – every step of the way.

Cardio-respiratory physiotherapists are proud to be working from admission to rehabilitation. We’re here for you through Covid-19.

Seeing first-hand the effects of Covid-19, cardio-respiratory physiotherapists are strong advocates for vaccination. Getting vaccinated reduces the risk of contracting Covid-19 and affords protection against becoming seriously ill or dying from the virus.

Whilst the vaccine cannot guarantee 100 percent protection, it is very effective in those who have received both doses.

Being fully vaccinated means that, even if someone does contract the virus, the symptoms would be much less severe and they are less likely to infect others. That’s a win for both the individual and for the team of five million.

Dr Sarah Rhodes is a cardio-respiratory physiotherapist and lecturer at the University of Otago' School of Physiotherapy.

Leave a comment