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M. Bull1, N. Clague-Baker1, K. Leslie1, N. Hilliard1
1Physios for ME, Widnes, United Kingdom
Background: The COVID-19 pandemic means a significant number of patients will require rehabilitation by physiotherapists to regain function/address deconditioning. Evidence from previous viral pandemics suggests up to 10% of patients with COVID-19 may develop Post Viral Fatigue Syndrome (PVFS) which if persistent after 4 to 5 months may be diagnosed as Myalgic Encephalomyelitis (ME) (Hickie et al 2006, Moldofsky & Patcai 2011).
Swift identification of PVFS is important because management techniques are significantly different to the typical reconditioning approach. Recent research has shown people with ME have an abnormal physiological response to exercise, requiring maintenance of activity below anaerobic threshold to avoid symptom exacerbation (Lien et al, 2019).
Physiotherapists delivering post COVID-19 rehabilitation should be aware of when standard rehabilitation may be detrimental and associated implications for management.
Swift identification of PVFS is important because management techniques are significantly different to the typical reconditioning approach. Recent research has shown people with ME have an abnormal physiological response to exercise, requiring maintenance of activity below anaerobic threshold to avoid symptom exacerbation (Lien et al, 2019).
Physiotherapists delivering post COVID-19 rehabilitation should be aware of when standard rehabilitation may be detrimental and associated implications for management.
Purpose: Undergraduate physiotherapy courses in the UK do not routinely include ME (Clague-Baker et al 2019) and 53% of patients with ME reported physiotherapy had made their symptoms worse (Leslie et al 2019), highlighting the need for an education programme to increase knowledge and awareness of PVFS and ME to ensure safe effective rehabilitation post COVID-19. With the range of symptoms being reported post COVID-19, this programme needed to reach across all fields of physiotherapy.
Methods: COVID-19 presented unique challenges to delivering education, necessitating delivery through virtual mechanisms. An online programme was developed to educate physiotherapists in PVFS and ME, to raise awareness and highlight the implications for post-COVID rehabilitation. Core elements included a slide-deck, series of podcasts/webinars, regular social media messaging and a specific covid-19 webpage.
Results: Impact of the programme was evaluated by qualitative and quantitative methods. Key qualitative themes identified include:
- Increased awareness of PVFS and ME
- Improved understanding of implications for rehabilitation of patients post-COVID-19
Online analytics demonstrate the wide-reaching impact of the education programme: over 14,000 visits made to the website with spikes in activity as podcasts and other educational activity were published.
There is evidence that participants in educational activities have shared learning with other physiotherapists.
Content from the programme was used to inform key documents including “World Physiotherapy response to COVID-19 Briefing paper 2”
Positive feedback and uptake of learning opportunities show that this is an appropriate mechanism for delivering an educational programme.
- Increased awareness of PVFS and ME
- Improved understanding of implications for rehabilitation of patients post-COVID-19
Online analytics demonstrate the wide-reaching impact of the education programme: over 14,000 visits made to the website with spikes in activity as podcasts and other educational activity were published.
There is evidence that participants in educational activities have shared learning with other physiotherapists.
Content from the programme was used to inform key documents including “World Physiotherapy response to COVID-19 Briefing paper 2”
Positive feedback and uptake of learning opportunities show that this is an appropriate mechanism for delivering an educational programme.
Conclusion(s): It is possible to raise awareness and educate using a range of online methods and there is a ripple effect to learning with participants spreading information more widely. Through the delivery of a wide-reaching online educational programme, physiotherapists have an increased knowledge of PVFS and ME. The lasting duration of the COVID-19 pandemic and significant numbers of people affected indicate that there is a need to continue with this work. More podcasts, continued social media activity and submission for publications/ conference presentations are planned.
Implications: Through increased knowledge and awareness, the results will translate into improved practice with safe effective rehabilitation delivered to patients post COVID-19. The positive feedback and significant uptake of the project demonstrate a clear need to educate physiotherapists in PVFS and ME, which should be considered by providers of physiotherapy education.
Funding, acknowledgements: This work was unfunded with the authors carrying it out as on a voluntary basis
Keywords: Myalgic encephalomyelitis, online education, Post viral fatigue syndrome
Topic: COVID-19
Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: This work addresses new and unique developments in education relating to COVID19, focusing on content and delivery of the programme.
All authors, affiliations and abstracts have been published as submitted.
