Experiences of physiotherapists working with adults living with Long COVID in Canada: a qualitative study

Michelle Wong, Saul Cobbing, Alyssa Minor, Chantal Lin, Caleb Kim, Shahd Al Hamour Al Jarad, Darren A. Brown, Soo Chan Carusone, Kelly K. O'Brien, Amy Gao, Nicole Kaufman, Kiera McDuff
Purpose:

To explore experiences of physiotherapists working with adults living with Long COVID in Canada.To explore experiences of physiotherapists working with adults living with Long COVID in Canada.

Methods:

We conducted a cross-sectional descriptive qualitative study involving online semi-structured interviews. We recruited physiotherapists in Canada who reported having worked with ≥1 adults with Long COVID in the past year. Using an interview guide, we asked participants about their knowledge of Long COVID, assessment and treatment experiences, perspectives on roles, and recommendations for working with adults living with Long COVID. Interviews were audio-recorded, transcribed verbatim, and analyzed using a group-based thematic approach. 

Results:

Of the 13 physiotherapists from 5 provinces, the majority were women (n=8), practiced in urban settings (n=11), and reported variable knowledge of existing guidelines and experiences working in Long COVID. Physiotherapists characterized their experiences as a dynamic process involving: 1) a disruption to the profession (encountering a new patient population and pivoting to new models of physiotherapy care delivery), followed by 2) a cyclical process of learning curves and evolving roles (navigating uncertainty with Long COVID physiotherapy care, keeping up with rapidly-emerging evidence, trial and error, adapting mindset and physiotherapy approaches, and growing prominence of roles as advocate and collaborator). Participants recommended the need for education and training in Long COVID, active and open-minded listening with patients, interdisciplinary models of care, and improvements for access to care for persons with Long COVID.

Conclusion(s):

Physiotherapists’ experiences involved a disruption to the profession followed by a dynamic process of learning curves and evolving roles in Long COVID rehabilitation. Not all participants demonstrated in-depth understanding of existing Long COVID rehabilitation guidelines. An individualized Long COVID rehabilitation program involving an interprofessional team is essential for patient-centered care. Integrating evidence-informed practice through education and training is crucial to prevent potential harm to patients living with Long COVID.

Implications:

The roles described by physiotherapists aligned with a subset of the Essential Core Competencies for Physical Therapy in Canada, including physiotherapy expertise, communication, collaboration, management, leadership, scholarly inquiry, and professionalism, which were emphasized and applied to the unique context of Long COVID rehabilitation. An individualized Long COVID rehabilitation program involving an interprofessional team is essential for patient-centered care. Integrating evidence-informed practice through education and training is crucial to prevent potential harm to patients. Results may help to inform physiotherapy education in Long COVID rehabilitation.

Funding acknowledgements:
This research was funded by the Rehabilitation Science Research Network for COVID, Temerty Faculty of Medicine, University of Toronto.
Keywords:
Long COVID
COVID-19
disability
Primary topic:
Disability and rehabilitation
Second topic:
Other
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study protocol was approved by the University of Toronto Health Sciences Research Ethics Board (Protocol #00043692).
Provide the ethics approval number:
REB Protocol #00043692
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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