Post Covid-19 physiotherapy and exercise programme

According to WHO Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. 

Symptoms of COVID-19:

The main symptoms include:

  • Fever
  • Coughing
  • Shortness of breath
  • Trouble breathing
  • Fatigue
  • Chills, sometimes with shaking
  • Body aches
  • Headache
  • Sore throat
  • Congestion/runny nose
  • Loss of smell or taste
  • Nausea
  • Diarrhea

COVID-19 rehabilitation:COVID-19 is a new virus that has affected many people across the world. At times people require admission into hospital for intensive care support to help with their breathing, this can cause some patients to experience muscle weaknessshortness of breath and fatigue.

As you recover from COVID-19, the information in this content about breathing techniquesgeneral mobility and strengthening exercises will help to improve your day-to-day function.

I recommend that you complete these exercises daily after you leave hospital. If your symptoms do not get better within six weeks, please speak to your doctor about this and, if appropriate, please ask them to refer you to outpatient physiotherapy for further rehabilitation.

The Active Cycle of Breathing Techniques (ACBT):

People with a lung problems often cough and produce more sputum than is usual. It is important to remove sputum from your lungs to help you breathe more easily, prevent chest infections and reduce bouts of coughing. Leaving sputum in your chest can make your condition worse.

 The Active Cycle of Breathing Techniques (ACBT) is one way to help you to clear your sputum from your chest. ACBT is a set of breathing exercises that loosens and moves the sputum from your airways. It is best to be taught ACBT by a physiotherapist. The ACBT exercises are breathing controldeep breathing and huffing which are performed in a cycle until your chest feels clear.

Breathing control: Breathing control is breathing gently, using as little effort as possible.

∙ Breathe in and out gently through your nose if you can. If you cannot, breathe through your mouth instead

∙ If you breathe out through your mouth, purse your lips like you are blowing out a candle

∙ Try to let go of any tension in your body with each breath out

∙ Gradually try to make the breaths slower

∙ Try closing your eyes to help you to focus on your breathing and to relax.

Deep breathing exercises: take a long, slow, deep breath in, through your nose if you can. Try to keep your chest and shoulders relaxed. Breathe out gently and relaxed, like a sigh. You should do three-five deep breaths. Ask your physiotherapist to help you choose the right number of deep breaths for you. Some people find it helpful to hold their breath for about two-three seconds at the end of the breath in, before breathing out. Try the deep breathing exercises both with and without holding your breath and see which works best for you.

Huffing: A huff is exhaling through an open mouth and throat instead of coughing. It helps move sputum up your airways so that you can clear it in a controlled way. To “huff” you squeeze air quickly from your lungs, out through your open mouth and throat, as if you were trying to mist up a mirror or your glasses. Use your tummy muscles to help you squeeze the air out, but do not force it so much that you cause wheezing or tightness in your chest. Huffing should always be followed by breathing control.

There are two types of huff, which help to move sputum from different parts of the lungs.

The small-long huff: This will move sputum from low down in your chest. Take a small to medium breath in and then huff (squeeze) the air out until your lungs feel quite empty

The big-short huff: This moves sputum from higher up in your chest, so use this huff when it feels ready to come out, but not before. Take a deep breath in and then huff the air out quickly. This should clear your sputum without coughing. How do I know I am huffing correctly? Your huff should move the sputum in your chest by making it “rumble” or “rattle”. This will mean you are moving the sputum up the airways, and it should then clear easily. If you are wheezing with each huff you may be huffing too hard or for too long. Make sure you do not huff too hard and always do some breathing control after each two huffs.

If you find it hard to keep your mouth and throat open when huffing, you may find it useful to use a small tube (e.g. the mouthpiece for a peak flow meter) when practising. Ask your physiotherapist to show you how. Putting it together to form a “cycle” Your physiotherapist may adjust the Active Cycle of Breathing Techniques to suit your need.

It is very important to do breathing control in between the more active exercises of ACBT as it allows your airway to relax. Breathing control can also help you when you are short of breath or feeling fearful, anxious or in a panic.


Mayfair wellness clinic is a well-organized physiotherapy clinic at gulshan 1,Dhaka. Our expert physical therapist can give you a solution if you have vertigo. Please visit us and let us know about your problem.

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