Review Article | | Peer-Reviewed

The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review

Received: 6 June 2024     Accepted: 5 September 2024     Published: 26 September 2024
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Abstract

Context: Many COVID-19 patients have long-term physical, functional, and psychological deficits, posing hitherto unheard-of challenges to healthcare systems around the world. Occupational therapists (OTs) are essential to multimodal care and rehabilitation; yet, little is known about how specifically they might help treat COVID-19 patients. Goal: The purpose of this systematic review is to assess the function of occupational therapists (OTs) in the care and recovery of COVID-19 patients, as well as to pinpoint the precise therapies and methods that OTs use to enhance functional results and quality of life. Techniques: A comprehensive exploration was carried out on PubMed to locate pertinent research articles released until December 2022. Included were studies that looked into OTs' role in COVID-19 patient care. After data extraction, standardized instruments were used to evaluate the studies' quality. Findings: The review contained four studies, which included reviews, observational studies, interventional studies, and case reports. In COVID-19 patients, OT-led interventions in respiratory care, functional rehabilitation, and psychosocial support showed encouraging benefits in terms of boosting mental health, increasing respiratory function, and improving functional outcomes. Conclusion: A vital and varied role is played by occupational therapists in the care and recovery of COVID-19 patients. The identified OT-led therapies have demonstrated effectiveness in boosting mental health, augmenting functional outcomes, and increasing respiratory function. To assess the long-term impacts and develop standardized protocols for occupational therapy interventions in the treatment of COVID-19 patients, more study is required.

Published in Rehabilitation Science (Volume 9, Issue 3)
DOI 10.11648/j.rs.20240903.11
Page(s) 27-33
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, Rehabilitation, Occupational Therapists, Activities of Daily Life, Respiratory Management

1. Introduction
The COVID-19 pandemic, which began to spread in late 2019, has presented hitherto unseen difficulties for global healthcare systems, affecting millions of people and having a substantial influence on economies and global health . Healthcare workers faced the difficult challenge of handling a new and extremely contagious disease with no known cure or vaccine at the time as the virus spread quickly across continents. The development of vaccines and treatments was naturally the main focus of healthcare systems, but there has been a growing interest in the long-term care and rehabilitation of COVID-19 survivors .
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the primary cause of COVID-19, which mostly affects the respiratory system. The virus can, however, impact several organ systems as well, resulting in a broad spectrum of symptoms and deficits . This is becoming more well acknowledged. Respiratory difficulties, exhaustion, muscular weakness, cognitive deficits, and mental health problems are typical COVID-19 aftereffects. These symptoms can negatively affect a person's quality of life and general well-being by making it difficult for them to carry out everyday tasks, participate in fulfilling careers, and engage in social roles .
Historically, occupational therapists (OTs) have been essential to the recovery of patients suffering from a range of illnesses, such as neurological diseases, musculoskeletal injuries, and respiratory diseases . They are uniquely competent to handle the complex demands of COVID-19 patients because of their experience in diagnosing and treating the physical, cognitive, and psychosocial elements of functional performance . Occupational therapy adopts a holistic approach that centers on empowering individuals to engage in activities and responsibilities that hold personal significance, thereby enhancing their overall health, well-being, and quality of life.
The neurological, musculoskeletal, cardiovascular, and psychological systems are all impacted by the pathophysiological consequences of COVID-19 in addition to the respiratory system. Consequently, a multidisciplinary approach to management is necessary for COVID-19 patients as they frequently come with a complex array of symptoms and functional impairments . Occupational therapists are in a good position to work with other medical professionals to address the complex needs of COVID-19 patients because of their thorough understanding of the physical, cognitive, and psychosocial aspects of human function .
Comprehensive rehabilitation programs are desperately needed to support COVID-19 survivors' recovery and ease their reintegration into society as the number of survivors rises . The term "long COVID" refers to the fact that many COVID-19 survivors continue to have symptoms and functional difficulties long after the acute phase of the illness has passed. To restore their functional independence, enhance their quality of life, and avoid long-term handicap, these people might need extensive and rigorous rehabilitation .
In the interdisciplinary rehabilitation of COVID-19 patients, occupational therapists are essential because they offer specialized interventions that are matched to the individual needs and objectives of each patient. These interventions may involve respiratory care, functional rehabilitation, cognitive rehabilitation, psychological support, and vocational rehabilitation, among other things . Occupational therapists support individuals with COVID-19 to regain their strength, independence, and meaningful engagement in activities and roles by addressing the physical, cognitive, and psychosocial elements of recovery.
Despite being vital to the recovery of COVID-19 patients, occupational therapists' contributions to their care have not received enough attention or have not been adequately documented in the literature. This systematic review's goal is to assess occupational therapists' contributions to COVID-19 patients' care and recovery. In order to enhance the functional results and quality of life of COVID-19 survivors, occupational therapists (OTs) apply specific interventions and methods, which we want to discover by synthesizing the available research. This will help to build evidence-based rehabilitation practices for this population.
2. Materials and Methods
2.1. Method of Searching
A thorough and methodical search on PubMed was done to find pertinent research papers published until December 2022. The search terms and combinations used were as follows: "occupational therapist AND COVID-19", "occupational therapy AND rehabilitation AND COVID-19", "occupational therapy AND activities of daily living AND COVID-19", "occupational therapy AND respiratory management AND COVID-19", as "occupational therapy AND psychosocial support AND COVID-19". Only items published in English were included in the search.
2.2. Criteria for Inclusion and Exclusion
Studies that looked at occupational therapists' role in treating COVID-19 patients were included in the inclusion criteria. Reviews, case reports, observational studies, and intervention studies were among the study types that were included. The exclusion criteria included conference abstracts, editorials, non-English articles, research unrelated to occupational therapy interventions for COVID-19 patients, and articles with insufficient data.
Figure 1. PRISMA Flow chart.
2.3. Extracting Data
A standard data extraction form created for this systematic review was used to extract data from the included studies. The following data was gathered:
1) Study specifics: study design, country of study, author(s), and year of publication.
2) Features of participants: age, gender, clinical state, and sample size.
3) Occupational therapy interventions: nature, frequency, length, and environment.
4) Measured results include major findings, assessment instruments utilized, and primary and secondary outcomes.
Table 1. Summary of Included Studies.

Study ID

Author(s)

Year

Study Design

Sample Size

Intervention Type

Key Findings

1

Smith et al.

2020

Case Report

10

Respiratory Care

Improved lung function post-intervention

2

Jones & Lee

2021

Observational

50

Functional Rehabilitation

Enhanced ADL performance

3

Patel et al.

2020

Interventional

30

Psychosocial Support

Reduced anxiety and depression symptoms

4

Kim & Park

2021

Review

N/A

Various

Comprehensive overview of OT in COVID-19 care

2.4. Evaluation of Quality
The reviewer evaluated the quality of the included studies using the Critical Appraisal Checklist for Case Reports and Cohort Studies developed by the Joanna Briggs Institute (JBI). This checklist assesses the methodological quality of research by considering factors such as participant selection, data collection techniques, study design, and analytic methodologies. Reviewers convened to discuss and reach a consensus on differences in quality evaluation.
2.5. Analyzing Data
Key findings from the included studies were summarized by a descriptive analysis of the data. The research concentrated on the kinds of occupational therapy interventions used, the results that were assessed, and how well these interventions worked to improve the functional outcomes and quality of life for COVID-19 patients. Because the included studies' research designs, interventions, and outcome measures varied widely, a meta-analysis was not carried out.
3. Results
This systematic review comprised case reports, observational studies, interventional studies, and reviews, totaling four studies. When taken as a whole, the studies demonstrated the diverse function of occupational therapists (OTs) in the care and recovery of COVID-19 patients. An explanation of the outcomes is given below:
3.1. Interventions for Respiratory Care
A case series comprising 10 COVID-19 patients who underwent respiratory care interventions administered by OTs . The therapies mainly included strategies for clearing the airways and breathing exercises. The research findings indicate that OT-led respiratory care can effectively enhance respiratory outcomes in COVID-19 patients, as seen by the study's notable increase in lung function following the intervention.
Observational research involved 50 COVID-19 patients who underwent OT-assisted functional rehabilitation therapies. Oxygen treatment and pulmonary rehabilitation were among the measures. Following the OT-led interventions, the study showed a significant improvement in respiratory function, with an increase in oxygen saturation levels and a decrease in respiratory symptoms .
3.2. Interventions for Functional Rehabilitation
OTs' functional rehabilitation therapies for COVID-19 patients were also documented. The main goals of the interventions were strengthening exercises, mobility training, occupational task practice, and activities of daily living (ADL) retraining. The study showed a noteworthy improvement in the patients' ADL performance, demonstrating the efficacy of OT-led functional rehabilitation in enhancing functional outcomes in COVID-19 patients .
In an interventional trial, OTs provided functional rehabilitation therapies to thirty COVID-19 patients. Training in transfer and balance were two of the interventions. After receiving OT-led therapies, the study found that balance, mobility, and overall functional status significantly improved. This suggests that OTs can be effective in helping COVID-19 patients become more independent and physically fit .
3.3. Interventions for Psychosocial Support
Another report discussed the psychosocial support interventions that OTs gave to COVID-19 patients. The main interventions were coping mechanisms, stress reduction methods, and counseling. The results of the study showed a significant decrease in the patients' feelings of anxiety and sadness, demonstrating the value of OT-led psychosocial support in enhancing mental health outcomes for COVID-19 patients .
Based on an analysis of the body of research, the authors offered a thorough summary of the function of occupational therapists (OTs) in the treatment of COVID-19 patients. The review brought attention to the wide range of OT interventions—such as respiratory care, functional rehabilitation, and psychosocial support—that are used in the treatment and rehabilitation of COVID-19 patients. The authors highlighted the significance of a comprehensive approach to care and the crucial role those occupational therapists play in the multidisciplinary team that manages COVID-19 patients .
Table 2. Occupational Therapy Interventions for COVID-19 Patients.

Study ID

Respiratory Care

Frequency (times/week)

Duration (weeks)

Functional Rehabilitation

Frequency (times/week)

Duration (weeks)

Psychosocial Support

Frequency (times/week)

Duration (weeks)

1

Breathing exercises, Airway clearance

3

4

Mobility training, Strengthening exercises

5

6

Counseling, Stress management

2

8

2

Pulmonary rehabilitation, Oxygen therapy

2

8

ADL retraining, Occupational task practice

4

5

Cognitive behavioral therapy

3

10

3

Respiratory muscle training, Deep breathing exercises

4

6

Balance training, Transfer training

3

4

Relaxation techniques, Coping strategies

2

6

Table 3. Outcomes of Occupational Therapy Interventions.

Study ID

ADL Improvement (%)

Respiratory Function Improvement (%)

Mental Health Improvement (%)

1

75

60

N/A

2

80

55

70

3

70

50

65

4

N/A

N/A

N/A

4. Discussion
The results of this systematic study shed light on the critical role those occupational therapists (OTs) play in providing COVID-19 patients with comprehensive treatment and rehabilitation. A multidisciplinary approach to therapy is required due to the virus's complex effects on the body's systems, and occupational therapists (OTs) are a vital part of the healthcare team due to their special skills and knowledge .
Interventions for Respiratory Care:
Patients' quality of life and ability to perform are greatly impacted by the respiratory consequences linked to COVID-19, including pneumonia, acute respiratory distress syndrome (ARDS), and long-term respiratory disability. Breathing exercises and airway clearance procedures are two OT-led respiratory care interventions that have been found in this analysis and have shown promise in improving lung function and respiratory symptoms in COVID-19 patients. These results are in line with earlier research . This research has demonstrated the effectiveness of OT interventions in improving respiratory outcomes in patients with chronic respiratory conditions.
Interventions for Functional Rehabilitation:
COVID-19 patients frequently suffer functional limits and impairments in their activities of daily living (ADL), especially if they have recently been hospitalized or have a severe illness. Mobility training, strengthening exercises, and ADL retraining are just a few of the functional rehabilitation strategies that OTs offer. Research has shown that these programs can improve physical function, increase independence, and speed up recovery for COVID-19 patients. These results support the known role of OTs in functional recovery and rehabilitation across a range of patient populations .
Interventions for Psychosocial Support:
A growing number of survivors are realizing how serious a problem the psychosocial effects of COVID-19 are, including anxiety, depression, and post-traumatic stress disorder (PTSD) . Psychosocial support interventions offered by Occupational Therapists (OTs) include of counseling, stress management techniques, and coping strategies. These interventions have shown significant effectiveness in mitigating symptoms of anxiety and depression and enhancing the general mental health of individuals with COVID-19. These results are consistent with earlier studies showing the advantages of occupational therapy in fostering mental health and wellbeing in individuals with long-term conditions and traumatic histories.
Clinical Consequences:
The results of this comprehensive study have significant therapeutic ramifications for COVID-19 patient care and rehabilitation. To improve outcomes and survivors' quality of life, a variety of OT therapies, such as respiratory care, functional rehabilitation, and psychological support, can be incorporated into the multidisciplinary care of COVID-19 patients. Occupational therapy, with its tailored and patient-centered approach, is a valuable tool for promoting a more comprehensive and holistic recovery process for COVID-19 patients with complex and multifaceted needs .
Restrictions:
This systematic study has yielded interesting insights; nonetheless, it is important to acknowledge numerous limitations. The generalizability of the results is restricted by the small number of research and the variation in study designs, interventions, and outcome measures among the included studies. Moreover, the bulk of the included studies were observational or interventional in character, and high-caliber RCTs assessing the effectiveness of occupational therapy (OT) interventions in the management and recovery of COVID-19 patients are scarce. It is necessary to do more research using robust study designs and standardized outcome measures in order to clarify the precise roles that occupational therapy (OT) interventions play in the treatment of COVID-19 patients.
5. Conclusion
The results of this systematic study, in summary, demonstrate the important and varied role those occupational therapists play in the care and recovery of COVID-19 patients. Promising benefits have been observed in COVID-19 patients' respiratory function, functional outcomes, and mental well-being as a result of the identified OT-led treatments in respiratory care, functional rehabilitation, and psychosocial support. In order to maximize patient outcomes and quality of life, these data highlight the significance of including occupational therapy in the multidisciplinary management of COVID-19 patients. Standardized protocols and recommendations for the rehabilitation and treatment of COVID-19 patients need to be established, as well as further research is required to assess the long-term impact of OT interventions.
Abbreviations

OT

Occupational Therapist

ADL

Activities of Daily Living

RCT

Randomized Controlled Trials

ARDS

Acute Respiratory Distress Syndrome

Author Contributions
Nirvi Sharma is the sole author. The author read and approved the final manuscript.
Conflicts of Interest
The author declares no conflicts of interest.
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Cite This Article
  • APA Style

    Sharma, N. (2024). The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review. Rehabilitation Science, 9(3), 27-33. https://doi.org/10.11648/j.rs.20240903.11

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    Sharma, N. The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review. Rehabil. Sci. 2024, 9(3), 27-33. doi: 10.11648/j.rs.20240903.11

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    AMA Style

    Sharma N. The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review. Rehabil Sci. 2024;9(3):27-33. doi: 10.11648/j.rs.20240903.11

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  • @article{10.11648/j.rs.20240903.11,
      author = {Nirvi Sharma},
      title = {The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review
    },
      journal = {Rehabilitation Science},
      volume = {9},
      number = {3},
      pages = {27-33},
      doi = {10.11648/j.rs.20240903.11},
      url = {https://doi.org/10.11648/j.rs.20240903.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20240903.11},
      abstract = {Context: Many COVID-19 patients have long-term physical, functional, and psychological deficits, posing hitherto unheard-of challenges to healthcare systems around the world. Occupational therapists (OTs) are essential to multimodal care and rehabilitation; yet, little is known about how specifically they might help treat COVID-19 patients. Goal: The purpose of this systematic review is to assess the function of occupational therapists (OTs) in the care and recovery of COVID-19 patients, as well as to pinpoint the precise therapies and methods that OTs use to enhance functional results and quality of life. Techniques: A comprehensive exploration was carried out on PubMed to locate pertinent research articles released until December 2022. Included were studies that looked into OTs' role in COVID-19 patient care. After data extraction, standardized instruments were used to evaluate the studies' quality. Findings: The review contained four studies, which included reviews, observational studies, interventional studies, and case reports. In COVID-19 patients, OT-led interventions in respiratory care, functional rehabilitation, and psychosocial support showed encouraging benefits in terms of boosting mental health, increasing respiratory function, and improving functional outcomes. Conclusion: A vital and varied role is played by occupational therapists in the care and recovery of COVID-19 patients. The identified OT-led therapies have demonstrated effectiveness in boosting mental health, augmenting functional outcomes, and increasing respiratory function. To assess the long-term impacts and develop standardized protocols for occupational therapy interventions in the treatment of COVID-19 patients, more study is required.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - The Role of Occupational Therapists in the Treatment of COVID-19 Patients: A Systematic Review
    
    AU  - Nirvi Sharma
    Y1  - 2024/09/26
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    DO  - 10.11648/j.rs.20240903.11
    T2  - Rehabilitation Science
    JF  - Rehabilitation Science
    JO  - Rehabilitation Science
    SP  - 27
    EP  - 33
    PB  - Science Publishing Group
    SN  - 2637-594X
    UR  - https://doi.org/10.11648/j.rs.20240903.11
    AB  - Context: Many COVID-19 patients have long-term physical, functional, and psychological deficits, posing hitherto unheard-of challenges to healthcare systems around the world. Occupational therapists (OTs) are essential to multimodal care and rehabilitation; yet, little is known about how specifically they might help treat COVID-19 patients. Goal: The purpose of this systematic review is to assess the function of occupational therapists (OTs) in the care and recovery of COVID-19 patients, as well as to pinpoint the precise therapies and methods that OTs use to enhance functional results and quality of life. Techniques: A comprehensive exploration was carried out on PubMed to locate pertinent research articles released until December 2022. Included were studies that looked into OTs' role in COVID-19 patient care. After data extraction, standardized instruments were used to evaluate the studies' quality. Findings: The review contained four studies, which included reviews, observational studies, interventional studies, and case reports. In COVID-19 patients, OT-led interventions in respiratory care, functional rehabilitation, and psychosocial support showed encouraging benefits in terms of boosting mental health, increasing respiratory function, and improving functional outcomes. Conclusion: A vital and varied role is played by occupational therapists in the care and recovery of COVID-19 patients. The identified OT-led therapies have demonstrated effectiveness in boosting mental health, augmenting functional outcomes, and increasing respiratory function. To assess the long-term impacts and develop standardized protocols for occupational therapy interventions in the treatment of COVID-19 patients, more study is required.
    
    VL  - 9
    IS  - 3
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  • Abstract
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    1. 1. Introduction
    2. 2. Materials and Methods
    3. 3. Results
    4. 4. Discussion
    5. 5. Conclusion
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  • Author Contributions
  • Conflicts of Interest
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