Assisted mobilisation in critical patients with COVID-19

The therapeutic value of early physiotherapeutic treatment in critical respiratory settings has already been clearly outlined in the last fifteen years by several authors. However, there is still a controversial perception of mobilisation by healthcare professions. In-bed cycling has attracted increasing attention having been demonstrated as a feasible and safe intervention in critical settings. Patients with respiratory diseases are typically prone to fatigue and exertional dyspnoea, as we observe in COVID-19 pandemic; in fact, these patients manifest respiratory and motor damage that can even be associated with cognitive and mental limitations. COVID-19 is at risk of becoming a chronic disease if the clinical sequelae such as pulmonary fibrosis are confirmed as permanent outcomes by further analysis, particularly in those cases with overlapping pre-existent pulmonary alterations. In the present article, we propose a practical analysis of the effects of in-bed cycling, and further discuss its potential advantages if used in critical patients with COVID-19 in intensive care settings.