Physiotherapy strategies in Post-COVID-19 pulmonary recovery: A narrative review

Abstract

The COVID-19 pandemic has left a substantial proportion of survivors with persistent respiratory complications, notably reduced lung function, dyspnea, fatigue, and decreased exercise tolerance. Physiotherapy, particularly pulmonary rehabilitation, plays a critical role in restoring respiratory function, physical performance, and overall quality of life in post-COVID-19 patients. This narrative review synthesizes current evidence on physiotherapeutic strategies aimed at improving pulmonary outcomes in post-acute and long COVID syndromes. It explores breathing retraining, aerobic reconditioning, airway clearance techniques, and tele-rehabilitation approaches tailored for COVID-19 survivors. The paper also discusses adaptations in rehabilitation protocols based on symptom severity, comorbidities, and healthcare access. Key challenges such as patient adherence, safety monitoring, and long-term outcomes are examined. A conceptual framework is presented to guide rehabilitation teams in implementing individualized, evidence-based strategies. Future research priorities include longitudinal studies, digital rehabilitation tools, and integrated multidisciplinary models.