List of contents

* Anatomy & Physiology of the Respiratory System

* Coronavirus disease definition and symptom

* OXYGEN THERAPY

* Physiotherapy management for COVID-19

- Assessment
-physiotherapy interventions with COVID-19 in acute phase
- physiotherapy interventions with covid19 during Intubation and Extubation
- Weaning from mechanical ventilation

*adverse effect of ICU stay

* Airway clearance techniques

* physiotherapy interventions in acute respiratory failure

* POST COVID-19 MANAGEMENT

 Anatomy & Physiology of the Respiratory System

The respiratory system is situated in the thorax, and is

responsible for gaseous exchange between the circulatory
system and the outside world.

Air is taken in via the upper air ways (the nasal cavity,
pharynx and larynx)
through the lower airways (trachea, primary bronchi and
bronchial tree)
and into the small bronchioles and alveoli within the lung
tissue.
Physiotherapy and ICU
Conclusion
Updating meet 

Doctors, nurses and physios must work as one to have 

a better outcome for the patient > if possible, they
should write their follow uos in the same paper, so
they can be aligned to the treatment
 Definition of Coronaviruses (COVID-19) :
- Coronavirus disease (COVID-19) is an infectious disease
caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2).
- COVID-19 is a new illness caused by a virus called
coronavirus.
It can affect your lungs and airways.
It is spread through droplets from the nose and mouth
example by talking loud, singing, shouting, coughing or
sneezing.
Droplets containing the virus can also fall onto surfaces.
If you touch that surface and then touch your eyes, nose or
mouth, you could also become infected.
 COVID-19 Symptoms
Common symptoms of coronavirus include:
Fever (high temperature - 38 degrees Celsius or above)
Cough
Shortness of breath or breathing difficulties
Loss or change to your sense of smell or taste

Emergency warning signs where immediate medical

attention should be sought include:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
 WHAT the underlying medical conditions associated with more
severe COVID-19 disease …….???????

•
•Asthma
cancer
• chronic kidney and end-stage disease
• chronic lung diseases
• cystic fibrosis
• dementia or other neurological conditions
• Diabetes (type 1 or type 2)
• Down syndrome
• epilepsy
• heart conditions
• such as heart failure, coronary artery disease, cardiomyopathies or hypertension
• HIV infection
• immunocompromised state
• interstitial lung disease
• liver disease
• motor neuron diseases
OXYGEN THERAPY
OXYGEN is a colorless, odorless, tasteless , transparent gas & is
slightly heavier than air.

OXYGEN is a gas, but when administered as a supplement to

normal atmospheric air, considered as a medication (or drug).

What is Oxygen Therapy:

Providing an adequate oxygen in the blood , while decreasing
the work of breathing and reducing stress in the myocardium.

Goal Of Oxygen Therapy:

To maintain adequate tissue oxygenation while minimizing
cardiopulmonary work.
 Oxygen Therapy Indications
The need for oxygen therapy should be assessed by:
Monitoring of ABG - PaO2, SpO2.
Clinical assessment findings.
PaO2 as an Indicator For Oxygen Therapy
PaO2 : 80 – 100 mm Hg : Normal.
60 – 80 mm Hg : Cold, clammy extremities.
< 60 mm Hg : Cyanosis.
< 40 mm Hg : Mental deficiency , memory loss.
< 30 mm Hg : Bradycardia , cardiac arrest.
PaO2 < 60 mm Hg and SaO2: < 88% is a indicator for
oxygen therapy
Methods of Oxygen Delivery
NASAL CANNULA Low-Flow Systems
This device delivers an unpredictable amount of oxygen ranging from
25 - 45 % at 1 - 6 L/min depending on how much the patient 
inhales through the mouth.

Flow
flow FiO2 
1LPM 0.24 
2LPM 0.28 
3LPM 0.32 
4LPM 0.36 
5LPM 0.40 
6LPM 0.44 
NASAL CANNULA
Advantages:
Inexpensive, well tolerated, comfortable.
Patient can eat and drink.
Disadvantages:
Irritant to the mucosal.
Higher flow rates are uncomfortable for the patient.
Maximum of 6LPM Why?
A high flow rate can quickly dry out the nasal mucosa
and become rapidly uncomfortable
 SIMPLE FACEMASK low oxygen device
The simple facemask at an oxygen flow of 6 L/min delivers
approximately 35-40 % oxygen.
Increasing the flow to 10 L/min may increase oxygen
concentration to about 60 %.
 Venturi Mask
Can deliver 24%, 28%, 35%, or 40% oxygen.
useful in the hospital management of Patients with COPD
and other chronic respiratory diseases
Tracheostomy Mask
Tracheostomy Mask
Used primarily to deliver humidity to patients with
artificial airways.
 Partial Rebreathing Mask with reservoir
Similar to simple mask with addition of the O2 reservoir to
increase FiO2 greater than 0.60.
Non-Rebreathing Mask with reservoir

Has one way valves to prevent rebreathing.

Delivers 95% Oxygen at 10-12 L/min.
 Bag-Mask Device
- Can deliver nearly 100% oxygen
- A delivered tidal volume of 500 to 600 mL (6 to 7
mL/kg) per breath will produce visible chest rise in most
adults.
- Deliver each breath over a period of 1 second at the
appropriate rate.
Oxygen Delivery devices
 Classification of patient with COVID-19 according
Severity and need Oxygen therapy
Mild to moderate status of patient complain :
Stage 1 :
Presentation:
On <5L O2 (nasal cannula or face non-rebreathe mask)
Stage 2 :
Presentation:
On certain % of O2 (on 28%, 35%, 40% Fio2 via venturi mask)
Stage 3 :
Presentation:
Maximal O2 therapy (60% Fio2 - 15L non-rebreathe mask)
 Sever and critical status of patient complain
1- Stage 1 :
Presentation:
* Maximal O2 therapy in ICU setting
* CPAP ( not within critical care , possible ceiling of care
* patient with tracheostomy with O2 support
* COVID 19 +Ve but different primary pathology causing ICU
admission .

1- Stage 2 :
Presentation: Intubation( light sedation – waking from sedation )
* patient with tracheostomy with bi level or CPAP support
* non intubation ( CPAP within ICU setting )

1- Stage 3 :
Presentation: Intubation , sedation + ventilator , paralysed
REST
Physiotherapy management
for COVID-19
physiotherapy
Assessment
Subject assessment :
past history :
Associated disease as cancer , COPD , Asthma , heart failure , hyper tension
and DM .
Any surgery : tracheostomy , CABAG , lobectomy
History Of : smoking and alcohol consumption

present history :complain of patient

objective assessment :
General Examination :

Vital signs :
Temperature
Pulse
Respiratory rate
Blood pressure
And Oxygen saturation (SpO2).

Chest X-rays
General Appearance:
- body weight
- Eyes - pallor (anemia); Jaundice (yellow color due to
liver or blood disturbance)
- Peripheral odema
- Pressure sores

observation of chest :
deformity : kyphosis , barrel chest , Pectus carinatum -
pigeon chest.
breathing pattern :
Typical rate - 12 to 16 breath per minute
Typical Inspiratory : expiratory ratio = 1:1.5 to 1:2
Prolonged expiration - 1:3 to 1:4
Check for bradypnea, tachypnea, hyperventilation
 In ICU Patients
*Mode of ventilation - supplemental oxygen; intermitent
positive pressure ventilation

*Route of ventilation - face mask, nasal cannula,

endotracheal tube, tracheostomy

*Level of consciousness - measured with Glasgow coma

scale.

*Central venous pressure (CVP) and pulmonary artery

pressure (PAP)
Percussion :It is performed by placing the left hand firmly
on the chest wall so that the finger have good contact with
the skin.
Resonance : the expected sound can usually be heard over
all areas of the lungs (normal)
Hyper resonance - associated with hyperinflation may
indicate emphysema , pneumothorax.
Dullness or Hypo resonance : pneumonia , atelactasis ,
pleural effusion .
 Auscultation with the stethoscope provides important information
to the condition of the lungs and pleura .
• Normal breath sounds : bronchial, vesicular
• Abnormal breath sounds :
crackles : indicate secretions , pneumonia
stridor : indicate upper air way obstruction
wheeze : in asthma , COPD
 Goal of physiotherapy intervention for patients
with COVID-19.
Short term goal :
1. increase lung volume and increase thoracic expansion
(Improve lung function).
2. Decrease the patient's dependency on the ventilator
and improve residual function.
3. Limit patient morbidity and mortality.
4. Optimize ventilation and oxygenation
5. Reduce number of hospitalization days of patient.
6. Reduce complications as DVT, and PE

Long term goal :

improve quality of life as much as possible.
ACUTE INPATIENT PULMONARY
REHABILITATION
 Physiotherapist should consider the following points before
starting the physiotherapy intervention:
1- During respiratory physiotherapy intervention, personal
Protective Equipment is recommended to assure airborne
infection precautions.
2- physiotherapist should keep a safe distance from patients if
there is no intervention by hand, such as education on airway
clearance techniques.
3-Understanding the mechanism of infection of COVID-19.
4- In ICU, the physiotherapist must consult the medical team
before starting the intervention.
5- should monitor clinical parameters such as SPO2, O2 level
, HR, RR and BP
 Continuo for consideration
During Assessment and evaluation:
-based on general clinical assessment, particularly
functional evaluation, respiration and cardiac status,
cognitive status, thoracic activity, respiratory pattern and
frequency, Wheeze , Cough Sputum Chest pain,…etc.
-past medical and drug history must be considered.
-vital signs and other reports such as Chest X-rays must be
considered
-It is important for physiotherapists to be aware of the
medical management for patients with COVID-19.
 Continuo for consideration

physiotherapy of a patient should be started only

when all the following conditions are met:
- Fraction of Inspired Oxygen (FiO2) ≤ 60%. (0.6).
- Saturation (SpO2) ≥ 90%.
- Respiratory rate: ≤ 40 breath/min.
- Positive End-Expiratory Pressure (PEEP) ≤ 10 cmH2O
- Systolic Blood Pressure (BP) ≥ 90 mmHg and ≤ 180
mmHg.
- Mean Arterial Pressure (MAP) ≥ 65 mmHg and ≤ 110
mmHg.
Heart rate (HR): ≥ 40 BPM and 120 ≤ BPM.
- No new arrhythmias or myocardial ischemia
- No sign of shock with concomitant lactic acid ≥ 4
mmol/L.
- No new unstable deep vein thrombosis and pulmonary
embolism.
- No suspected aortic constriction.
- No serious liver and kidney disease
- Body temperature ≤ 38.5°C.
 physiotherapy session must be stopped when the following situation
occurs and inform nurse in charge
− High intensity of fatigue and intolerance of physical activity
of the patient.
− patient suffering from Chest pain, palpations, and
dizziness.
− Start of arrhythmia or developing myocardial ischemia.
− Systolic blood pressure: <90 mmHg or > 180 mmHg.
− Unsealing of the closed respiratory system.
− Blood oxygen saturation: < 90% or drop > 4% from the
baseline.
Main Arterial Pressure (MAP) less than 65 mmHg or more
than 110 mmHg or a change of more than 20% from the
baseline or > 120 BPM.
− Respiratory rate > 40 breaths/min..
Use these physiotherapy interventions with precaution in
the acute phase of COVID-19 :

• Diaphragmatic breathing
• Incentive spirometry
• Pursed lips breathing
• Respiratory muscle training
• Exercise training
• Mobilization during clinical instability (multi-disciplinary
decision required)
• Nasal washings
• Bronchial hygiene
• Thoracic mobilization
physiotherapy interventions with
covid19 during Intubation and
Extubation
physiotherapy for Unconscious INTUBATED PATIENTS

a) Turn patient to both sides and manually hyperventilate the patient using
the “ambu bag" and hyperoxygenate using 10-15 L O2; if the patient who
can't be taken off ventilator, set the ventilator FIO2 100%

b) Use pulmonary hygiene techniques to mobilize secretions such as

vibration, percussion, rib springs, shaking and acceleration of the expiratory
flux (AEF)

c) Endotracheal suctioning to clear retained secretions using sterile

techniques.

D) Positioning for relaxation, decreased dyspnea and improved ventilation

and oxygenation are with the head of the bed elevated to 30 degrees and
lying on well aerated lung. The prone lying position is also proven to be
beneficial
physiotherapy for conscious INTUBATED PATIENTS

Proceed with the same procedures done with the

unconscious patient, and then encourage the following:
1. Independent efforts of inspiration and coughing
2. Coordinate upper extremities mobility with
inspiration and expiration to improve lung expansion
 Physiotherapy Role for unconscious EXTUBATED PATIENTS
Modified postural drainage position, usually with the head of the bed elevated to
30 degrees, and then performs the following:

1. If no contraindications, then use pulmonary hygiene techniques to mobilize

secretions.

2. Use neurophysiological facilitation of respiration to facilitate deep breathing,

increase lung volume and increase thoracic expansion
.
3. Use tracheal tickle technique to elicit a cough, if not successful, then use
nasopharyngeal suctioning to clear the retained secretions. It is very important to
hyperoxygenate the patient with 10-15 L O2 prior to suctioning to avoid
complications.

4. If the patient has a tracheostomy, then manually hyperventilate and

hyperoxygenate the patient before suctioning.
 When to wean from mechanical ventilation :
* lung disease is stable

* Reducing FiO2 (usually <0.5)

* No requirement for high PEEP

* Appropriate underlying respiratory rate

* Appropriate tidal volume with moderate airway pressures

* absence of dyspnea, absence of paradoxical respiratory muscle

activity, and agitation or tachycardia during the weaning trial.

* able to initiate spontaneous breaths (good neuromuscular

function)
Physiotherapy Role for conscious EXTUBATED PATIENTS
Modified postural drainage position, usually with head of
the bed elevated to 30 degrees, and then encourages the
following:
1. Teach patient effective coughing and huffing to clear
retained secretions .
2. ACBT
3. use of incentive spirometer to increase lung volume.
4. pursed lip breathing exercises to decrease dyspnea and
prolong exhalation phase.
The procedure is as follows:
- Explanation of the procedure to the patient
- The ventilator support is gradually reduced
- The patient is placed into a better postural position (e.g.
sitting upright or half-sitting
- The airway is suctioned
- The patient is disconnected from the ventilator and
given oxygen or mechanical assistance (CPAP).
- The patient is encouraged to breathe spontaneously
- Encourage the patient to cough after being extubated
Patients may be extubated when they are alert, show a
stable breathing pattern and control their airway.

Difficulties in weaning patients from a ventilator can

occur due to:
- Inspiratory muscle atrophy
- Fatigue
- Paralysis of the diaphragm
- A fear of suffocating
 Adverse effect of ICU stay
*Physical Inactivity leading to muscular atrophy,
contractures , deformities and generalized weakness
*Diaphragmatic weakness due to prolonged mechanical
ventilation
*Pressure Ulcers
*compromised cardiac and respiratory function
*deep vein thrombosis
* infections
* Swelling
End of first day

Thank you
Physiotherapy interventions
according complain patients
* Pt. with Severe respiratory failure with increasing
oxygen requirements, fever, difficulty breathing,
frequent, severe or productive coughing.
* PT plan of treatment :
positioning
passive ROM exercise of limbs to prevent complication .
Breathing exercise
 Patient with productive cough:
Patient coughing and able to clear secretions independently
PT plan of treatment :
- Daily low intensity aerobic exercises are recommended.
- Design simple exercise poster is recommended (e.g. with
indications for daily walks, stretches, strengthening and
balance exercises) to be posted within patients rooms and
wards .
What are the Airway clearance
techniques?????
- Manual Techniques as mobilization of chest
- ACBT
- postural drainage
- Mobility
- Positioning
-Pursed lib breathing
- 3-sec breath hold
- Forced expiratory manoeuvre
- Huff, cough
- Percussion and Vibration
- Positive expiratory pressure therapy (PEP) .
Manual Techniques as mobilization of chest
Active cycle of breathing techniques uses
combinations and cycles of airway clearance techniques
to ventilate obstructed lung segments.

Active cycle of breathing techniques( ACBT)

postural drainage
Postural drainage
optimal positioning for covid 19
Early use of optimal positioning can have
a positive effect on patient’s physiology
and gas exchange and should be
considered as a treatment choice .
PRONE POSITIONING
-Pillows placed under pelvis, upper chest and head, arms
in‘swimmer’ position.
-Head turned to side
-Check monitoring of patient, placement of
lines/ventilator/oxygen.
-Ensure expiratory port on ventilator tubing (if using) is
not obstructed.
SIDE LYING ON PILLOWS
Pillows placed lengthways under one side and under
head, bent knee to aid maintenance of position
SUPPORTED SITTING
POSITIONING
Pillows behind head, knees
and under arms can help
decrease work of breathing
and manage breathlessness
FORWARD LEAN POSITIONING
 Pursed lips breathing
* Pursed lips breathing is performed by a nasal inspiration,
followed by expiratory blowing against pursed lips to
decrease airway collapse .

* Oxygen supplementation has also been successfully

used during exercise training to help unload the
respiratory muscles.
 physiotherapy interventions in acute respiratory
failure:
Positioning
Prone: helps to improve V/Q matching, redistribute
edema and increase functional residual capacity(FRC) in
patients with acute respiratory distress syndrome. It has
been shown to result in oxygenation for 52-92% of patients
with severe acute respiratory failure .
Side-lying: with affected lungs uppermost to improve
aeration through increased lung volumes in patients with
unilateral lung disease.
Upright: helps to improve lung volumes and decrease
work of breathing in patients that are being weaned from
mechanical ventilator.
 physiotherapy interventions in acute respiratory
failure:
Postural drainage and Percussion to facilitate mucociliary clearance
Suction: used for clearing secretions when the patient cannot do so
independently
Active cycle of breathing technique and manual techniques such as
shaking and vibration to facilitate mucus clearance
Limb exercises: passive, active-assisted, active exercises may optimize
oxygen transport and reduce the effects of immobility

Inspiratory muscle training: aims to improve inspiratory muscle strength

and it facilitates weaning from mechanical ventilation

Early mobilisation: improves function, mobility and quality of life.

REST
POST COVID-19
MANAGEMENT
 POST COVID-19 MANAGEMENT
People with many serious medical conditions and older
people are most likely to experience lingering COVID -19
symptoms and complications.

Physiotherapy can play an important role in rehabilitation

of patients with COVID-19 who have;
fatigue, shortness of breath, cough, joint pain, chest pain,
muscle pain and limitation in daily physical functioning.
Although, COVID-19 is seen as a disease that primarily
affects the lung lead to damage to the tiny air sac
(alveoli), it can damage many other organs such as heart,
brain damage (stroke, seizures and GPS) and blood clots
of blood vessels problems.
Post COVID-19 Rehabilitation
Pulmonary rehabilitation:
• breathing exercises (Diaphragmatic breathing) to
increase lung volume and increase thoracic expansion.
• Incentive spirometry
• Pursed lips breathing
• Respiratory muscle training
• Exercise training
Positioning :
Spending many hours on your back can lead to
deconditioning and other medical problems.

We recommend sitting upright as much as you can during

the day, walk around your space as tolerating and
changing positions regularly.

Some patients have an easier time breathing on their

stomachs with a pillow under their chest, which can open
up different parts of the lungs.
Walking :

During your recovery period, we encourage you to walk

to improve your overall conditioning.
Week 1 : 5 minutes, 5 times per day
Week 2 : 10 minutes, 3 times per day
Week 3 : 15 minutes, 2 times per day
 Exercise
Through your recovery from Coronavirus, we encourage you
stay active and start an exercise routine. These exercise will
help post COVID-19 patients to:
• Recover lungs during and after illness
• Optimize functioning / minimize impact of impairments
on independence and quality of life
• Reduce breathlessness, increase muscle strength, improve
balance and coordination
• Improve fitness , arms and legs stay strong
• Prevents blood clots
• Improve mental health , reduce stress and improve mood
and increase confidence
Start gentle exercise if you:

• Do not have a fever for 2 days

• Do not have chest pain or feel severely short of breath

while walking inside your house.

• Do not have leg swelling

Do not exercise if you have :
• A fever above 39 degrees(Celsius) in the past 2 days
• Severe shortness of breath or pulse oximetry below 90% at rest
• A breathing rate above 24 breaths per minute
• A heart rate above 105 beats per minute
• A systolic blood pressure (top number) 30 points below your
“normal”
• Chest pain or palpitations (feeling of rapid, strong or irregular
heartbeat)
• Dizziness or lightheadedness
• Confusion
• Recent falls
• Not eating or drinking for past 12 hours
Exercise Precautions
- Begin this exercise program after discharging from the
hospital and have no fever.

- Stop exercise immediately if you get chest pain,

palpitations, exhaustion, or dizziness/ lightheadedness.

- Keep your mask on when exercising if there are others

around you.
Monitoring :
* You can buy a pulse oximeter upon the discharge from the
hospital to use it at home.
* This will monitor your heart rate and oxygen levels during
activities and exercises.
* Check and log your heart rate and oxygen level before,
during, and after exercises to monitor how your body is
responding to your exercises.
* Normal oxygen saturation is 96-100% and it should not go
below 90% during exercise.
* Stop exercising and rest if you see a drop in your oxygen
saturation below 90 %.
Diaphragmatic breathing exercises
To improve your shortness of breath, increase your exercise capacity,
and improve quality of life
Incentive Spirometer Exercise :
To strengthen the breathing muscles and open up the
airspaces in your lung.
It is designed to help you take long, slow, deep breaths,
like natural sighing or yawning
Muscle strengthening
Muscle strengthening To strengthen weakness
and muscle loss that can occur after a lengthy
hospital stay.
1- Exercise type Sit to Stand Squats
2- Exercise type: Standing Heel Raises
3- Exercise type: Seated Arm Reaches
4- Exercise type: Sidestepping
5- Exercise type: Wall Pushups
 Home-based exercise therapy can be just
as effective as an in-person hospital based
program
1- Exercise type: Ankle Pumps

Exercise duration: repeat slowly for 1 minute.

2. Exercise type: Heel Slide
Exercise frequency: repeat 5 to 10 times with each leg
3- Exercise type : Side Lying Leg Raises

Technique: lie on your side with knees straight.

Lift the top leg toward the ceiling , Slowly lower it.
Exercise frequency: repeat 5 to 10 times with each leg.
4- Exercise Type : Prone Lying
Technique: Lie on your stomach for a few minutes, relax and
focus on deep breathing.
Exercise duration: 2 to 10 minutes.
5- Exercise type: Arm Raises
Exercise frequency: repeat 5 to 10 times with each arm.
6- Exercise type: Sitting in a Chair or Side of the Bed

Technique: try to sit at the edge of bed. Do a few minutes

of deep breathing.
Exercise duration: repeat 1 to 3 minutes
7- Exercise type : Sit to Stand.
Technique: use your arms to help
you stand up from your chair or
bed.
Try to stand for 1 to 3 minutes.
Then sit or lie down for a rest.
Exercise frequency: repeat 1 to 3
times.
Exercise duration: 1 to 3 minutes.
Do not try standing on your own if
you feel you might fall .Sit or lie
down right away if you feel
lightheaded or dizzy.
8- Exercise type : Long Arc Quad
Technique: sit with your knee bent. Straighten your knee
as you raise your foot upwards. Repeat with the other
leg.
Exercise frequency: repeat 5 to 10 times with each leg.
9- Exercise type: Seated Marching
Technique: sit in a chair with your knees bent. Lift your foot
and knee, then set it down. Do this with your other leg, like
you are marching
Exercise frequency : repeat 5 to 10 times with each leg
10- Exercise type : Shoulder Blade Squeeze

Technique: sit up straight. Try to squeeze/pinch your shoulder

blades together, and slightly downward. Hold this for 1 to 2
seconds.
Exercise frequency : repeat 5 to 10 times.
Outcome measurement :
- Borg rating of perceived exertion (RPE)

- Borg Scale CR10

- Strength( manual muscle testing by oxford scale )

-Gait , Endurance and aerobic capacity : ( 10 meter time walk test ,

6minute walk test ).

- Balance ( berg balance scale )

- Walking ability and assess for risk falling (time up to go test)

 Borg rating of perceived exertion (RPE)
In Borg RPE;
9 = ‘very light’ exercise which equals walking slowly for few
minutes at own pace of a healthy individual.

13 = ‘somewhat hard’ but the individual is still able to continue

the activity.

17 = ‘very hard’. A healthy person can continue but must push

themselves beyond their comfort of being very fatigued.

19 = extremely strenuous exercise. for most people, the hardest

they have ever experienced.
 Borg Scale CR10
Use for shortness of
breath and fatigue
6 Minute Walk Test
It evaluates the functional capacity of the individual
and it provides valuable information regarding all
the systems during physical activity, including
pulmonary and cardiovascular systems, blood
circulation, neuromuscular units, body
metabolism, and peripheral circulation
6 Minute Walk Test
Is a sub-maximal exercise test used to
assess aerobic capacity and endurance
The distance covered over a time of 6
minutes is used as the outcome by
which to compare changes in
performance capacity.
Thank you