While America debates whether it should reopen for business, remain in COVID-19 lockdown or find a safe space in between, Angela Abeyta Campbell, DPT’96, is asking different questions.
As president of the Cardiovascular & Pulmonary Section of the American Physical Therapy Association (APTA), this graduate of Creighton’s doctoral program in physical therapy is thinking post-pandemic. Patients who recover after experiencing moderate to severe COVID-19 infections are likely to need ongoing rehabilitation, she says. Even those whose exposure is considered mild are reporting difficulty resuming sports and endurance events. As for those who survived a severe exposure, Campbell says, the path back will pose cardiorespiratory challenges as well as cognitive and neurological hurdles erected by the immune system’s exhaustive and exhausting response to COVID-19’s viral assault.
“Physical therapists are crossing the doorstep to meet this challenge head on,” Campbell says.
A tenured full professor at Springfield College in Springfield, Massachusetts, Campbell teaches courses in cardiopulmonary physical therapy, clinical pharmacology, acute care issues, clinical medicine and pathology, and applied research. Nevertheless, COVID-19 is new for everyone.
“We are still in the learning phase of COVID-19,” Campbell says. “‘Unprecedented’ and ‘unpredictable’ are terms frequently used to describe it. The challenge in the post-acute phase will be the large numbers of individuals with new cardiopulmonary and critical-illness related impairments in a health care system not prepared to accept them.”
While currently serving as president of APTA’s Cardiovascular & Pulmonary Section, the responsibility for devising a national response to these post-COVID-19 needs has landed squarely on Campbell’s doorstep.
She sees three challenges: improving access to quality education for clinicians who might not fully understand the relationship between physical therapy and cardiopulmonary impairment; interprofessional collaboration between APTA’s sections and academies; and a clear chronicling of the positive impact physical therapy can have on post-COVID-19 recovery.
Campbell addressed the first of these by building a series of free, online continuing education courses featuring prominent experts in physical therapy. Dubbed the PACER Project (for Post-Acute COVID-19 Exercise & Rehabilitation), the course series addresses such matters as pulmonary rehabilitation, airway clearance, posture and breathing ventilation, and geriatric therapies, as well as general PT approaches to rehabilitation for post-COVID-19 patients.
The PACER program has been impactful beyond its immediate purpose, Campbell says, and has helped birth an active and open collaboration between APTA’s sections and academies, thus answering the second of her three challenges. Courses on pelvic health, blood flow restriction and best practices in acute care and health policy, along with the establishment of weekly “Covid Conversations,” have improved the reach and quality of PT care, she says.
Indeed, a March 28 webinar on “COVID-19 Best Practices” experienced more than 50,000 YouTube views, 15,000 downloads and was shared globally. Collaboration has now arisen between APTA and the European Respiratory Society.
A COVID Outcomes Task Force that Campbell initiated is building consensus on measuring core outcomes with the goal of eventually creating a centralized data base that demonstrates the value PT practices can bring to post-COVID-19 patient care.
“Clinicians should be prepared for patients who have lingering multi-system impairments,” she says. “Clinician knowledge and expertise in cardiopulmonary and post-ICU management, along with equipment and procedures for infection control management, will need to be addressed in order for these clinics to see these patients safely.”