Karen Pryor & Shelly Denes – COVID Long Hauler Symposium: Address the Unmet Needs of Post-COVID Patients

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Exploring the Essential Features of “Karen Pryor & Shelly Denes – COVID Long Hauler Symposium: Address the Unmet Needs of Post-COVID Patients”

Speakers: Karen Pryor, PhD, PT, DPT, CH, CFPS | Shelly Denes, PT, C/NDT, CFPS, CGCP

Duration: 11 Hours 49 Minutes

Format: Audio and Video

Copyright: Aug 17, 2023

Media Type: Digital Seminar

Description

When it comes to working with COVID long haulers, there are so many questions and conflicting answers…

How hard should you push these patients?
Which evals and special tests are most effective for this population?
You’re treating them for another diagnosis…but they had COVID…how do you modify your plan of care?
How do you treat functional limitations stemming from COVID-19?

Answer these and so much more in this action-packed training that breaks down how long COVID impacts nearly every system in the body.

Featuring content experts Dr. Karen Pryor, PhD, PT, DPT, and Shelly Denes, PT, this dynamic duo brings a wealth of knowledge from extensive clinical practice in nearly every setting. They will build a solid foundation and offer clinical pearls from their combined 70+ years of experience with whole-patient solutions to:

Perform a thorough evaluation for a patient with respect to Long COVID to identify functional limitations and deficits
Conduct a head-to-toe neurologic assessment
Assess contributions from related organ systems
Construct an evidence-based plan of care to address symptoms: brain fog, fatigue, pain, neuropathy, myalgias and sleep disorders
Implement whole-body solutions for accelerated healing: anti-inflammatory diet, mindfulness, diaphragmatic breathing
Walk away with dozens of tips sheets: fall prevention, autonomic checklist, depression screen, home exercise program and more!

Whether you work in acute care, rehab or outpatient – uncover strategies to meet the unique needs of your patients as you give them hope for recovery and healing.

Speaker

Karen Pryor, PhD, PT, DPT, CH, CFPS
Health Sphere Wellness Center

Karen Pryor, PhD, PT, DPT, CH, CFPS, has a doctorate in physical therapy and has practiced for 40 years in the field. Dr. Pryor is the owner of Health Sphere Wellness Center, an integrative therapy clinic in Nashville, Tennessee. Involved with early intervention in the birth-three population for over 30 years, she has developed neuroplasticity techniques that are used in a wide variety of settings, including homes, childcare centers, and school systems, to advanced pediatric therapy programs.

Dr. Pryor serves on several boards, including the Leadership Interagency Council for Early Intervention (2014-2019), a position to which she was appointed by Tennessee Governor Bill Haslam. In 2010, she received the President’s Volunteer Service Award for her contributions to the advanced treatment of children from President Barack Obama. In addition to her work with children, Dr. Pryor has served as an adjunct professor at the Tennessee State University Occupational Therapy Assistant program. She is a clinical instructor for several universities and colleges. With her years of experience and passion for complete wellness, Dr. Pryor advances a more expansive view of how to integrate therapy throughout the lifespan by using neuroplasticity techniques.

Speaker Disclosures:
Financial: Karen Pryor is the owner of Health Sphere Wellness Center, LLC and is a field examiner for PDMS-3. She has employment relationships with Tennessee State University, the University of Tennessee at Chattanooga Physical Therapy School, the Daymar Physical Therapy Assistant School and the Volunteer State Community College. She is a paid consultant for Evergreen Certifications. Karen Pryor receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Karen Pryor is a reviewer with Tennessee Physical Therapy Association and American Physical Therapy Association. She is an Ambassador for National Down Syndrome Society.

Objectives

Examine challenges of Post-COVID patients and their impact on function.
Describe presentations of initial referral with multisystem effects.
Explain full neurological assessment as it relates to present diagnosis and multisensory and autonomic symptoms.
Construct a screening tool for lingering effects of COVID-19 and address solutions for these problems to enhance performance of ADLs and other tasks.
Understand how to make a tip sheet for patients specific to their needs.
Investigate the latest available treatments for the management of COVID-19, including the vaccines to prevent COVID-19 for the outpatient setting and individuals at home.
Construct an evidence-based toolkit for neurological, musculoskeletal and organ system challenges for outpatient symptom management.
Instruct the significance of sleep/rest in rehabilitation post SARS-CoV-2 infection.
Assess for symptoms of the immune response in COVID-19 ‘Long Haulers’ and how to address these changes.
Investigate the significance of the inflammatory response in COVID-19 and how to address these changes in patients.
Differentiate cytokine storms and how it relates to multi-organ failure and coagulation.
Investigate post-viral autonomic dysregulation and how to rewire with neuroplasticity techniques for enhanced function.
Appraise, accommodate, and treat rehabilitation challenges such as brain fog with poor memory of home program, tachycardia, POTS, and immune system challenges to improve client participation in activities and treatment.
Analyze symptoms of autonomic system dysfunction including night sweats, temperature dysregulation, gastroparesis, and peripheral vasoconstriction and their impact on function.
Appraise anxiety levels and discuss changes in the emotional environment of the COVID-19 patient to promote mental and emotional health improvements.
Describe how to boost the immune system and decrease inflammation for symptom and condition management.

Outline

SAR-Co-V2 and COVID-19
- SAR-CoV-2 VIRUS DEFINITION and DETAILS 
- COVID-19 DISEASE and ‘LONG HAULERS’ 
- The huge impact on the body’s:
  - AUTONOMIC NERVOUS SYSTEM 
  - SYMPATHETIC NERVOUS SYSTEM 
  - THE IMMUNE SYSTEM
    - Innate immune response
    - Adaptive immune response
    - Cytokine Storm
    - Gender differences in immunity
The COVID ‘Long Hauler’
- Pre-existing diseases and their impact on COVID-19
  - Hyperglycemia / DM
  - Obesity
  - Lingering viral disease
  - Hypertension
  - Underlying Auto-immune disease
- History of Covid Symptoms 
- Exposure 
- Poor Nutrition and/or Diet with High Processed Foods 
Pathology of illness and course in hospital
- ICU 
- Respirator 
- Feeding – IV, Feeding tube 
Comprehensive Evaluation with emphasis on the Neuro Screen
- Neuro
  - Damage to CNS 
  - Damage and Symptoms of ANS 
  - Homeostasis? 
- CNS
  - Blood Brain Barrier 
  - Stroke 
  - Headaches 
  - Tremors 
- Cranial nerves
  - Visual tracking 
  - Hearing 
  - Swallowing 
  - Chewing 
  - Vagus nerve 
  - Tremors 
  - Balance 
  - Dizziness – Vertigo 
- Peripheral nerves
  - Numbness – peripheral neuropathy 
  - Tingling 
  - Weakness 
- Strength
  - Functional movements 
  - Balance – sitting, standing, walking 
  - Gait disturbances 
  - Post exertional malaise 
  - Reaction to heat 
  - Myalgias 
- Pain
  - Location 
  - Central 
  - Peripheral 
- Brain fog
  - Extreme fatigue 
  - Poor focus 
  - Difficulty reading 
  - Sleep disturbances 
Related Organ Systems
- Psychology Related
  - Depression 
  - Anxiety & Reducing Stressors 
  - PTSD 
- Respiratory
  - Dyspnea 
  - SOBOE 
  - Chest pain 
  - Cough 
  - ‘Happy Hypoxia’ 
  - Use of a Pulse Ox 
  - Proning 
  - Breath Control / Nasal Breathing 
- Cardiac
  - Chest Pain 
  - Myocarditis 
  - Palpitations 
  - Evaluating HR (Apple Watch / EKG Monitor) 
- Vascular
  - The Inflammation Response 
  - Coagulopathy 
- G-I Tract
  - Bowel and Bladder Issues 
  - Sore Throat 
  - Nausea 
  - Non-inflammatory Foods 
- Liver, Kidney, Spleen, Pancreas 
Persistent Symptoms after the active Covid phase and what can we as health care providers do about it?
- SOBOE 
- Nerve Pain 
- Myalgias 
- Nerve Pain 
- Anxiety 
- Extreme Fatigue and Post-Exertional Fatigue
  - AVOID EXHAUSTION AT ALL COSTS 
  - ‘Energy Envelope’ 
- Brain Fog 
- Sleeping Disorders
  - Foundation on the importance of sleep 
  - Healthy Circadian Rhythms  
  - Recommendations with COVID-19 ‘Long Haulers’ 
POTS & Dysautonomia in Long Haulers
- What it is  
- “Hitting the Wall” 
- How to deal with it 
- Scenarios for this continuum 
Bouncing Back from COVID-19 as a ‘Long Hauler’
- Beginning Phase 
- Building Phase 
- Being Phase 
- Exercise Prescription 
- Recovery is slow and variable 
- Reduce inflammation
Ramifications of the Variants 
Case Scenarios & Appropriate Screening Tools
Key Takeaways
- Proning 
- Enough Sleep and REST 
- Correcting Sleep-Wake Cycles
- Resetting the Circadian Rhythms  
- Hydration 
- Anti-inflammatory Diet 
- Lower Anxiety Levels / Mindfulness 
- Breath Control / Nasal Breathing / Multi-Dimensional Breathing 
- Compression Socks 
- Stay on the cool side 
- Avoid Fatigue / Avoid “Hitting The Wall”