The COVID-19 pandemic transformed healthcare delivery, including rapid expansion of telehealth. Telerehabilitation, defined as therapy provided by physical therapy, occupational therapy and speech and language pathology, was rapidly adopted with goals to provide access to care and limit contagion. The purpose of this brief report was to describe feasibility of and satisfaction with telerehabilitation. Two-hundred five participants completed online surveys following a telerehabilitation visit. Most commonly, participants were women (53.7%), 35-64 years old, and completed PT (53.7%) for established visits of 30-44 minutes in duration for primary impairments in sports, lower limb injuries, and pediatric neurology. Overall high ratings (“excellent” or “very good” responses) were observed for all patient-centered outcome metrics (ranging 93.7-99%) and value in future telehealth visit (86.8%) across telerehabilitation visits. Women participated more frequently and provided higher ratings than men participants. Other benefits included eliminating travel time, incorporating other healthcare advocates, and convenience delivering care in familiar environment to pediatric patients. Technology and elements of hands-on aspects of care were observed limitations. Recognizing reduced indirect costs of care that telerehabilitation may provide along with high patient satisfaction are reasons policy makers should adopt these services into future healthcare delivery models.
Objective To characterize the functional impairments of a cohort of patients undergoing inpatient rehabilitation after surviving severe COVID-19 illness, in order to better understand the ongoing needs of this patient population. Methods This study consisted of a retrospective chart review of consecutive patients hospitalized for COVID-19 and admitted to a regional inpatient rehabilitation hospital from April 29th to May 22nd, 2020. Patient demographics, clinical characteristics and complications from acute hospitalization were examined. Measures of fall risk (Berg Balance Scale), endurance (6 Minute Walk Test), gait speed (10 Meter Walk Test), mobility (transfer and ambulation independence), cognition, speech and swallowing (American Speech and Hearing Association National Outcomes Measurement System Functional Communication Measures) were assessed at rehabilitation admission and discharge. Results The study population included 29 patients and was 70% male, 58.6% white and with a mean age of 59.5. The mean length of acute hospitalization was 32.2 days with a mean of 18.7 days intubated. Patients spent a mean of 16.7 days in inpatient rehabilitation and 90% were discharged home. Patients demonstrated significant improvement from admission to discharge in measures of fall risk, endurance, gait speed, mobility, cognition, speech and swallowing, (p< 0.05). At discharge, a significant portion of the population continued to deficits in cognition (attention 37%; memory 28%; problem solving 28%), balance (55%) and gait speed (97%). Conclusion Patients admitted to inpatient rehabilitation after hospitalization with COVID-19 demonstrated deficits in mobility, cognition, speech and swallowing at admission and improved significantly in all of these domains by discharge. However, a significant number of patients exhibited residual deficits at discharge highlighting the post-acute care needs of this patient population.
The current COVID‐19 pandemic has rapidly affected a large number of people across the world. In the US, New York and Massachusetts were two states significantly affected early on in the pandemic. Many individuals infected with COVID‐19 require hospitalization and following discharge, a subset develop longer‐term rehabilitation needs. To address the ongoing rehabilitation needs in this growing population, multidisciplinary teams at academic centers in NYC and Boston designed and implemented post‐COVID outpatient clinical recovery programs. In this report, we describe the local development of the outpatient programs and characteristics of the initial patient cohort referred for evaluation. This article is protected by copyright. All rights reserved.
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