Continuing Care through Telerehabilitation for Patients in a COVID-19 Referral Center in the Philippines: A Case Series

Abstract

In April 2020, the Department of Rehabilitation Medicine (DRM) of the University of the Philippines - Philippine General Hospital (UP-PGH) transitioned to a telerehabilitation program called ITAWAG, an acronym for Introducing Telerehab As a Way to Access General rehabilitation medicine services. This was in response to the designation of UP-PGH as a COVID-19 referral center and the abrupt closure of all its in-patient and out-patient rehabilitation services. Eleven previous in-patients and out-patients with musculoskeletal and neurologic impairments continued their rehabilitation programs remotely, either through a phone call or video call. Their clinical outcomes and the implementation of the ITAWAG program were monitored to determine the effectiveness of an offsite continuing care program. Using the Clinical Global Impressions-Severity (CGI-S) scale, eight patients had a reduction in the severity of their illness, while the remaining three clients had no change. Feedback surveys showed that most clients and caregivers (68%) and health providers (77%) were satisfied with the program's implementation and its outcome. A frequent complaint was the poor phone reception and internet connection. As threats of a COVID-19 outbreak continue, telerehabilitation gives patients a safe, affordable, and convenient alternative for follow-up and continuity of care in medical rehabilitation. Integrating the ITAWAG program into the initial facility-based rehabilitation management can enhance its value in optimizing functional gains and resolving its shortcomings.

Clinical outcome of supervised pulmonary telerehabilitation program among adult patients with post‐acute COVID‐19 symptoms (PACS): A case series

“…The COVID‐19 pandemic has led to a surge in demand for pulmonary rehabilitation, specifically in low‐income countries, and with the shift from traditional rehabilitation to social distancing. Integrating a telerehabilitation program into a facility‐based rehabilitation unit has resolved this problem 9 . Several factors that may hinder the implementation of such program are the availability of resources such as an internet connection, and the Philippines' probable limitation is its meagre connectivity.…”

“…Integrating a telerehabilitation program into a facility‐based rehabilitation unit has resolved this problem. 9 Several factors that may hinder the implementation of such program are the availability of resources such as an internet connection, and the Philippines' probable limitation is its meagre connectivity. The results presented here show favourable outcomes, similar to patients with COPD on pulmonary telerehabilitation regarding dyspnea and exercise capacity.…”

“…In addition, anxiety and depression show a decreasing trend post‐pulmonary rehabilitation. Lung function also showed remarkable results; most 9 had increasing FVC, and six had improvement on FEV1, respectively, as summarized in Table 2.…”