Rehabilitation setting during and after Covid-19: An overview on recommendations

Abstract

Objective The aim of this review is to identify the best evidence to define rehabilitative approaches to acute and post-acute phases of coronavirus 2019 (COVID-19) disease. Methods A literature search (of PubMed, Google Scholar, PEDro and Cochrane databases) was performed for relevant publications from January to April 2020. Results A total of 2,835 articles were retrieved, and the search resulted in a final total 31 published articles. A narrative synthesis of the selected articles was then performed. Some studies examine the effect of the pandemic on rehabilitation services and provide suggestions for a new reorganization of these services. Other studies focus on COVID-19 sequelae, formulating recommendations for rehabilitative interventions. Conclusion For COVID-19 patients, an integrated rehabilitative process is recommended, involving a multidisciplinary and multi-professional team providing neuromuscular, cardiac, respiratory, and swallowing interventions, and psychological support, in order to improve patients’ quality of life. The intervention of a physician expert in rehabilitation should assess the patient, and a dedicated intervention set up after thorough assessment of the patient’s clinical condition, in collaboration with all rehabilitation team professionals. LAY ABSTRACT Rehabilitation, in a multidisciplinary and multi-professional setting, plays a pivotal role in the management of Covid-19 patients, focusing on respiratory and motor functions and it is therefore crucial to establish treatment strategies to guarantee an optimal recovery of these patients. We performed a review of the scientific literature. All the studies concerning respiratory rehabilitation treatments for Covid-19 patients were included. Respiratory rehabilitation has the goal of improve respiratory symptoms, preserve function and reduce complications and disability; it also has positive effects on the psychological sphere, reducing anxiety and depression that can frequently develop in this context.

Italian and Japanese public attention toward balneotherapy in the COVID-19 era

“…The reduction in interest in balneotherapy in the countries surveyed may suggest the need to rethink the role of health resorts in emergency situations (Clementi et al 2020 ; Maccarone and Masiero 2021 ). For post-COVID-19 subjects, a comprehensive rehabilitative approach comprising a multidisciplinary and multi-professional team, offering neuromuscular, cardiorespiratory, and psychological interventions, is strongly recommended (Agostini et al 2021 ). Considering the high number of patients with important outcomes from COVID-19 infection needing early rehabilitation (Agostini et al 2021 ) and the lack of structures designed to offer comprehensive treatment to these subjects, it was hypothesized that spa health resorts could represent an appropriate setting in order to conduct rehabilitation programs for discharged subjects (Maccarone et al 2020 ; Masiero et al 2020b , 2020c ; Antonelli and Donelli 2020 ; Kardeş 2021b ).…”

“…For post-COVID-19 subjects, a comprehensive rehabilitative approach comprising a multidisciplinary and multi-professional team, offering neuromuscular, cardiorespiratory, and psychological interventions, is strongly recommended (Agostini et al 2021 ). Considering the high number of patients with important outcomes from COVID-19 infection needing early rehabilitation (Agostini et al 2021 ) and the lack of structures designed to offer comprehensive treatment to these subjects, it was hypothesized that spa health resorts could represent an appropriate setting in order to conduct rehabilitation programs for discharged subjects (Maccarone et al 2020 ; Masiero et al 2020b , 2020c ; Antonelli and Donelli 2020 ; Kardeş 2021b ). The balneotherapy setting, benefiting from a multidisciplinary team, offers the possibility to apply several interventions directed to the improvement of musculoskeletal, neuropsychological, pulmonary, and cardiac outcomes that could affect COVID-19 survivors.…”

Spa therapy interventions for post respiratory rehabilitation in COVID-19 subjects: does the review of recent evidence suggest a role?

“…For post-COVID-19 subjects, a comprehensive rehabilitative approach comprising a multidisciplinary and professional team, offering cardiorespiratory, neuromuscular, and psychological interventions, is recommended (Agostini et al 2021 ). The main goals of respiratory rehabilitation in post-COVID-19 subjects are to improve symptoms of dyspnea, to reduce chronic inflammation in the airways, to ameliorate chest wall kinematics, to reduce complications and long-term outcomes, to minimize disability, and to improve QoL (Wang et al 2020 , Liu et al 2020 , Antonelli and Donelli 2020 ).…”

Spa therapy interventions for post respiratory rehabilitation in COVID-19 subjects: does the review of recent evidence suggest a role?

“…For post COVID-19 subjects, a comprehensive rehabilitative approach comprising a multidisciplinary and professional team, offering cardiorespiratory, neuromuscular, and psychological interventions, is recommended (Agostini et al 2021). Main goals of respiratory rehabilitation in post COVID-19 subjects are: to improve symptoms of dyspnea, to reduce chronic in ammation in the airways, to ameliorate chest wall kinematics, to reduce complications and long-term outcomes, to minimize disability, and to improveQoL (Wang et al 2020, Liu et al 2020, Antonelli et al 2020).…”