Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation

Burns, Suzanne Perea; Fleming, Talya K.; Webb, Sam Sappho; Kam, Alice; Fielder, Jaimee D.P.; Hu, Xiaolei; Hill, Mary Thelander; Kringle, Emily

doi:10.1016/j.apmr.2022.04.004

Cited by 22 publications

(19 citation statements)

References 79 publications

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“…29 Patients with neurologic conditions unrelated to COVID-19 also experienced gaps resulting from disruptions caused by the pandemic. 30 Accordingly, the current number of excess deaths attributable to racial and ethnic disparities in neurologic mortality is likely higher than this study's estimates from 2010 to 2019 indicate.…”

Section: Discussionmentioning

confidence: 63%

The Lives Lost to Inequities

Woolf,

Chapman,

Lee

et al. 2023

Neurology

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Background and Objectives Mortality rates for neurologic diseases are increasing in the United States, with large disparities across geographical areas and populations. Racial and ethnic populations, notably the non-Hispanic (NH) Black population, experience higher mortality rates for many causes of death, but the magnitude of the disparities for neurologic diseases is unclear. The objectives of this study were to calculate mortality rates for neurologic diseases by race and ethnicity and—to place this disparity in perspective—to estimate how many US deaths would have been averted in the past decade if the NH Black population experienced the same mortality rates as other groups. Methods Mortality rates for deaths attributed to neurologic diseases, as defined by the International Classification of Diseases, were calculated for 2010 to 2019 using death and population data obtained from the Centers for Disease Control and Prevention and the US Census Bureau. Avertable deaths were calculated by indirect standardization: For each calendar year of the decade, age-specific death rates of NH White persons in 10 age groups were multiplied by the NH Black population in each age group. A secondary analysis used Hispanic and NH Asian populations as the reference groups. Results In 2013, overall age-adjusted mortality rates for neurologic diseases began increasing, with the NH Black population experiencing higher rates than NH White, NH American Indian and Alaska Native, Hispanic, and NH Asian populations (in decreasing order). Other populations with higher mortality rates for neurologic diseases included older adults, the male population, and adults older than 25 years without a high school diploma. The gap in mortality rates for neurologic diseases between the NH Black and NH White populations widened from 4.2 individuals per 100,000 in 2011 to 7.0 per 100,000 in 2019. Over 2010 to 2019, had the NH Black population experienced the neurologic mortality rates of NH White, Hispanic, or NH Asian populations, 29,986, 88,407, or 117,519 deaths, respectively, would have been averted. Discussion Death rates for neurologic diseases are increasing. Disproportionately higher neurologic mortality rates in the NH Black population are responsible for a large number of excess deaths, making research and policy efforts to address the systemic causes increasingly urgent.

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Section: Discussionmentioning

confidence: 63%

The Lives Lost to Inequities

Woolf,

Chapman,

Lee

et al. 2023

Neurology

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“…The growing literature on telerehabilitation indicates that there is no significant difference between telerehabilitation and in-person rehabilitation for activities of daily living, balance, and UE outcomes [ 64 ]. The COVID-19 pandemic disrupted access to healthcare for individuals with stroke and forced both healthcare providers and clients to abruptly adopt telehealth methods to deliver all types of healthcare visits including rehabilitation [ 65 , 66 ]. The current healthcare climate has provided a clear opportunity to re-imagine the best methods of stroke rehabilitation delivery, and accelerated the need to understand the best methods in which we can deliver rehabilitation to individuals living in the community [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic disrupted access to healthcare for individuals with stroke and forced both healthcare providers and clients to abruptly adopt telehealth methods to deliver all types of healthcare visits including rehabilitation [ 65 , 66 ]. The current healthcare climate has provided a clear opportunity to re-imagine the best methods of stroke rehabilitation delivery, and accelerated the need to understand the best methods in which we can deliver rehabilitation to individuals living in the community [ 66 ]. The current study addresses this need and examines the use of MI and EMA methods to facilitate effective remote rehabilitation for a 4-week UE self-training protocol.…”

Section: Discussionmentioning

confidence: 99%

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Gahlot¹,

Magsombol²,

Waskjewicz³

et al. 2023

Contemporary Clinical Trials Communications

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“…In primary care, telemedicine (e.g., video telemedicine, new devices for patient follow-up, and telerehabilitation) will help to improve the control of the risk factors and avoid unnecessary visits to hospitals, especially in areas with no purely nondedicated (e.g., non-COVID-19) hospitals. 94 95 96 In hospitals, better spaces in emergency departments will also help to both reduce the transmission of the disease and reduce the fear of becoming infected for people suffering from other diseases. Smart campaign strategies distributed by digital media will be needed in order to eliminate avoidable harm in health care or reduce the prehospital time delay of patients with CV events, since many community interventions in the past had no major effect on patient behavior.…”

Section: Future Directionsmentioning

confidence: 99%

Cerebro-/Cardiovascular Collateral Damage During the COVID-19 Pandemic: Fact or Fiction?

et al. 2023

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Numerous observational studies have identified a decline in cerebro-/cardiovascular (CV) admissions during the initial phase of the COVID-19 pandemic. Recent studies and meta-analyses indicated that the overall decrease was smaller than that found in initial studies during the first months of 2020. Two years later we still do not have clear evidence about the potential causes and impacts of the reduction of CV hospitalizations during the COVID-19 pandemic. It has becoming increasingly evident that collateral damage (i.e., incidental damage to the public and patients) from the COVID-19 outbreak is the main underlying cause that at least somewhat reflects the effects of imposed measures such as social distancing and self-isolation. However, a smaller true decline in CV events in the community due to a lack of triggers associated with such acute syndromes cannot be excluded. There is currently indirect epidemiological evidence about the immediate impact that the collateral damage had on excess mortality, but possible late consequences including a rebound increase in CV events are yet to be observed. In the present narrative review, we present the reporting milestones in the literature of the rates of CV admissions and collateral damage during the last 2 years, and discuss all possible factors contributing to the decline in CV hospitalizations during the COVID-19 pandemic. Healthcare systems need to be prepared so that they can cope with the increased hospitalization rates for CV events in the near future.

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Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation

Cited by 22 publications

References 79 publications

The Lives Lost to Inequities

The Lives Lost to Inequities

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Cerebro-/Cardiovascular Collateral Damage During the COVID-19 Pandemic: Fact or Fiction?

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