Challenges and Lessons Learned for Acute Inpatient Rehabilitation of Persons With COVID-19: Clinical Presentation, Assessment, Needs, and Services Utilization.
Susan Maltser, Erika Trovato, Heidi N Fusco and 17 others
PMID 34793372WHAT IT FOUND
Acute inpatient rehabilitation for COVID-19 patients resulted in functional gains comparable to prepandemic debility patients, with most discharged home.
Clinicians adapted by creating separate therapy spaces, using telehealth for family training, and managing high rates of delirium and pressure injuries.
Key findings
01Patients gained an average of two points on functional self-care and mobility scales, a level of improvement similar to or exceeding prepandemic debility patients.
02Discharge home rates were high, with four of seven institutions significantly exceeding prepandemic home discharge proportions.
03Care delivery required adaptations including separate therapy spaces, telehealth for family education, and management of complex issues like delirium and pressure injuries.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Data were collected retrospectively and were not standardized across institutions, with most using different electronic medical record systems. Individual patient data were not shared, only aggregate statistics, limiting the ability to control for confounders. Important clinical factors like body mass index and comorbidities were not available for analysis. Admission criteria varied between institutions, which likely influenced the patient populations and outcomes. The study only covers the first surge of the pandemic, so findings may not apply to later variants or phases. Narrative data on challenges came from untranscribed discussions, introducing potential bias or omission.
Declared interests
The authors declared no conflicts of interest. Funding sources are not explicitly detailed in the provided text, though it mentions institutional regulatory board permissions.
The easy way to misread this
Do not interpret the functional gains as evidence that rehabilitation causes better outcomes than other care models, as there was no control group receiving no rehab. The comparison to prepandemic 'debility' patients is observational and may be confounded by the younger age and different sex distribution of the COVID-19 cohort.