Changes in Stroke Rehabilitation during the Sars-Cov-2 Shutdown in Switzerland.
Jeremia P O Held, Anne Schwarz, Johannes Pohl and 7 others
PMID 34927210WHAT IT FOUND
During shutdown, 72% of 36 stroke survivors reported less outpatient therapy, sat more, and had slightly worse depression.
Upper-limb usage did not worsen, and some motor measures improved after therapy restarted.
Key findings
0172% of participants reported reduced therapy during shutdown, and physical and occupational therapy time fell significantly by 51 and 41 minutes per week.
02Sitting time increased during and after shutdown, and depressive symptoms increased slightly at each follow-up.
03Upper limb usage did not deteriorate during or after shutdown, and motor function improved between the end of shutdown and 3-month follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 36 stroke survivors were included, and 26 were in the chronic stage, so the findings mainly reflect chronic stroke survivors. Participants were recruited from two earlier research cohorts, and those who declined participation were more impaired, so the sample may not represent typical stroke survivors. The study was observational with no control group, so it cannot prove that the shutdown or therapy restart caused the changes. Therapy restart, self-directed training and physical activity changed together, so the contribution of any single component cannot be separated. Baseline data were collected at a median of 160 days before enrollment, not immediately before the shutdown. Four participants declined follow-up measurements. Mood and function varied widely between individuals, so average changes may not predict any one patient.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that stopping outpatient therapy is beneficial or that restarting it caused functional improvement. This was a small observational cohort, and therapy restart, self-directed training and physical activity changed together, so the contribution of any single component cannot be separated.