Rehabilitation to enable recovery from COVID-19: a rapid systematic review.
Victoria A Goodwin, Louise Allan, Alison Bethel and 9 others
PMID 33637294WHAT IT FOUND
Rehabilitation for severe respiratory illness improves walking and muscle strength, but evidence for post-ICU recovery is weak.
No studies exist for COVID-19 specifically, so generalising requires caution. Individualised programmes are valued by patients, though quality of life results remain inconclusive.
Key findings
01Early mobilisation and exercise interventions improved muscle strength, walking ability, and functional independence in adults with severe respiratory illness requiring critical care.
02There is currently no evidence specifically evaluating rehabilitation for those recovering from COVID-19; findings are extrapolated from studies on other severe respiratory illnesses and mixed medical/surgical populations.
03Qualitative studies indicate that patients value individualised rehabilitation approaches that build hope and confidence, although evidence for interventions after hospital discharge is limited.
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
No studies were included that specifically involved patients with COVID-19, so all findings are extrapolated from other severe respiratory illnesses and mixed medical/surgical populations. The review excluded cognitive rehabilitation interventions, which limits its applicability to occupational therapy and speech-language pathology practice. Many included studies had variable quality, with some RCTs failing to describe randomisation methods or account for dropouts. Adverse events were inconsistently reported across the included studies. The rapid nature of the review meant some potentially relevant studies may have been missed, particularly those not available in English.
Declared interests
One author (SL) served on several Health Technology Assessment (HTA) boards. Another author (VG) was an Associate Editor but was not involved in the peer review of this article. The other authors declared no competing interests.
The easy way to misread this
Do not assume this evidence directly proves rehabilitation works for COVID-19 patients. No studies in this review included patients with COVID-19, so the findings are based on other severe respiratory illnesses. Additionally, the review excluded cognitive rehabilitation, so it does not address outcomes relevant to speech-language pathologists or specific OT cognitive interventions.