The role of acute rehabilitation in COVID-19 patients.
Tamara Filipović, Ivana Gajić, Francesca Gimigliano and 4 others
PMID 36999952WHAT IT FOUND
Hospitalized COVID-19 patients receiving usual medications including blood thinners, steroids, vitamins, oxygen or antivirals plus acute breathing, mobility and strength exercises improved on walking, balance and independence.
No untreated control group, so the separate effect of any treatment is unknown.
Key findings
01Of 205 patients recruited, 147 completed the rehabilitation program; six patients died, 21 declined and 31 were transferred.
02Both mild/moderate and stable severe groups had significant within-hospital changes on Timed Up and Go, sit-to-stand, one-leg stance, Barthel Index, 6-minute walk and Borg dyspnea.
03At discharge, the stable severe group had higher Timed Up and Go and sit-to-stand times and lower one-leg stance time than the mild/moderate group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no untreated control group, so changes during hospitalization cannot be separated from natural recovery or from the other treatments given at the same time. The study was single-center, and it was not feasible to run it across multiple centers during the pandemic. Only 147 of 205 recruited patients completed the rehabilitation program; six died, 21 declined and 31 were transferred, which may limit generalizability. Patients had to be able to move independently without assistance and have SpO2 above 94% on admission, so the results do not address more disabled or unstable patients. Patients with paresis or plegia from stroke or neurodegenerative disease, severe heart failure, or impaired cognitive status were excluded. The severe group was older and had worse baseline function than the mild/moderate group, so direct group comparisons are not straightforward. There was no follow-up after discharge, so it is unclear whether the changes persisted. The study did not include neuropsychological support as a fundamental activity.
Declared interests
The authors declared no conflict of interest with any financial organization. No separate funding source is reported.
The easy way to misread this
Do not conclude that acute rehabilitation caused the functional gains. Patients also received blood thinners, steroids, vitamins, oxygen or antivirals, and there was no untreated control group, so natural recovery and other treatments cannot be separated.