ABSTRACT
OBJECTIVES: As patients recovering from the novel coronavirus disease 2019 (COVID-19) present with physical, respiratory, cognitive, nutritional, and swallowing-related impairments and mental health complications, their rehabilitation needs are complex. This study aimed to describe the demographic, clinical, and functional status after the discharge of COVID-19 survivors who underwent intensive multidisciplinary inpatient rehabilitation at the Physical and Rehabilitation Medicine Institute of the University of Sao Paulo Medical School General Hospital and Lucy Montoro Rehabilitation Institute. We determined the most important factors related to the length of inpatient rehabilitation treatment and present the functional outcomes. METHODS: This was a retrospective study based on electronic medical records. In addition to the severity of COVID-19 and length of hospital stay for the management of COVID-19 and comorbidities, we collected sociodemographic data including age, sex, height, and weight. Functional assessments were performed using the Functional Independence Measure (FIM); Short Physical Performance Battery; Montreal Cognitive Assessment; Depression, Anxiety and Stress Scale; Revised Impact of Events Scale; bioelectrical impedance; Functional Oral Intake Scale; oropharyngeal dysphagia classification; and nutritional assessment. RESULTS: There was a significant improvement in FIM before and after inpatient rehabilitation treatment (p<0.0001). Muscle strength and walking capacity were significantly improved (p<0.01). The most important factors related to the length of inpatient rehabilitation treatment were improvement in FIM scores (Spearman's r=0.71) and gain in lean mass (Spearman's r=0.79). CONCLUSIONS: Rehabilitation of patients after COVID-19 recovery improves their functional status and should be considered in the post-acute phase for selected patients with COVID-19.
Subject(s)
Humans , Physical and Rehabilitation Medicine , COVID-19 , Retrospective Studies , Treatment Outcome , Recovery of Function , SARS-CoV-2 , Length of StayABSTRACT
Objective : Recently, children with more severe disabilities are being hospitalized for inpatient rehabilitation. Therefore, it is becoming more difficult to adequately assess the effect of rehabilitation by conventional methods alone. The objective of this study is to evaluate the usefulness of the Canadian Occupational Performance Measure (COPM), which is an open-ended questionnaire that allows patients to prioritize their needs and rate their performance in different tasks of daily living as well as their satisfaction in performing them. Methods : The COPM performance and satisfaction scores of 81 patients hospitalized for over one month were measured at admission and discharge. Changes during inpatient rehabilitation were evaluated in each case. Results : The mean age at admission was 8.2 yrs. The mean length of inpatient stay was 56.2 days. The children included 31 girls and 50 boys. The distributions according to the Gross Motor Function Classification System (GMFCS) were Levels Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ in 3.7%, 8.6%, 28.4%, 32.1%, and 27.2% of patients, respectively. The mean COPM performance score and satisfaction score increased from 3.41 to 5.71 and 3.22 to 5.88 respectively with significant difference. The GMFCS level did not affect the changes in COPM scores. Conclusion : The COPM may work as a useful assessment method for relatively short-term inpatient rehabilitation children since it identifies child-unique problems that are mostly not assessed by conventional methods.
ABSTRACT
The ultimate goal of Rehabilitation is for optimal functioning and independence of the patient. This includes the physical, psychological, social, educational, vocational, and recreational abilities and participation. It is holistic in nature and addresses restoration where possible or compensation where necessary. Rehabilitation Medicine is the medical field specialising in care of patients with disabling disease or injury. The person with disabilities has to cope with many changes including physical, psychological and cognitive. They go through an adjustment or crisis coping process, and there are various strategies and philosophies that help with healthy coping. An understanding of the options and processes involved in rehabilitation, as well as how patients cope with adversity, is important to the family practitioner as the aging of Singapore will result in increasing numbers of patients presenting with disabilities needing more than simply medicines.
ABSTRACT
The ultimate goal of Rehabilitation is for optimal functioning and independence of the patient. This includes the physical, psychological, social, educational, vocational, and recreational abilities and participation. It is holistic in nature and addresses restoration where possible or compensation where necessary. Rehabilitation Medicine is the medical field specialising in care of patients with disabling disease or injury. The person with disabilities has to cope with many changes including physical, psychological and cognitive. They go through an adjustment or crisis coping process, and there are various strategies and philosophies that help with healthy coping. An understanding of the options and processes involved in rehabilitation, as well as how patients cope with adversity, is important to the family practitioner as the aging of Singapore will result in increasing numbers of patients presenting with disabilities needing more than simply medicines.
ABSTRACT
OBJECTIVE: To evaluate the effect of prolonged inpatient rehabilitation therapy in subacute stroke patients. METHOD: We enrolled 52 subacute stroke patients who had received 3 months of inpatient rehabilitation therapy. Thirty stroke patients received additional inpatient rehabilitation therapy for 3 months and 22 control patients received only home-based care. The evaluation was measured at 3 and at 6 months after stroke occurrence. Functional improvement was measured using the modified motor assessment scale (MMAS), the timed up and go test (TUG), the 10-meter walking time (10 mWT), the Berg balance scale (BBS) and the Korean-modified Barthel index (K-MBI). The health-related quality of life was evaluated using the medical outcome study, 36-item short form survey (SF-36). RESULTS: In the experimental group, significant improvements were observed for all parameters at 6 months (p<0.05). However, significant improvements were observed only in MMAS, BBS, and K-MBI at 6 months in the Control group (p<0.05). In comparing the 2 groups, significant difference were observed in all parameters (p<0.05) except 10 meter walking time (p=0.73). The improvement in SF-36 was meaningfully higher in experimental group compared to control group. CONCLUSION: This study demonstrates that subacute stroke patients can achieve functional improvements and an enhanced quality of life through prolonged inpatient rehabilitation therapy.