Group-based pulmonary telerehabilitation is feasible, safe, beneficial and well-received in patients who have been hospitalised with COVID-19.

Introduction: Coronavirus disease 2019 (COVID-19) has caused worldwide mass hospitalisation. The need for multidisciplinary post-hospitalisation rehabilitation is becoming increasingly apparent, and telerehabilitation has been endorsed. The aim of study was to investigate the feasibility and efficacy of pulmonary telerehabilitation for COVID-19 survivors. Methods: This was a single-centre, mixed-methods, fast-track (wait-list), randomised controlled trial of telerehabilitation for patients who had been hospitalised with COVID-19. 40 patients discharged from two university teaching hospitals in the north of England were recruited. Telerehabilitation consisted of 12 exercise classes, six education events and opportunity for peer support. Patients commenced telerehabilitation 14 days after randomisation in the fast-track group and 56 days after randomisation in the wait-list group. Outcome measures and results: Descriptive and statistical improvements were noted in several clinical outcome measures. Exercise capacity increased from a median (interquartile range) 20 (14-24) sit-to-stand repetitions in 1 min at baseline to 25 (24-30) post-telerehabilitation. Breathlessness rated using the Medical Research Council dyspnoea scale changed from 3.5 (3-4) at baseline to 2 (1.5-3) post-telerehabilitation, with additional favourable outcomes noted in respiratory symptoms measured using numerical rating scales and visual analogue scales (VAS). Quality of life measured using the EuroQol VAS improved from 55 (60-70) units at baseline to 70 (55-80) units following telerehabilitation. Improvements in fatigue (modified Functional Assessment of Chronic Illness Therapy: Fatigue) and mood (Hospital Anxiety and Depression Scale - Depression) were also observed. Natural recovery was observed in the wait-list group prior to receiving telerehabilitation; however, improvements were accelerated by early telerehabilitation in the fast-track group. Conclusions: We have shown that group-based telerehabilitation is feasible, safe, beneficial and well-received in this population.

Telerehabilitation for patients who have been hospitalised with covid-19: a qualitative study.

PURPOSE: The aim of this qualitative study was to explore the views of participants of a group-based, supervised, telerehabilitation programme, following discharge from hospital with Covid-19. This study was part of a single-centre, fast-track (wait-list), randomised, mixed-methods, feasibility trial of telerehabilitation (Registration: Clinicaltrials.gov reference:285205). METHODS: Semi-structured interviews were conducted over a virtual teleconference platform with 10 participants who took part in a telerehabilitation programme following Covid-19 after discharge from an acute hospital. Data were transcribed verbatim and analysed using thematic analysis. RESULTS: Five themes were important from the participant perspective: telerehabilitation programme as part of the Covid-19 journey; the telerehabilitation programme design and delivery; peer aspects; the role of the instructor; and the role of technology and online delivery. CONCLUSIONS: Overall, the telerehabilitation programme was a positive experience for participants. The instructors were central to this positive view as was the group nature of the programme. The group aspect was particularly important in supporting the broader perceived wellbeing gains, such as the sense of enjoyment and reduced social isolation. Several participants would have liked to have continued with the exercises beyond the six-week intervention indicating that the programme could be a way to help people sustain a physically active lifestyle.IMPLICATIONS FOR REHABILITATIONParticipants who were recovering from Covid-19 following hospital admission perceived the telerehabilitation to be a positive experience overall.The group aspect of the telerehabilitation programme was important in supporting the broader perceived wellbeing gains such as the sense of enjoyment and reduced social isolation.Telerehabilitation programmes for Covid-19 may need to include pathways for participants to continue to engage in exercise beyond the time-limited six-week intervention to support ongoing self-management.

Collaborative, Two-Directional Live Streaming to Deliver Hands-on Dissection Experience during the COVID-19 Lockdown.

Cadaveric dissection is widely used in anatomy teaching worldwide. This method develops anatomical knowledge and practical dissection skills, as well as communication and team working. At the School of Anatomy, University of Bristol, two of our undergraduate units depend on dissection as a teaching tool.Social distancing guidelines brought about by COVID-19 brought challenges and meant it was not possible for all students to be present around a cadaver simultaneously. We adapted with secure, two-way live streaming, facilitated by ceiling-mounted cameras.Our units utilised the technology in slightly different ways. In a larger cohort, students were not able to attend the dissection room simultaneously and 2-4 students from each group attended, with the remainder (6-8 students) attending via Zoom. In the smaller cohort, all students attended, though only two students could be present around the cadaver, with Zoom used to stream the dissection to those distanced around the room. Those present narrated and ensured visibility of the dissection, whilst posing questions to those at home. The home group provided feedback, generated discussion, and conducted research.This chapter reflects on our experiences using this innovative teaching method. It was a valuable alternative to being in person. Whilst students might have spent less time in the dissection room, their dissection time equalled or was greater than pre-pandemic. Students developed digital confidence and built cohorts, and whilst we reflect on the need for effective communication and digital equity, we offer our best practice and solutions.Whilst in-person teaching has resumed in 2021-2022, investment in this technology enables us to rapidly pivot to a reduced in-person, or an entirely online delivery where required, and we are confident that our delivery will be effective in either case. There are also exciting opportunities for new forms of delivery as well as national and international collaborations.

Group-based pulmonary telerehabilitation is feasible, safe, beneficial and well-received in patients that have been hospitalised with Covid-19

Introduction Covid-19 has caused worldwide mass hospitalisation. The need for multi-disciplinary post-hospitalisation rehabilitation is becoming increasingly apparent and telerehabilitation has been endorsed. The aim of study was to investigate the feasibility and efficacy of pulmonary telerehabilitation for Covid-19 survivors. Methods A single centre, mixed-methods, fast-track (wait-list), randomised controlled trial of telerehabilitation for patients who have been hospitalised with Covid-19. Participants Forty patients discharged from two University Teaching Hospitals in the North of England. Interventions: Telerehabilitation consisted of twelve exercise classes, six education events and opportunity for peer support. Patients commenced telerehabilitation 14 days after randomisation in the fast-track group and 56 days after randomisation in the wait-list group. Outcome measures and results Descriptive and statistical improvements were noted is several clinical outcome measures. Exercise capacity increased from a median (Q1–Q3) 20 (14–24) sit-to-stand repetitions in one-minute at baseline to 25 (24–30) post-telerehabilitation. Breathlessness rated using the MRC changed from 3.5 (3–4) at baseline to 2 (1.5–3) post-telerehabilitation, with additional favourable outcomes noted in respiratory symptoms measured using numerical rating scales and visual analogue scales (VAS). Quality of life measured using the EQ-VAS improved from 55 (60–70) units at baseline to 70 (55–80) units following telerehabilitation. Improvements in fatigue (FACIT-F) and mood (HADS-D) were also observed. Natural recovery was observed in the wait-list group prior to receiving telerehabilitation, however, improvements were accelerated by early telerehabilitation in the fast-track group. Conclusions We have shown that group-based telerehabilitation is feasible, safe, beneficial and well-received in this population.