Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 23
Filter
1.
Eur Spine J ; 31(6): 1333-1342, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1782812

ABSTRACT

PURPOSE: The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. METHODS: On September 17-18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recommendations were uploaded to the SPINE20 website 10 days before the meeting and opened to the public for comments. The recommendations were discussed at the meeting allowing the participants to object and provide comments. RESULTS: In total, 27 societies endorsed the following recommendations. SPINE20 calls upon the G20 countries: (1) to expand telehealth for the access to spine care, especially in light of the current situation with COVID-19. (2) To adopt value-based interprofessional spine care as an approach to improve patient outcomes and reduce disability. (3) To facilitate access and invest in the development of a competent rehabilitation workforce to reduce the burden of disability related to spine disorders. (4) To adopt a strategy to promote daily physical activity and exercises among the elderly population to maintain an active and independent life with a healthy spine, particularly after COVID-19 pandemic. (5) To engage in capacity building with emerging countries and underserved communities for the benefit of spine patients. (6) To promote strategies to transfer evidence-based advances into patient benefit through effective implementation processes. CONCLUSIONS: SPINE20's initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe.


Subject(s)
COVID-19 , Spinal Diseases , Aged , Humans , Italy , Pandemics/prevention & control , Spinal Diseases/therapy
2.
Eur J Phys Rehabil Med ; 57(5): 850-857, 2021 10.
Article in English | MEDLINE | ID: covidwho-1592179

ABSTRACT

INTRODUCTION: This paper updates and summarizes the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences of the disease and its treatment. EVIDENCE ACQUISITION: Studies published from May 1st to June 30th, 2021 were selected, excluding descriptive studies and expert opinions. Papers were categorized according to study design, research question, COVID-19 phase, limitations of functioning of rehabilitation interest, and type of rehabilitation service involved. From this edition, we improved the quality assessment using the Joanna Briggs Institute checklists for observational studies and the Cochrane Risk of Bias Tool for randomized-controlled clinical trials (RCTs). EVIDENCE SYNTHESIS: Twenty-five, out of 3699 papers, were included. They were three RCTs, 13 cross-sectional studies and nine cohort studies. Twenty studies reported data on symptom prevalence (N.=13) or disease natural history (N.=7); and five studies reported intervention effectiveness at the individual level. All study participants were COVID survivors and 48% of studies collected information on participants 6 months or longer after COVID-19 onset. The most frequent risks of bias for RCTs concerned weaknesses in allocation concealment, blinding of therapists, and lack of intention-to-treat analysis. Most analytical studies failed to identify or deal with confounders, describe or deal with dropouts or eventually perform an appropriate statistical analysis. CONCLUSIONS: Most studies in this updated review targeted the prevalence of limitations of functioning of rehabilitation interest in COVID-19 survivors. This is similar to past review findings; however, data in the new studies was collected at longer follow-up periods (up to one year after symptom onset) and in larger samples of participants. More RCTs and analytical observational studies are available, but the methodological quality of recently published studies is low. There is a need for good quality intervention efficacy and effectiveness studies to complement the rapidly expanding evidence from observational studies.


Subject(s)
COVID-19 , Bias , Cohort Studies , Cross-Sectional Studies , Humans , SARS-CoV-2
3.
Eur Spine J ; 30(10): 2944-2954, 2021 10.
Article in English | MEDLINE | ID: covidwho-1326826

ABSTRACT

PURPOSE: The COVID-19 pandemic and the containment measures such as social distancing, mobility restrictions and quarantine have significantly impacted the delivery of healthcare services, with possible negative effects on low back pain patients. In this study, we used an innovative agent-based model to quantify the effects of COVID-19 on the prevalence and severity of low back pain in the general population. METHODS: Epidemiological data were used to simulate the low back pain evolution in a population of 300,000 agents. Reduced access to treatment due to the containment measures was simulated with a probabilistic approach, in which 500 random scenarios (differing in: length of the lockdown, probability of having access to treatment, time before the resumption of treatment, duration of the effects of the treatment after its interruption) were simulated. RESULTS: The lockdown may increase the mean pain score higher than 1/10 points for patients suffering from acute low back pain, up to 4-5/10 points for specific individuals. The lockdown also affected the length of pain episodes, possibly impacting chronicity and disability. All the variables describing the random scenarios had a relevant impact in determining both the increase of pain intensity in the population and the length of the effects of the lockdown. CONCLUSIONS: "Optimal lockdown parameters" which minimize the impact on low back pain while preserving the effects on infection spread and mortality could not be identified. Policies favouring a prompt resumption of treatments after the lockdown may be effective in shortening the duration of its negative effects.


Subject(s)
COVID-19 , Low Back Pain , Communicable Disease Control , Humans , Low Back Pain/epidemiology , Pandemics , SARS-CoV-2
5.
New Zealand Journal of Physiotherapy ; 49(1):5-6, 2021.
Article in English | ProQuest Central | ID: covidwho-1306113

ABSTRACT

Called the "Rehabilitation - COVID-19 Evidencebased Response" (REH-COVER), the project has been organised around five main activities related to Covid-19 rehabilitation: production of rapid living systematic reviews, production of an Interactive living evidence map, prioritisation of research topics on rehabilitation and Covid-19 In collaboration with the World Health Organization (WHO), production of a Cochrane Library Special Collection on Covid-19 and rehabilitation for patients with functional consequences of acute Illness, and lastly, collaboration with the COVID-19 Evidence Network to support decision-making (https://rehabilitation.cochrane.org/resources/ cochrane-rehabilitatIon-versus-covId-19). The CONSORT statement Is a list of criteria endorsed by all leading health science journals, Including the New Zealand Journal of Physiotherapy, that describes a minimum level of reporting required In any published article on a clinical trial. The CONSORT statement ensures that when researchers publish findings from randomised controlled trials, all key Information needed to evaluate the quality of the study and to apply It to clinical practice has been Included In the report.

6.
J Clin Epidemiol ; 138: 194-198, 2021 10.
Article in English | MEDLINE | ID: covidwho-1253152

ABSTRACT

OBJECTIVE: This study aims to describe "rapid living" systematic reviews, an innovative methodological design used to systematically synthesize emerging evidence in the field of rehabilitation during the COVID-19 pandemic. STUDY DESIGN AND SETTING: A methodological paper, with a formative approach to rapid living systematic reviews. RESULTS: Based on our experience, we propose the following definition of rapid living SR: ``A dynamic method of knowledge synthesis that allows for the constant updating of new emerging evidence and refinement of its methodological quality.'' This method has the benefit of accelerating the conduct of traditional systematic reviews and allows for a synergistic adaptation of methodology based on the quality of the evidence with a flexibility to update results, methods and collaborations. CONCLUSION: Our proposed methodology has been helpful to synthesize the rapidly evolving evidence in the field of rehabilitation during the pandemic. Similarly, it may be useful when a rapid answer is urgently needed to make informed decisions. The COVID-19 disease has shown that modern medical science has the ability to produce new knowledge at a rate never seen before. Therefore, our proposed rapid living systematic reviews provide the scientific community with a method to rapidly synthesize evidence when facing health emergencies.


Subject(s)
COVID-19/epidemiology , Pandemics , Research Design , Systematic Reviews as Topic/methods , Humans
7.
J Rehabil Med ; 53(8): jrm00221, 2021 08 07.
Article in English | MEDLINE | ID: covidwho-1243929

ABSTRACT

BACKGROUND: Multiple organ dysfunction syndrome, defined as altered organ function in critically ill patients, is a possible consequence of COVID-19. Investigating the current evidence is therefore crucial in this pandemic, as early rehabilitation could be effective for the functioning of patients with multiple organ failure. This rapid review assesses the effectiveness of rehabilitation interventions in adults with multiple organ dysfunction syndrome. METHODS: A rapid review was conducted including only randomised control trials, published until 30 November 2020. All databases were investigated and the results synthesized narratively, evaluating the risk of bias and quality of evidence in all included studies. RESULTS: A total of 404 records were identified through database searches. After removal of duplicates 346 articles remained. After screening, 3 studies (90 participants) met the inclusion criteria. All studies reported positive effects of neuromuscular electrical stimulation on muscle mass preservation compared with no treatment or standard physio-therapy. CONCLUSION: The lack of evidence on the effectiveness of rehabilitation interventions does not allow any firm conclusion to be drawn. Neuromuscular electrical stimulation might be a possible rehabilitation intervention to prevent muscle volume loss and improve function in patients with multiple organ dysfunction syndrome. However, further studies are needed to support these preliminary findings.


Subject(s)
COVID-19 , Critical Illness , Multiple Organ Failure/rehabilitation , Adult , Humans , Multiple Organ Failure/etiology , Pandemics , Randomized Controlled Trials as Topic , SARS-CoV-2
8.
Eur J Phys Rehabil Med ; 57(2): 303-308, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1224411

ABSTRACT

During its fourth year of existence, Cochrane Rehabilitation went on to promote evidence-informed health decision-making in rehabilitation. In 2020, the outbreak of the COVID-19 pandemic has made it necessary to alter priorities. In these challenging times, Cochrane Rehabilitation has firstly changed its internal organisation and established a new relevant project in line with pandemic needs: the REH-COVER (Rehabilitation - COVID-19 evidence-based response) action. The aim was to focus on the timely collection, review and dissemination of summarised and synthesised evidence relating to COVID-19 and rehabilitation. Cochrane Rehabilitation REH-COVER action has included in 2020 five main initiatives: 1) rapid living systematic reviews on rehabilitation and COVID-19; 2) interactive living evidence map on rehabilitation and COVID-19; 3) definition of the research topics on "rehabilitation and COVID-19" in collaboration with the World Health Organization (WHO) rehabilitation programme; 4) Cochrane Library special collection on Coronavirus (COVID-19) rehabilitation; and 5) collaboration with COVID-END for the topics "rehabilitation" and "disability." Furthermore, we are still carrying on five different special projects: Be4rehab; RCTRACK; definition of rehabilitation for research purposes; ebook project; and a prioritization exercise for Cochrane Reviews production. The Review Working Area continued to identify and "tag" the rehabilitation-relevant reviews published in the Cochrane library; the Publication Working Area went on to publish Cochrane Corners, working more closely with the Cochrane Review Groups (CRGs) and Cochrane Networks, particularly with Cochrane Musculoskeletal, Oral, Skin and Sensory Network; the Education Working Area, the most damaged in 2020, tried to continue performing educational activities such as workshops in different online meetings; the Methodology Working Area organized the third and fourth Cochrane Rehabilitation Methodological (CRM) meetings respectively in Milan and Orlando; the Communication Working Area spread rehabilitation evidences through different channels and translated the contents in different languages.


Subject(s)
COVID-19/rehabilitation , Decision Making , Pandemics , COVID-19/epidemiology , Humans , Retrospective Studies , SARS-CoV-2
10.
Arch Phys Med Rehabil ; 102(7): 1424-1430, 2021 07.
Article in English | MEDLINE | ID: covidwho-1126680

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This article introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development. The questions have been developed among the World Health Organization (WHO) Rehabilitation Programme, Cochrane Rehabilitation, and the experts of its Rehabilitation-COVID-19 Evidence-based Response Action International Multiprofessional Steering Committee. The framework is divided into 2 parts and includes 20 questions organized in 4 groups: epidemiology, and evidence at the micro- (individual), meso- (health services), and macro- (health systems) levels. The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the population with COVID-19. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management, and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.


Subject(s)
COVID-19/rehabilitation , Pandemics , Program Evaluation , Rehabilitation Research/methods , COVID-19/epidemiology , Global Health , Humans , Retrospective Studies , SARS-CoV-2 , World Health Organization
13.
Eur J Phys Rehabil Med ; 56(5): 642-651, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1024858

ABSTRACT

INTRODUCTION: This paper improves the methodology of the first edition of the rapid living systematic review started in April 2020, with the aim to gather and present the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences due to the disease and its treatment. EVIDENCE ACQUISITION: The Cochrane methodology for a rapid living systematic review was applied. Primary research papers, published from 1 January to 30 June 2020, reporting patients' data, with no limits of study design were included. Studies were categorized for study design, research question, COVID-19 phase, limitations of functioning (disability) of rehabilitation interest and type of rehabilitation service involved. Methodological quality assessment was based on the Cochrane Risk of Bias tools, and the level of evidence table (OCEBM 2011) for all the other studies. EVIDENCE SYNTHESIS: Thirty-six, out of 3703 papers, were included. One paper was of level 2 (RCT), 7 were of level 3 (2 cohort studies, 2 cross-sectional studies and 3 case-control studies), and 28 papers of level 4 (descriptive studies); 61% of papers reported epidemiological data on clinical presentations, 5 investigated natural history/determining factors, 1 searched prevalence, 2 studies reported on intervention efficacy (though not on harms), and 5 studies looked at health service organization. CONCLUSIONS: Main issues emerging from the review: it is advised to test for COVID-19 people with neurological disorders presenting with symptom changes; dysphagia is a frequent complication after oro-tracheal intubation in COVID-19 patients admitted to the ICU; after discharge, COVID-19 survivors may report persistent restrictive ventilatory deficits regardless of disease severity; there is only sparse and low quality evidence concerning the efficacy of any rehabilitation intervention to promote functional recovery; a substantial increase in resource (staff and equipment) is needed for rehabilitation.


Subject(s)
Coronavirus Infections/rehabilitation , Critical Illness/rehabilitation , Exercise Therapy/methods , Pneumonia, Viral/rehabilitation , Rehabilitation Centers/statistics & numerical data , Respiratory Therapy/methods , COVID-19 , Case-Control Studies , Cohort Studies , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Early Ambulation/methods , Female , Humans , Intensive Care Units/statistics & numerical data , Italy , Male , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Prognosis , Randomized Controlled Trials as Topic , Recovery of Function , Risk Assessment , Treatment Outcome
14.
Arch Phys Med Rehabil ; 102(1): 155-158, 2021 01.
Article in English | MEDLINE | ID: covidwho-996630

ABSTRACT

OBJECTIVES: To report the cognitive features of patients with severe coronavirus disease 2019 (COVID-19) entering the postacute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits, and to determine whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need. DESIGN: Case series. SETTING: Rehabilitation hospital. PARTICIPANTS: We assessed the general cognitive functioning through tablet-supported video calls in 9 of 12 consecutive patients (N=9) admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. Three patients were excluded based on the exclusion criteria. None of the patients presented cognitive symptoms before hospitalization. MAIN OUTCOME MEASURE: General cognitive functioning, measured using the Mini-Mental State Examination (MMSE) test. RESULTS: A general cognitive decay was observed in 3 patients (33.3%) who had a pathologic score on the MMSE, with a specific decline in attention, memory, language, and praxis abilities. The cognitive malfunctioning appears to be linearly associated with the length of stay (in d) in the intensive care unit (ICU). The longer the amount of time spent in the ICU, the lower the MMSE score, indicating a lower global cognitive functioning. CONCLUSIONS: Our results indicate that some patients with COVID-19 might also benefit from neuropsychological rehabilitation, given their possible global cognitive decay. The link between neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly toward patients who treated in the ICU, rather than toward every patient who experienced acute respiratory distress syndrome owing to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up period.


Subject(s)
COVID-19/complications , Cognition Disorders/etiology , Cognition Disorders/rehabilitation , Pneumonia, Viral/complications , Subacute Care/methods , Adult , Aged , Female , Hospitalization , Humans , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Mental Status and Dementia Tests , Middle Aged , Risk Factors , SARS-CoV-2
15.
Arch Phys Med Rehabil ; 101(11): 2027-2032, 2020 11.
Article in English | MEDLINE | ID: covidwho-709325

ABSTRACT

OBJECTIVES: To investigate the feasibility and acceptability of telemedicine as a substitute for outpatient services in emergency situations such as the sudden surge of the COVID-19 pandemic in Italy. DESIGN: Observational cohort study with historical control. SETTING: Tertiary referral outpatient institute. PARTICIPANTS: Consecutive services provided to patients with spinal disorders (N=1207). INTERVENTIONS: Telemedicine services included teleconsultations and telephysiotherapy, and lasted as long as usual interventions. They were delivered using free teleconference apps, caregivers were actively involved, and interviews and counseling were performed as usual. Teleconsultations included standard, but adapted, measurements and evaluations by video and from photographs and videos sent in advance according to specific tutorials. During telephysiotherapy, new sets of exercises were defined and recorded as usual. MAIN OUTCOME MEASURES: We compared the number of services provided in 3 phases, including corresponding periods in 2018 and 2019. During the control (30 working d) and COVID-19 surge (13d) only usual consultations and physiotherapy were provided; during the telemed phase (15d), only teleconsultations and telephysiotherapy were provided. If a reliable medical decision was not possible during teleconsultations, usual face-to-face interventions were prescribed. Continuous quality improvement questionnaires were also evaluated. RESULTS: During telemed, 325 teleconsulations and 882 telephysiotherapy sessions were provided in 15 days. We found a rapid decrease (-39%) of outpatient services from the control to the COVID-19 phase (R2=0.85), which partially recovered in the telemed phase for telephysiotherapy (from -37% to -21%; P<.05) and stabilized for teleconsultation (from -55% to -60%) interventions. Usual face-to-face interventions were required for 0.5% of patients. Patients' satisfaction with telemedicine was very high (2.8 out of 3). CONCLUSIONS: Telemedicine is feasible and allows medical professionals to continue providing outpatient services with a high level of patient satisfaction. During the current pandemic, this experience can provide a viable alternative for many outpatient services while reducing the need for travel and face-to-face contact to a minimum.


Subject(s)
Ambulatory Care/psychology , COVID-19 , Outpatients/psychology , Patient Satisfaction/statistics & numerical data , Rehabilitation/psychology , Spinal Diseases/rehabilitation , Telemedicine/methods , Adult , Ambulatory Care/methods , Cohort Studies , Feasibility Studies , Female , Humans , Italy , Male , Middle Aged , Referral and Consultation , Rehabilitation/methods , SARS-CoV-2 , Spinal Diseases/psychology
16.
Eur J Phys Rehabil Med ; 56(4): 508-514, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-603436

ABSTRACT

INTRODUCTION: This paper adds to the series of systematic rapid living reviews, started in April 2020, to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to the COVID-19 pandemic. The aim of this study was to present the results of a systematic search performed on papers published from May 1st to May 31st, 2020. EVIDENCE ACQUISITION: An extensive search on the main medical literature databases for articles published (including Epub), in English, from May 1st to May 31st, 2020 was performed, according to the methodology already described in the previous 2 rapid reviews, with 2 important improvements: first, we made the search string more comprehensive; second, we relied on accredited terminologies to describe the study designs and report the rehabilitation settings. EVIDENCE SYNTHESIS: Fifty-eight out of 618 articles were finally included for qualitative analysis. The number of primary studies has increased, with respect to the previous months, although still around 60% papers are just expert opinions. Six papers report on the prevalence and /or characteristics of emerging disability after COVID-19, 12 on rehabilitation approaches to COVID-19 patients, up to 25 on the organization of rehabilitation services after COVID-19, 13 papers on the impact of COVID-19 on health conditions of rehabilitative interest and only 2 on late complications due to COVID-19 that may be of rehabilitative interest. CONCLUSIONS: Nowadays, all patients with disability, regardless of COVID-19 infection, are suffering because of restrictions imposed to rehabilitation service delivery. Neurological involvement is often present during acute and postacute stage, conveying the risk of a long-lasting disability. Accordingly, careful neurological monitoring should be granted. Although new therapies are under development, the main gap in the available scientific literature is the lack of high-quality primary studies, so experimental studies on the effects of rehabilitation are still warranted.


Subject(s)
Betacoronavirus , Coronavirus Infections/rehabilitation , Pandemics , Pneumonia, Viral/rehabilitation , Qualitative Research , Rehabilitation Centers/statistics & numerical data , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
17.
Eur J Phys Rehabil Med ; 56(3): 354-360, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-271764

ABSTRACT

INTRODUCTION: This paper adds to the series of systematic rapid living reviews, started in April 2020, to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to COVID-19 pandemic. The aim of this paper is to present the results of a systematic scientific literature search performed on papers published from April 1st to April 30th, 2020. EVIDENCE ACQUISITION: A systematic search was performed on PubMed, Embase, Scopus, CINAHL, PEDro, Web of Science and the main international guideline databases for articles published (including Epub), in English, from April 1st to April 30th, 2020. Papers were included if they reported on one of the following: 1) prevalence and features of the emerging disability after COVID-19; 2) rehabilitation strategies applied for COVID-19 patients, regardless of setting or stage; 3) information about rehabilitation services after COVID-19; 4) impact on diseases of rehabilitative interest; 5) complications of rehabilitative interest. EVIDENCE SYNTHESIS: Out of 445 articles retrieved for the time frame, 50 were finally included for qualitative analysis. They consist of seven guidelines, one scoping review, one randomized controlled trial, four descriptive studies (qualitative), one case series, one case report, and 35 expert opinions. CONCLUSIONS: This systematic rapid living review showed an increasing evidence on rehabilitation needs due to COVID-19 outbreak during April 2020. The main novelties include: 1) the first appearance of epidemiological data on the likely high incidence of neurological complications/disabling sequelae in patients hospitalized for COVID-19; 2) rapid guidelines on the management of chronically disabled patients in the COVID-19 era; 3) advices to provide COVID-19 patients with early respiratory rehabilitation in the acute phase, and with telemonitoring and telerehabilitation in the post-acute phase. Although the overall quality of studies has increased, prospective cohort studies on disability course in COVID-19 pandemic and experimental studies on the effects of rehabilitation are still warranted.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/rehabilitation , Health Services Needs and Demand , Pneumonia, Viral/epidemiology , Pneumonia, Viral/rehabilitation , Rehabilitation , COVID-19 , Coronavirus Infections/complications , Humans , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2
18.
Eur J Phys Rehabil Med ; 56(3): 361-365, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-209492

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having a great impact on health services. Patients not receiving care due to closure of outpatient services suffer a collateral damage. Our aim was to provide first data on impact of COVID-19 on people experiencing disability in Europe. METHODS: We developed an estimation from a survey and publicly available data. Thirty-eight countries have been inquired through the European Bodies of Physical and Rehabilitation Medicine - the rehabilitation medical specialty. The nine questions of the survey focused on March 31st, 2020. We used the following indicators: for inpatients, acute and rehabilitative hospital beds; for outpatients, missing uniform European data, we used information from Italy, Belgium and the UK, and estimated for Europe basing on population, number of rehabilitation physicians, physiotherapists, and people with self-reported limitations. RESULTS: Thirty-five countries (92%) including 99% of the population (809.9 million) answered. Stop of admissions to rehabilitation, early discharge and reduction of activities involved 194,800 inpatients in 10 countries. Outpatient activities stopped for 87%, involving 318,000 patients per day in Italy, Belgium and the UK, leading to an estimate range of 1.3-2.2 million in Europe. Seven countries reported experiences on rehabilitation for acute COVID-19 patients. CONCLUSIONS: COVID-19 emergency is having a huge impact on rehabilitation of people experiencing disability. This may lead to future cumulative effects due to reduced functional outcome and consequent increased burden of care. When the emergency will fade, rehabilitation demand will probably grow due to an expected return wave of these not well treated patients, but probably also of post-COVID-19 patients' needs.


Subject(s)
Betacoronavirus , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Disabled Persons/rehabilitation , Health Services Accessibility/organization & administration , Physical and Rehabilitation Medicine/organization & administration , Pneumonia, Viral/epidemiology , COVID-19 , Coronavirus Infections/prevention & control , Disabled Persons/psychology , Disabled Persons/statistics & numerical data , Europe , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Social Isolation
19.
Eur J Phys Rehabil Med ; 56(3): 327-330, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-116443

ABSTRACT

COVID-19 pandemic is creating collateral damage to outpatients, whose rehabilitation services have been disrupted in most of the European countries. Telemedicine has been advocated as a possible solution. This paper reports the contents of the third Italian Society of Physical and Rehabilitation Medicine (SIMFER) webinar on "experiences from the field" COVID-19 impact on rehabilitation ("Covinars"). It provides readily available, first-hand information about the application of telemedicine in rehabilitation. The experiences reported were very different for population (number and health conditions), interventions, professionals, service payment, and technologies used. Commonalities included the pushing need due to the emergency, previous experiences, and a dynamic research and innovation environment. Lights included feasibility, results, reduction of isolation, cost decrease, stimulation to innovation, satisfaction of patients, families, and professionals beyond the starting diffidence. Shadows included that telemedicine can integrate but will never substitute face-to-face rehabilitation base on the encounter among human beings; age, and technology barriers (devices absence, bad connection and human diffidence) have also been reported. Possible issues included privacy and informed consent, payments, cultural difficulties in understanding that telemedicine is a real rehabilitation intervention. There was a final agreement that this experience will be incorporated by participants in their future services: technology is ready, but the real challenge is to change PRM physicians' and patients' habits, while better specific regulation is warranted.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Physical and Rehabilitation Medicine/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Telemedicine/organization & administration , COVID-19 , Humans , Italy , Pandemics , SARS-CoV-2
20.
Eur J Phys Rehabil Med ; 56(3): 347-353, 2020 06.
Article in English | MEDLINE | ID: covidwho-102324

ABSTRACT

INTRODUCTION: The outbreak of COVID-19 epidemics has challenged the provision of health care worldwide, highlighting the main flaws of some national health systems with respect to their capacity to cope with the needs of frail subjects. People experiencing disability due to COVID-19 express specific rehabilitation needs that deserve a systematic evidence-based approach. The aim of this article is to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to COVID-19. The first rapid "living" review will present the results of a systematic search performed up to March 31st, 2020. EVIDENCE ACQUISITION: A systematic search in PubMed, Pedro, and Google Scholar was performed using the search terms: "COVID-19," "Coronavirus," "severe acute respiratory syndrome coronavirus 2," "rehabilitation," "physical therapy modalities," "exercise," "occupational therapy," and "late complications." Papers published up to March 31st, 2020, in English, were included. EVIDENCE SYNTHESIS: Out of the 2758 articles retrieved, nine were included in the present review. Four of them are "calls for action", three provide recommendations about rehabilitation interventions in the acute phase, two address the needs of people quarantined at home or with restricted mobility due to the lockdown, and one provides a Core Outcome Set to be used in clinical trials to test the efficacy of health strategies in managing COVID-19 patients. CONCLUSIONS: All selected papers were based on previous literature and not on the current COVID-19 pandemic. Main messages included: 1) early rehabilitation should be granted to inpatients with COVID-19; 2) people with restricted mobility due to quarantine or lockdown should receive exercise programs to reduce the risk of frailty, sarcopenia, cognitive decline and depression; 3) telerehabilitation may represent the first option for people at home. Further updates are warranted in order to characterize the emerging disability in COVID-19 survivors and the adverse effects on the health of chronically disabled people.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/rehabilitation , Health Services Needs and Demand , Pneumonia, Viral/epidemiology , Pneumonia, Viral/rehabilitation , Rehabilitation , COVID-19 , Coronavirus Infections/complications , Humans , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL