Influence of massage on respiratory and circulatory parameters in a post- COVID-19 patient: a case study

Monitoring the SaO2 levels and other respiratory function parameters after recovering from COVID-19 can have essential meaning in the assessment of the efficacy of using physiotherapy methods, including classical massage. Purpose of the research was to assess the influence of an individual classical back massage session as well as the effects of an entire 8-session back massage therapy on SaO2, HR and spirometry parameters in a patient after recovering from COVID-19, with constant monitoring of massage areas' temperature changes. Data and methods. The study comprised a case study of a patient who recovered from COVID-19. The patient was subjected to a classical back and spine massage therapy utilising all the basic techniques. The design was based on the results of the following tests: lung x-ray, SaO2, HR, spirometry parameters, and the 6-minute walking distance test. The degree of the influence of the classical massage techniques was monitored using the infrared thermography. Results. Continuous oxygen saturation monitoring during the massage sessions enabled to observe a decrease in the level of this parameter during utilisation of rubbing and tapotement on muscles of both the right and the left side of the back. During the usage of the intense massage techniques SaO2 dropped maximally to 92-93%. Such decrease was noted after massaging the right as well as the left side of the back, during every massage session. I addition it was found that in the case of the patient who recovered from COVID-19 changing the body position from sitting down to lying down after the massage session the level of tissues saturation decreased. The observed changes in the VA/Q ratio that occurred in response to the 8-session massage therapy lasting for 3 weeks might indicate that better conditions for ventilation and oxygen perfusion at the alveolar surface were reached. This translated in the patient who recovered from COVID-19 into 2% increase in oxygen saturation level after completing the massage therapy. Conclusion. Utilising the intense rubbing and tapotement techniques has to be carefully considered due to their significant influence on decrease in the level of saturation.

Patient's perspectives of treatment satisfaction and efficiency of the 2:1 clinical education model in physical therapy rehabilitation

Managing clinical education placements in physical therapy and physical therapy assistant programs continue to evolve to meet the needs of accredited programs (Commission on Accreditation in Physical Therapy Education [CAPTE], 2021b). The onset of COVID-19, the increased market demand, and the rise of more universities' program growth in physical therapy created a need for increased clinical placements. The 2:1 model has the potential to increase available placements. However, the implementation is slow due to resistance and obstacles. The 2:1 clinical model differs from the 1:1 model because it adds another student in the clinical experience for the clinical instructor;therefore, one clinical instructor mentors two students simultaneously. Research on the 2:1 model explored the viewpoints of clinical instructors, students,academia, and clinical site coordinators and lacked patient perspectives. This qualitative multiplecase study included an exploration of the patient's perspective of treatment satisfaction and efficiency of the 2:1 clinical education model. Reflexive thematic analysis, RA, was the method applied to the data obtained through semi-structured interviews. RA uses an inductive approach in qualitative studies for healthcare research without a predetermined set of codes or a codebook(Braun et al., 2021, 2014). Kotter's Change Management Model, KCMM, was the theoretical framework for this study. The first step is to create a sense of urgency, accomplished by the COVID-19 pandemic, market demand, and an increase in physical therapy and physical therapist university programs. This study focused on the second step, which is to create a guiding coalition of all the stakeholders. Obtaining patient perspectives was essential, as it was missing from previous research. Patients are the stakeholders who are usually the primary stakeholder for quality control in healthcare. The positive results of this study about satisfaction and effectiveness of the 2:1 model were from seven participants of diverse ages, locations, treatment settings, and diagnoses and supported 2:1 model in physical therapy and physical therapist assistant clinical education. By gaining insight from a primary stakeholder contributed to the gap in the literature and supported implementing a change initiative for the 2:1 model. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

THE EFFECTS OF SPINAL STABILIZATION EXERCISES VIA TELEREHABILITATION ON INDIVIDUALS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY

BackgroundChronic low back pain is a very common problem worldwide. Reasons such as repetitive problems and lack of a clear treatment cause low back pain to be a serious burden for society [1]. Telerehabilitation provides remote application of rehabilitation services with the developing technology. Especially in the COVID-19 pandemic, the problems experienced in health services have increased the popularity of telerehabilitation services [2].ObjectivesAim in this study is to investigate the effects of spinal stabilization exercises performed remotely with asynchronous video clips on pain, disability, quality of life, trunk flexion range of motion and gait parameters.MethodsA total of 20 individuals with chronic low back pain were included in the study. After recording demographic information, pain levels were evaluated with the Visual Analogue Scale (VAS), disability levels were evaluated with the Oswestry Disability Index (ODI), and quality of life was evaluated with the Nottingham Health Profile (NHP). Trunk flexion range of motion was evaluated with the Valedo ® system (Hocoma, Switzerland), and the spatiotemporal parameters of the gait (step time, cadance) were evaluated with the OPTOGAIT system (OPTOGait, Microgate, Italy). After the evaluation, the individuals were divided into 2 groups. One group did face-to-face progressive spinal stabilization exercises in the clinic, while the other group did the same exercise program remotely with asynchronous videos. The exercise program was 8 weeks, 3 days a week.ResultsThe mean age of the telerehabilitation group (4 M, 5 F) was 41.44 ± 9.74, and their body mass index (BMI) was 26.34 ± 3.1. The mean age of the clinical group (1 M, 8 F) was 41.0 ± 13.0, and their BMI was 27.64 ± 3.55. All parameters were similar in the two groups before treatment. There was a significant difference in parameters except gait parameters in both groups after treatment (p<0.05). In the evaluation between the groups after treatment, the results of the two groups were similar in all parameters (p>0.05) (Table 1).Table 1.Baseline and after treatment characteristics of telerehabilitation and face to face group and comparison of with-in group and between groupTelerehabilitationFace to FaceBaselineAfter Treatmentp valueBaselineAfter Treatmentp valueBetween GroupVAS6.51±1.612.41±1.170.00*6.62±0.952.33±1.980.00*0.79ODI20.66±9.9413.55±100.00*30.22±15.517.11±120.02*0.54NHP131.51±121.2934.0±29.610.01*203.55±60.0763.08±76.240.00*0.66Trunk Flexion Range of Motion99.55±12.24106.55±7.510.04*88.11±15.2694.11±15.180.00*0.09Step length (cm)60.67±9.0764.35±9.580.5153.82±2165.95±9.410.170.54Step Time (sec)0.55±0.040.51±0.080.260.40±0.120.34±0.180.130.06Cadance105.67±9.17106.13±17.460.44103.37±8.64105.31±9.450.670.73ConclusionAccording to the results of our study, it is seen that both methods did not provide any change in gait parameters. However, it has similar effects in reducing pain and disability, improving quality of life, and increasing trunk range of motion. For individuals with chronic low back pain, it seems that remote exercise with asynchronous videos can be as effective a treatment as face-to-face exercise. There is a need for studies to be conducted in a larger population with longer follow-up.References[1] Anderson GB. epidemiological features of chronicles low back pain _ the lance _ 1999;354(9178):581-5.[2] Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal physical therapy during the COVID-19 pandemic: is telerehabilitation the answer? Phys. ther. 2020;100(8): 1260-4.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The Psychological Impacts of Taking Physiotherapy Teaching Online in 2020: What Did We Learn?

Introduction. The rapid shift to online learning due to the COVID-19 pandemic presented challenges for physical therapy (PT) education worldwide. This article aims to explore the factors influencing the well-being of the PT faculty and department chairs involved in delivering PT programs during the initial stages of the COVID-19 pandemic. Review of Literature. The literature has focused on the pedagogical impacts of the rapid shift to online learning. Little is known about the social and psychological impacts of this rapid transition on the well-being of the faculty involved in implementing PT programs. Subjects. Physical therapy faculty and department chairs at 3 universities in metropolitan Sydney, Australia who taught into or led PT programs in 2020. Methods. Focus group methodology was used to explore the experiences of PT faculty and department chairs during the initial stages of the COVID pandemic. The focus groups were digitally recorded and transcribed verbatim and the transcripts analyzed thematically. Results: The main finding of this study was the extent of stress experienced by PT program faculty and chairs during this period. Both work-related institutional and faculty factors and non-work-related personal factors contributed to perceived high levels of stress. Overall, there was a feeling that the stressors had not improved over the duration of the pandemic and that this had left the faculty and chairs feeling more fatigued, less collegiate, and may have ongoing impacts on their mental health. Discussion: The pandemic created stresses for faculty and program chairs over and above the usual stress of faculty and college work. The reality of taking steps to reduce the stressors in the current climate is very difficult. Conclusion. Moving forward, it is vital to secure increased institutional support, including the support for creating realistic boundaries without the risk of penalty, to address the psychological health and well-being of PT faculty and chairs to enable high-quality education in the future. Copyright © 2023 Academy of Physical Therapy Education, APTA.

Instrument-assisted soft tissue mobilization versus myofascial release therapy in treatment of chronic neck pain: a randomized clinical trial.

OBJECTIVE: The purpose of this study was to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) versus myofascial release therapy (MRT) on college students with chronic mechanical neck pain (CMNP). METHODS: Thirty-three college students with a mean age of 21.33 ± 0.98 involved in distance learning due to the Corona Virus 2019 (COVID-19) restriction were randomized to receive either IASTM on the upper trapezius and levator scapulae muscles or MRT. Researchers measured their pain with a visual analog scale (VAS), function with neck disability index (NDI), and pain pressure threshold (PPT) with a pressure algometer. The subjects received eight therapy sessions over four weeks and outcome measures were assessed pre and post-intervention. The study was registered as a clinical trial on clinicaltrials.gov (registration number: NCT05213871). RESULT: Unpaired t-test showed no statistical significance between the two groups post-intervention regarding improvement in pain, function, and PPT (p > 0.05). CONCLUSION: This study showed insignificant differences between groups. However, we did not use a control group, indicating that the improvement in outcomes may not have been caused by the intervention. STUDY DESIGN: Quasi-experimental two groups pre-posttest clinical trial. LEVEL OF EVIDENCE: Therapy, level 2b.

Rehabilitation of a Child with Neonatal Brachial Plexus Palsy: Case Report Described by Parents.

This paper presents a case report of a child with Neonatal Brachial Plexus Palsy on the right arm, with C5, C6, and C7 nerve injuries. The symptoms presented at birth and at the time of diagnosis were absence of movement in the right arm but with mobility of the fingers; internal rotation of the injured limb with elbow extension; active flexion of the wrist and fingers; and ulnar deviation of the hand. The rehabilitation plan followed the conservative approach and included different intervention strategies (passive and active mobilisation, kinesio tape, use of splints, bimanual stimulation, etc.) carried out by the occupational therapist and the physical therapist. The rehabilitation allowed the child to have a functional limb for daily activities, with bimanual motor integration and coordination; passive and active range of motion in the different joints except for pronation, sensibility, and maintained strength. In conclusion, it can be said that this case report describes a set of rehabilitation strategies that were used in the conservative treatment of a child with NBPP and the functional gains they allowed. Early intervention, parental involvement in the rehabilitation process, and continuous follow-up of the child favoured the prognosis and allowed the prevention of functional sequelae of the limb.

The Role of the Physical Therapist in Cystic Fibrosis Care.

In looking back on 2020 and 2021, this Perspective reflects on the monumental impacts of the rollout of cystic fibrosis (CF) transmembrane conductance regulator highly effective modulator therapies and the COVID-19 pandemic on the management of CF. Advancements in the clinical management of people with CF have been both enormous and rapid, and physical therapists specializing in the care of people with CF have been at the forefront of driving this evolution in care. This year sees the thirtieth anniversary of the UK Association of Chartered Physiotherapists in Cystic Fibrosis and, as is inevitable in reaching such milestones, thoughts have turned to origins, role, impacts, and the future. With the changing demographics of the population of people with CF after the introduction of highly effective modulator therapies, potentially with fewer secondary complications, the future role of the physical therapist who specializes in CF is in question. This Perspective reflects upon and highlights the role of physical therapy within CF and provides insights into how physical therapists and respiratory therapists can evolve their roles to ensure relevance for the future.

Qualitative exploration of physical therapists' experiences providing telehealth physical therapy during COVID-19.

BACKGROUND: Physical therapists are trained to provide treatment to patients through a mixture of strategies. The coronavirus (COVID-19) pandemic resulted in social distancing restrictions, and physical therapists, some without previous experience, adopted telehealth physical therapy modalities to treat their patients. OBJECTIVES: The objective of this study was to explore physical therapists' experiences of providing telehealth physical therapy during the COVID-19 pandemic. DESIGN AND METHODS: A multisite qualitative semi-structured interview study was conducted. Seventeen physical therapists were interviewed by videoconference or by phone, and the interviews were transcribed and analyzed thematically. RESULTS: Three main themes emerged from the study. Firstly, physical therapists experienced professional challenges with diagnosing and treating patients hands-off and becoming more verbal. Secondly, telehealth physical therapy was perceived as not feasible or effective for certain patients, attesting to the digital care divide. Lastly, participants' perceptions of patient-therapist communication varied, expressing both communicative advantages and challenges. CONCLUSIONS: Physical therapists who practiced telehealth physical therapy during the COVID-19 period experienced information and communication technology as professionally challenging. Physical therapists adapted positively to the use of telehealth physical therapy but perceived that not every patient could benefit from it. The study emphasized the need for a better understanding of physical therapists' hands-off skills for practicing telehealth physical therapy and considers the need to establish a patient classification for telehealth physical therapy.

From Strict Bedrest to Early Mobilization: A History of Physiotherapy in the Intensive Care Unit.

Critically ill patients are at risk of post-intensive care syndrome, including physical, cognitive, and psychological sequelae. Physiotherapists are rehabilitation experts who focus on restoring strength, physical function, and exercise capacity. Critical care has evolved from a culture of deep sedation and bed rest to one of awakening and early mobility; physiotherapeutic interventions have developed to address patients' rehabilitation needs. Physiotherapists are assuming more prominent roles in clinical and research leadership, with opportunities for wider interdisciplinary collaboration. This paper reviews the evolution of critical care from a rehabilitation perspective, highlights relevant research milestones, and proposes future opportunities for improving survivorship outcomes.

The Role of Acute Rehabilitation during the COVID-19 Pandemic: A Retrospective Study in the Czech Republic.

In this retrospective study, we used data from the hospital information system (HIS) to evaluate the influence of the COVID-19 pandemic on rehabilitation care at the University Hospital of Ostrava (UHO). From March 2020 to December 2021, 5173 COVID-19 cases were hospitalized at UHO. Cases within individual groups and categories are shown in a flowchart. The average patient age was 64.9 ± 16.9 years. The mean BMI value was 30.6 ± 6.8 in the rehabilitated group, which was significantly higher compared to that among the non-rehabilitated cases 29.1 ± 6.9 (p < 0.001). Among the admitted patients, 16.6% required artificial pulmonary ventilation (APV), 1.8% extracorporeal membrane oxygenation (ECMO), and 11.9% high-flow oxygenation (HF). The days of rehabilitation ranged from 1-102 days. Among all rehabilitated patients, 92.0% (n = 1302) had a hospitalization duration ranging from 1-15 days and 8.0% (n = 114) longer than 15 days. Overall, rehabilitation care plays an important role in providing exercise, mobilization, and rehabilitation interventions to survivors of critical illness associated with COVID-19, enabling the early and functional return to home, and it must, therefore, be integrated into the clinical care of patients with COVID-19.

Exploring the Influence of the Coronavirus Disease 2019 Pandemic on the Accessibility of Rehabilitation Services Provided to Children with Disabilities: A Cross-Sectional Study.

Background and Objectives: Children with disabilities (such as cerebral palsy, autistic spectrum disorder, and Down syndrome) are the most vulnerable and marginalized subset of the population, representing 2.7% of the total population of Saudi Arabia. The COVID-19 outbreak might have disproportionately affected children with disabilities, augmented their isolation, and induced severe disruptions to the services on which these children rely. Limited research has been conducted in Saudi Arabia to understand the impact of the COVID-19 pandemic on the rehabilitation services provided to children with disabilities and barriers. This study aimed to investigate the effect of the lockdown implemented as a result of the coronavirus disease-2019 (COVID-19) pandemic on the accessibility of rehabilitation services, including communication, occupational therapy, and physical therapy, in Riyadh, Kingdom of Saudi Arabia. Materials and Methods: In this cross-sectional study, a survey was conducted between June and September 2020 during the lockdown in Saudi Arabia. A total of 316 caregivers of children with disabilities from Riyadh participated in the study. The accessibility of rehabilitation services provided to children with disabilities was assessed by designing a valid questionnaire. Results: A total of 280 children with disabilities received rehabilitation services before the COVID-19 pandemic and showed improvement following therapeutic sessions. However, during the pandemic, most children stopped receiving therapeutic sessions because of lockdown, which deteriorated their condition. This shows a significant reduction in the accessibility of the rehabilitation services provided during the pandemic. Conclusions: The findings of this study revealed a drastic decline in services provided to children with disabilities. This caused a notable deterioration in the abilities of these children.

Development, Implementation and Evaluation of an Acute Care Physical Therapy 'Float' Placement during the COVID-19 Pandemic: A Case Report.

Clinical education is a mandatory component of physical therapy curricula globally. COVID-19 disrupted clinical education, jeopardizing students' abilities to meet graduation requirements. The objective of this case report is to outline the development, implementation and evaluation of a multiple clinical instructor (CI), multiple unit, acute care float clinical placement for a final year, entry-level physical therapy student and offer implementation recommendations. This placement included an eight-week, multiple CI (one primary, four supporting), multiple (five) unit clinical placement which was developed between St. Joseph's Healthcare and the McMaster University Masters of Science (Physiotherapy) Program between 10 August and 2 October 2020. Student evaluations and reflections by the student and CIs were collected and analyzed using interpretive description. Analysis from the reflections revealed six themes: (1) CI and student attributes; (2) increased feasibility; (3) varied exposure; (4) central communication and resources; (5) organization; and (6) managing expectations. An acute care clinical experience is required for students in Canadian entry-to-practice physical therapy programs. Due to COVID-19, placement opportunities were limited. The float placement allowed clinicians to offer supervision despite staff re-deployment and increased organizational and work-life pressures during the pandemic. This model provides an approach to extenuating circumstances and may also increase acute care placements during non-pandemic times for physical therapy and other similarly structured healthcare professions.

Role of Oral Intake, Mobility, and Activity Measures in Informing Discharge Recommendations for Hospitalized Inmate and Noninmate Patients With COVID-19: Retrospective Analysis.

BACKGROUND: Patients who were incarcerated were disproportionately affected by COVID-19 compared with the general public. Furthermore, the impact of multidisciplinary rehabilitation assessments and interventions on the outcomes of patients admitted to the hospital with COVID-19 is limited. OBJECTIVE: We aimed to compare the functional outcomes of oral intake, mobility, and activity between inmates and noninmates diagnosed with COVID-19 and examine the relationships among these functional measures and discharge destination. METHODS: A retrospective analysis was performed on patients admitted to the hospital for COVID-19 at a large academic medical center. Scores on functional measures including the Functional Oral Intake Scale and Activity Measure for Postacute Care (AM-PAC) were collected and compared between inmates and noninmates. Binary logistic regression models were used to evaluate the odds of whether patients were discharged to the same place they were admitted from and whether patients were being discharged with a total oral diet with no restrictions. Independent variables were considered significant if the 95% CIs of the odds ratios (ORs) did not include 1.0. RESULTS: A total of 83 patients (inmates: n=38; noninmates: n=45) were included in the final analysis. There were no differences between inmates and noninmates in the initial (P=.39) and final Functional Oral Intake Scale scores (P=.35) or in the initial (P=.06 and P=.46), final (P=.43 and P=.79), or change scores (P=.97 and P=.45) on the AM-PAC mobility and activity subscales, respectively. When examining separate regression models using AM-PAC mobility or AM-PAC activity scores as independent variables, greater age upon admission decreased the odds (OR 0.922, 95% CI 0.875-0.972 and OR 0.918, 95% CI 0.871-0.968) of patients being discharged with a total oral diet with no restrictions. The following factors increased the odds of patients being discharged to the same place they were admitted from: being an inmate (OR 5.285, 95% CI 1.334-20.931 and OR 6.083, 95% CI 1.548-23.912), "Other" race (OR 7.596, 95% CI 1.203-47.968 and OR 8.515, 95% CI 1.311-55.291), and female sex (OR 4.671, 95% CI 1.086-20.092 and OR 4.977, 95% CI 1.146-21.615). CONCLUSIONS: The results of this study provide an opportunity to learn how functional measures may be used to better understand discharge outcomes in both inmate and noninmate patients admitted to the hospital with COVID-19 during the initial period of the pandemic.

Reflections on Digital Physiotherapy

The COVID-19 pandemic has brought with it a new way of caring for patients by health professionals. In physiotherapy, implementing the digital component in the field of telehealth is seen as an effective care alternative that should be investigated and regulated in all population groups. Although its advantages are reported, it is still too early to know its full scope;therefore, it is convenient to expand its disciplinary construction with a view to improving professional practice.

Rehabilitation

Many patients hospitalized due to COVID-19 presented with varying degrees of impairments and disabilities mostly attributed to prolonged ICU stay. The consequences of severe respiratory illness and longer duration of ICU stay can lead to long-term physical, emotional, and cognitive dysfunction. The rehabilitation department at SBH Health System had its own set of challenges and had to quickly adapt to constant changes and needs of the patients. This chapter focuses on the important role of rehabilitation in pandemic response, restoring function, and recovery of COVID-19 survivors. It outlines the effectiveness of prone positioning and early mobilization that can make a significant difference in the patients' long-term quality of life. The integrated approach to discharge planning with multidisciplinary involvement facilitated a smooth transition from the hospital to their home. This helped as demands for post-acute care needs increased whether it was skilled nursing facilities for short-term rehabilitation, home care services, or outpatient services, including virtual rehabilitation or telehealth. © SBH Health System 2022.

Evolution of functionality and muscle strength from intensive care to hospitalization in survivors of COVID-19

Introduction: The critically ill patient hospitalized in intensive care unit (ICU), has a higher risk of deterioration in physical function. One way to counteract its related to early physiotherapy intervention, but there are few reports in patients with severe disease from COVID-19. Objective: To describe the compromise and change in functionality and muscle strength in patients with COVID-19 who received early physiotherapy intervention in ICU until hospital discharge and compare the evolution according to whether or not they received invasive mechanical ventilation. Methodology: Retrospective study of patients with COVID-19 admitted to the ICU between March and September 2020 and received physiotherapy intervention. Functionality was assessed with the Barthel Index (BI) and muscle strength with the Medical Research Council Sum Score (MRC-SS), which were measured by the physiotherapist at two moments, upon discharge from ICU and from hospitalization. For the correlations, a value P<.05 was considered significant. Results: Sixty-six records were reviewed;the mean age was 53.3 (32±11.5) years;32 (48.5%) required mechanical ventilation. Compromise in functionality and muscle strength was observed, with progressive improvement before hospital discharge: IB [64.1 (± 34.7) vs. 87.7 (± 18.4), P =.000], MRC-SS [40.5 (± 11) vs. 48 (± 9), P =.000]. The group of ventilated patients presented greater compromise: IB [34.2 (± 24.7) vs. 76.7 (± 21.2), P =.000] and MRC-SS [31.5 (± 7.2) vs. 42.3 (± 8.3), P =.000]. The days of mechanical ventilation, relaxation, and higher APACHE II showed a significant negative correlation with the outcome variables (P =.000). Conclusions: Patients with severe disease from COVID-19 who received physiotherapy intervention, showed significant changes in functionality and muscle strength. The patients who required mechanical ventilation presented greater functional compromise. © 2023 Asociación Española de Fisioterapeutas

Acute inpatient rehabilitation for COVID-19 survivors: A retrospective case series.

BACKGROUND: Patients with Coronavirus Disease 2019 (COVID-19) who required mechanical ventilation and had prolonged hospital stay present with medical instability and functional impairments after the acute hospitalization. OBJECTIVE: To present the rehabilitation outcome of three patients with COVID-19 admitted to an inpatient rehabilitation unit using a case series method. METHODS: Subjects included three consecutive male patients admitted to the rehabilitation unit with a diagnosis of deconditioning and critical illness myopathy. On admission, patients were evaluated by a multidisciplinary team using outcome measures such as 6-min walk test (6 MWT), 10-m walk test (10 MWT), berg balance scale (BBS), and dynamometry. Each patient received daily therapy with a minimum of 900 min per week during their rehabilitation stay. Treatment strategies included fatigue management, training of mobility and activities for daily living tasks, muscle strengthening, and cognitive retraining. RESULTS: All patients showed significant improvements across all the outcome measures, specifically, the 6MWT (minimal clinically identifiable difference (MCID) range: 14-30.5 m) and the 10MWT (MCID range: 0.10-0.20 m/s) which exceeded the MCID for all three patients. The BBS also demonstrated significant improvement, surpassing the minimum detectable change of 5-7 points. Of the three patients, two were able to be discharged at an independent level, while one required supervision for safety. CONCLUSION: Patients with COVID-19, who experienced prolonged hospital stay present with severe impairments in muscle strength, functional mobility, and participation in daily living tasks. Inpatient rehabilitation may have the potential to reduce impairments and accelerate the recovery process while managing ongoing medical issues.

The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes-a systematic review and meta-analysis protocol.

BACKGROUND: The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. METHODS: A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. DISCUSSION: The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. TRIAL REGISTRATION: This systematic review has been registered with PROSPERO under registration number CRD42022297849.

Association between GHQ-12, Duke-UNC-11, Physical Activity, and Self-Perceived Health in Spanish Adults with Cancerous Tumours: A Cross-Sectional Study.

Background: In Spain, people who have overcome some type of cancer have significantly worse self-perceived health (SPH) and higher rates of depression than people who have never suffered any type of cancer. Objective: to explore the relationships among physical activity levels (PAL), perceived social support (PSS), and SPH in terms of mental health and its dimensions in Spanish adults with cancerous tumours. Methods: A correlational study rooted in the National Health Survey 2017 for adults was carried out, including 627 Spanish residents who reported having malignant tumours. Results: A dependent association was found between PAL and SPH (p < 0.001). The mental health mean score decreased as PAL increased for the total sample and for both sexes, separately (p < 0.001). Low reverse associations were also observed between PAL and mental health (rho: −0.274; p < 0.001), successful coping (rho: −0.239; p < 0.001) and self-confidence (rho: −0.264; p <0.001). Moreover, PSS weakly and inversely correlates with mental health (r: −0.225; p < 0.001), successful coping (r: −0.218; p < 0.001) and self-confidence (r: −0.231; p < 0.001). A binary logistic model showed that active and very active people presented less threat of poor SPH, as did people with higher PSS (p < 0.001). Conclusions: Greater levels of physical activity are associated with larger mean scores in the three dimensions of mental health, perceived social support and self-perceived health in people with cancerous tumours.