ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic and the response to the pandemic are combining to produce a tidal wave of need for rehabilitation. Rehabilitation will be needed for survivors of COVID-19, many of whom are older, with underlying health problems. In addition, rehabilitation will be needed for those who have become deconditioned as a result of movement restrictions, social isolation, and inability to access healthcare for pre-existing or new non-COVID-19 illnesses. Delivering rehabilitation in the same way as before the pandemic will not be practical, nor will this approach meet the likely scale of need for rehabilitation. This commentary reviews the likely rehabilitation needs of older people both with and without COVID-19 and discusses how strategies to deliver effective rehabilitation at scale can be designed and implemented in a world living with COVID-19.
Subject(s)
Aging , Chronic Disease , Coronavirus Infections , Delivery of Health Care , Health Services Accessibility/standards , Pandemics , Pneumonia, Viral , Rehabilitation , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Chronic Disease/epidemiology , Chronic Disease/rehabilitation , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Coronavirus Infections/rehabilitation , Delivery of Health Care/methods , Delivery of Health Care/trends , Forecasting , Health Services Needs and Demand , Humans , Organizational Innovation , Physical Functional Performance , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Pneumonia, Viral/rehabilitation , Recovery of Function , Rehabilitation/methods , Rehabilitation/organization & administration , Rehabilitation/trends , SARS-CoV-2ABSTRACT
Severe acute respiratory syndrome coronavirus 2-also known as COVID-19-is primarily known for respiratory illness. Although it is clear that patients with moderate to severe cases of COVID-19 will require pulmonary rehabilitation, physiatrists will need to consider effective management plans for COVID-19 survivors with extrapulmonary involvement. This report will summarize key nonpulmonary considerations to guide rehabilitation clinicians who may be involved in the care of COVID-19 survivors with the best available early evidence.
Subject(s)
Chronic Disease/rehabilitation , Coronavirus Infections/complications , Pandemics/statistics & numerical data , Physiatrists/standards , Physical and Rehabilitation Medicine/standards , Pneumonia, Viral/complications , Practice Guidelines as Topic/standards , COVID-19 , Coronavirus Infections/rehabilitation , Female , Follow-Up Studies , Global Health , Humans , Male , Pneumonia, Viral/rehabilitation , Risk Assessment , Severe Acute Respiratory Syndrome/physiopathology , Severe Acute Respiratory Syndrome/rehabilitation , Severity of Illness Index , Survivors/statistics & numerical data , Time Factors , Treatment OutcomeABSTRACT
More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.
Subject(s)
Chronic Disease/rehabilitation , Critical Care , Critical Illness/rehabilitation , Home Care Services , Patient Discharge , Physical Therapy Modalities , Betacoronavirus , COVID-19 , Cognitive Dysfunction/etiology , Cognitive Dysfunction/rehabilitation , Coronavirus Infections , Humans , Pandemics , Pneumonia, Viral , SARS-CoV-2Subject(s)
Chronic Disease/rehabilitation , Coronavirus Infections/rehabilitation , Critical Illness/rehabilitation , Pneumonia, Viral/rehabilitation , Survivorship , Anxiety/psychology , Anxiety/rehabilitation , Betacoronavirus , COVID-19 , Chronic Disease/psychology , Cognitive Dysfunction/rehabilitation , Contracture/rehabilitation , Critical Illness/psychology , Depression/psychology , Depression/rehabilitation , Humans , Intensive Care Units , Muscle Weakness/rehabilitation , Pandemics , Polyneuropathies/rehabilitation , Quality of Life , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/rehabilitation , Wasting Syndrome/rehabilitationABSTRACT
The spread of coronavirus disease 2019 (COVID-19) has placed many individuals in need of critical care, with a high proportion of hospitalized patients being admitted to intensive care units (ICU) to treat acute outcomes of COVID-19 (e.g., respiratory failure via mechanical ventilation). The ICU is known to be a setting where individuals are at a high risk of experiencing significant psychological difficulties, and patients with COVID-19 are particularly susceptible to such experiences, which can impact their recovery process (e.g., postintensive care syndrome). This article seeks to highlight the intersection between critical care related to trauma and COVID-19 and point providers toward opportunities for anticipating and managing secondary effects in effort to promote psychological adaptation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).