What can we learn from the Baduanjin rehabilitation as COVID-19 treatment?: A narrative review.

AIM: To understand Baduanjin rehabilitation therapy in mild COVID-19 patients. DESIGN: A narrative review. METHODS: A literature search for COVID-19 and Baduanjin treatments was conducted on Chinese and English electronic databases: China National Knowledge Infrastructure, Wanfang Data, Embase, PubMed, Scopus, Science Direct, Ebscohost, SPORTDiscus and ProQuest. RESULTS: Twelve studies on the Baduanjin rehabilitation for COVID-19 patients have been included. We acknowledged the considerable published research and current clinical practice using Baduanjin for COVID-19 treatment in the following areas: anxiety, depression, insomnia, lung function rehabilitation, immunity and activity endurance. CONCLUSION: The use of Baduanjin as adjuvant therapy for COVID-19 patients' rehabilitation is still limited, therefore, more clinical studies are needed to confirm its efficacy.

Developing a model for rehabilitation in the home as hospital substitution for patients requiring reconditioning: a Delphi survey in Australia.

BACKGROUND: Reconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning. METHODS: A multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses. RESULTS: One-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each. CONCLUSIONS: Strong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed.

Massive cutback in orthopaedic healthcare services due to the COVID-19 pandemic.

PURPOSE: Due to the lack of evidence, it was the aim of the study to investigate current possible cutbacks in orthopaedic healthcare due to the coronavirus disease 2019 pandemic (COVID-19). METHODS: An online survey was performed of orthopaedic surgeons in the German-speaking Arthroscopy Society (Gesellschaft für Arthroskopie und Gelenkchirurgie, AGA). The survey consisted of 20 questions concerning four topics: four questions addressed the origin and surgical experience of the participant, 12 questions dealt with potential cutbacks in orthopaedic healthcare and 4 questions addressed the influence of the pandemic on the particular surgeon. RESULTS: Of 4234 contacted orthopaedic surgeons, 1399 responded. Regarding arthroscopic procedures between 10 and 30% of the participants stated that these were still being performed-with actual percentages depending on the specific joint and procedure. Only 6.2% of the participants stated that elective total joint arthroplasty was still being performed at their centre. In addition, physical rehabilitation and surgeons' postoperative follow-ups were severely affected. CONCLUSION: Orthopaedic healthcare services in Austria, Germany, and Switzerland are suffering a drastic cutback due to COVID-19. A drastic reduction in arthroscopic procedures like rotator cuff repair and cruciate ligament reconstruction and an almost total shutdown of elective total joint arthroplasty were reported. Long-term consequences cannot be predicted yet. The described disruption in orthopaedic healthcare services has to be viewed as historic. LEVEL OF EVIDENCE: V.

Value and Cost Savings From Access to Multi-disciplinary Rehabilitation Services After Severe Acquired Brain Injury.

Acquired brain injury (ABI) is a major global public health problem and source of disability. A major contributor to disability after severe ABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return-to-work, and reduced need for long-term care. A societal model of value in rehabilitation matches patient and family expectations of outcomes and system expectations of value for money. A policy analysis of seven studies (2009-2019) exploring outcomes and cost-savings from access to multi-disciplinary rehabilitation identified average lifetime savings of $1.50M per person, with costs recouped within 18 months. Recommendations: Increase access to multi-disciplinary rehabilitation following severe ABI; strengthen prevention focus; increase access to case management; support return-to-work; and systematically collect outcome and cost data.

Առաջարկություններ COVID-19-ով պայմանավորված հիվանդությունից հետո ինքնուրույն վերականգնման վերաբերյալ: Երկրորդ հրատարակություն

Սույն գրքույկը տրամադրում է օգտակար խորհուրդներ բոլոր մեծահասակների համար, որոնք բուժվում են COVID-19-ից։ Այն կարող է օգտագործվել անհատների կողմից հոսպիտալացվելուց հետո կամ նրանց կողմից, ովքեր կարիք չունեն հոսպիտալացման։ Գրքույկը կարող է փոխլրացնել բուժհաստատություններում մատուցվող բժշկական ծառայությունները։ Սա 2020 թվականին տպագրված գրքույկի երկրորդ հրատարակությունն է։ Այս գրքույկը ներառում է մի շարք բաժինների թարմացումներ և նոր թեմաներ՝ ներառելով ամենավերջին տեղեկատվությունը հիվանդության զարգացման և պացիենտների ապաքինման վերաբերյալ։ Գրքույկը պատրաստվել է վերականգնողական ոլորտի մասնագետների կողմից, որոնք խորհրդակցել են նաև COVID-19-ից ապաքինվող պացիենտների հետ։ Չնայած այն հանգամանքին, որ հղումները ներկայացված չեն՝ ավելի դյուրին դարձնելու ընթերցումը, խորհուրդները հիմնված են ապացուցողական փաստերի վրա։ Այդուհանդերձ, մենք դեռ բավական տեղեկատվություն չունենք հետկորոնավիրուսային հիվանդության վերականգնման վերաբերյալ։ Փաստերն արագ են զարգանում։

რეაბილიტაციის მხარდაჭერა: პოსტ-კოვიდური მდგომარეობის თვით-მართვა, მეორე გამოცემა

წარმოდგენილი ბროშურა და რეკომენდაციები განკუთვნილია COVID-19-ისგან გამოჯანმრთელების პროცესში მყოფი მოზრდილებისთვის. ბროშურით სარგებლობა შეუძლიათ როგორც პირებს, რომლებიც გადიან ჰოსპიტალიზაციის შემდგომ პერიოდს, ასევე, გამოჯანმრთელების პროცესში მყოფ ადამინებს, რომლებსაც არ დასჭირდათ ჰოსპიტალში მკურნალობა. ექიმებისგან მიღებულ სამედიცინო დახმარებასთან ერთად, ბროშურა ადამიანებს დამატებითი ინფორმაციის მიღებასა და ზრუნვის გაუმჯობესებაში დაეხმარება. ეს არის მეორე გამოცემა იმ ბროშურისა, რომელიც თავდაპირველად 2020 წლის შუა პერიოდში გამოიცა და რამდენიმე განახლებულ განყოფილებასა და ახალ თემას მოიცავს. იგი აერთიანებს იმ ინფორმაციას რაც კოვიდ-მდგომარეობისა და მისგან გამოჯანმრთლების პროცესზე ბოლო ერთი წლის განმავლობაში გახდა ცნობილი. ბროშურა შედგენილია რეაბილიტაციის სპეციალისტების მიერ, COVID-19-ისგან გამოჯანმრთელებულ ადამიანებთან კონსულტაციის საფუძველზე. მიუხედავად იმისა, რომ მისი წაკითხვის გამარტივების მიზნით ბროშურაში რეფერენციები (მტკიცებულებები) წარმოდგენილი არ არის, ყველა რეკომენდაცია მომზადებულია მტკიცებულებებზე დაყრდნობით. ჯერ კიდევ ბევრი რამ არ ვიცით პოსტ-კოვიდური მდგომარეობის შესახებ და ახალი მტკიცებულებები ძალიან სწრაფად იჩენს თავს.

Impact of COVID-19 Pandemic on Developmental Service Delivery in Children With a History of Neonatal Seizures.

BACKGROUND: Children with a history of acute provoked neonatal seizures are at high risk for disability, often requiring developmental services. The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in how health care is delivered. Our objective was to determine the magnitude of service interruption of among children born between October 2014 and December 2017 and enrolled in the Neonatal Seizure Registry (NSR), a nine-center collaborative of pediatric centers in the United States. METHODS: This is a prospective cohort study of children with acute provoked seizures with onset ≤44 weeks' gestation and evaluated at age three to six years. Parents of children enrolled in the NSR completed a survey about their child's access to developmental services between June 2020 and April 2021. RESULTS: Among 144 children enrolled, 72 children (50%) were receiving developmental services at the time of assessment. Children receiving services were more likely to be male, born preterm, and have seizure etiology of infection or ischemic stroke. Of these children, 64 (89%) experienced a disruption in developmental services due to the pandemic, with the majority of families (n = 47, 73%) reporting that in-person services were no longer available. CONCLUSIONS: Half of children with acute provoked neonatal seizures were receiving developmental services at ages three to six years. The COVID-19 pandemic has led to widespread changes in delivery of developmental services. Disruptions in services have the potential to impact long-term outcomes for children who rely on specialized care programs to optimize mobility and learning.

Европейский региональный технический брифинг ВОЗ. Реабилитация после COVID-19: что нам известно, и какими ресурсами мы располагаем. Виртуальное совещание, организованное Европейским региональным бюро ВОЗ

Настоящий технический брифинг был организован с целью предоставить государствам-членам Европейского региона ВОЗ информацию и ресурсы по вопросам реабилитации после перенесенной инфекции COVID-19. Участникам брифинга были представлены общие сведения о важности реабилитации после COVID-19, обзор моделей реабилитационных услуг для оказания помощи лицам, перенесшим COVID-19, включая примеры из практики ряда государств-членов. Постковидный синдром, получивший и другое название: «затяжной ковид», был рассмотрен также с позиций пациентов, в частности была подчеркнута важность участия пациентов в планировании научных исследований. Под эгидой ВОЗ разработаны многочисленные информационные ресурсы по вопросам реабилитации после COVID-19 для различных категорий заинтересованных сторон, и Организация готова к оказанию необходимой поддержки государствам-членам.

康复指导手册: COVID-19相关疾病的自我管理

本手册旨在为COVID-19（中国称“新冠肺炎”）感染恢复后的成人提供帮助和建议。适用 对象包括新冠疾病出院患者及社区感染无需住院的患者。本手册可以作为医务人员专业治疗的 补充本手册为原出版于2020年的首版的更新，包含了对原有章节的更新、新的主题以及过去一年中我们对该病及其恢复过程的新的认知。本手册由康复专业人员通过咨询康复后的新冠患者编写。虽然为了方便阅读并没有提供参 考文献，但所给出的建议依然是基于证据的。关于新冠感染后的恢复情况，我们迄今仍然知之 甚少，而证据也在迅速增多。

WHO European Regional technical briefing: rehabilitation after COVID-19: what we currently know and resources we have. A virtual meeting hosted by WHO Regional Office for Europe

This technical briefing aimed to provide Member States of the WHO European Region with information and resources to support rehabilitation after COVID-19 infection. It provided background on the importance of rehabilitation following COVID-19 infection, followed by an overview of rehabilitation service models for managing the post-COVID-19 condition, including examples from a number of Member States. The post-COVID-19 condition, termed long COVID by patient groups, was also considered from the patients’ perspective, including the importance of including patients in research. WHO has produced a variety of resources for different stakeholders on rehabilitation following COVID-19 infection, and stands ready to support Member States.

Подкрепа за самоуправление на рехабилитацията в периода след заболяване, свързано с COVID-19: Второ издание

Тази брошура предоставя подкрепа и съвети за възрастни, които се възстановяват от COVID-19. Тя може да се използва от лица след хоспитализация от заболяването и от лица, които не са имали нужда от хоспитализация. листовката може да допълни грижите, получени от медицинските лица.Това е второто издание на брошурата, която първоначално беше публикувана в средата на 2020 г., и включваща актуализации на разделите и нови теми, обхващащи това, което научихме за състоянието и възстановяването през последната година.Брошурата е написана от специалисти по рехабилитация в консултация с хора, възстановяващи се от COVID-19. Въпреки че препратките не са показани, за да се улесни четенето, съветите са oсновани на факти от възстановяващите се лица. Все още има много неща, които не знаем за възстановяването след COVID-19, но бързо се появяват нови сведенията от преболедувалите.

Characterizing non-critically ill COVID-19 survivors with and without in-hospital rehabilitation.

This study investigated pre-COVID-19 admission dependency, discharge assistive equipment, discharge medical follow-up recommendation, and functional status at hospital discharge of non-critically ill COVID-19 survivors, stratified by those with (N = 155) and without (N = 162) in-hospital rehabilitation. "Mental Status", intensive-care-unit (ICU) Mobility, and modified Barthel Index scores were assessed at hospital discharge. Relative to the non-rehabilitation patients, rehabilitation patients were older, had more comorbidities, worse pre-admission dependency, were discharged with more assistive equipment and supplemental oxygen, spent more days in the hospital, and had more hospital-acquired acute kidney injury, acute respiratory failure, and more follow-up referrals (p < 0.05 for all). Cardiology, vascular medicine, urology, and endocrinology were amongst the top referrals. Functional scores of many non-critically ill COVID-19 survivors were abnormal at discharge (p < 0.05) and were associated with pre-admission dependency (p < 0.05). Some functional scores were negatively correlated with age, hypertension, coronary artery disease, chronic kidney disease, psychiatric disease, anemia, and neurological disorders (p < 0.05). In-hospital rehabilitation providing restorative therapies and assisting discharge planning were challenging in COVID-19 circumstances. Knowledge of the functional status, discharge assistive equipment, and follow-up medical recommendations at discharge could enable appropriate and timely post-discharge care. Follow-up studies of COVID-19 survivors are warranted as many will likely have significant post-acute COVID-19 sequela.

Mbështetje për rehabilitim: vetë-menaxhimi pas sëmundjes së lidhur me COVID-19, botimi i dytë

Kjo fletëpalosje ofron mbështetje dhe këshilla për të rriturit që po e marrin veten pas COVID-19. Mund të përdoret nga individë pas shtrimit në spital prej kësaj sëmundjeje dhe nga ata persona në komunitet që nuk kishin nevojë të shtroheshin në spital. Fletëpalosja mund të shërbejë si plotësuese e kujdesit të dhënë nga profesionistët e kujdesit shëndetësor. Ky është botimi i dytë i fletëpalosjes që u botua fillimisht në mesin e vitit 2020. Ajo përfshin përditësim të seksioneve dhe tema të reja, duke përfshirë ato që kemi mësuar në lidhje me sëmundjen dhe rikuperimin nga viti i kaluar.

Підтримка для самостійної реабілітації після пов’язаних із COVID-19 захворювань, друге видання

Ця пам’ятка має на меті надати підтримку та поради для дорослих, які відновлюються після COVID-19. Нею можуть скористатися як ті, хто були госпіталізовані з цим захворюванням, так і ті, хто хворіли, але не потребували госпіталізації. Наведені в пам’ятці рекомендації можуть бути корисним доповненням до вказівок медичних працівників.

Adaptations for rehabilitation services during the COVID-19 pandemic proposed by scientific organizations and rehabilitation professionals.

OBJECTIVE: To describe adaptations in the provision of rehabilitation services proposed by scientific and professional rehabilitation organizations to avoid interruptions to patients rehabilitation process and delays in starting rehabilitation in patients with COVID-19. METHODS: A narrative review approach was used to identify the recommendations of scientific and professional organizations in the area of rehabilitation. A systematic search was performed in the main data-bases in 78 international and regional web portals of rehabilitation organizations. A total of 21 publications from these organizations were identified and selected. RESULTS: The results are presented in 4 categories: adequacy of inpatient services, including acute care services and intensive care unit for patients with and without COVID-19; adequacy of outpatient services, including home-based rehabilitation and tele-rehabilitation; recommendations to prevent the spread of COVID-19; and regulatory standards and positions during the COVID-19 pandemic expressed by organizations for protecting the rights of health workers and patients. CONCLUSION: Health systems around the world are rapidly learning from actions aimed at the reorganization of rehabilitation services for patients who are in the process of recovery from acute or chronic conditions, and the rapid response to the rehabilitation of survivors of COVID-19, as well as from efforts in the prevention of contagion of those providing the services.

Respiratory rehabilitation for Covid-19 related persistent dyspnoea: A one-year experience.

BACKGROUND: Growing consideration is emerging regarding the burden of persisting sequelae after SARS-CoV-2 infection. Out-patients exhibiting long Covid may benefit from ambulatory rehabilitation which is, to date, poorly documented. METHODS: A longitudinal follow-up over a one-year period was conducted in two ambulatory rehabilitation structures in order to describe the characteristics of real-life patients referred with Covid-19 sequelae and their evolution over the course of rehabilitation. RESULTS: 39 consecutive patients were included from April 1st, 2020 to April 1st, 2021. Patients were middle-aged (48 ± 15yr), without comorbidities, and mostly mild to moderate SARS-CoV-2 infection (25(64%) not requiring hospitalisation). Rehabilitation referral was considered with a median delay of 73[34-178] days after disease onset. Most prevalent symptoms were dyspnoea (n = 35(90%)) and fatigue (n = 30(77%)). Hyperventilation syndrome was highly frequent (n = 12(34%)). 29(74%) patients presented with prolonged functional sequelae, which was associated with younger age (43 ± 14 vs. 50 ± 10yr; p = 0.002), greater prevalence of hyperventilation syndrome (n = 12(41%) vs. 0(0%); p = 0.255) and poorer quality of life (VQ-11; 31 ± 10 vs. 23 ± 9; p = 0.030). Over the course of rehabilitation, exertional dyspnoea, 6-min walking distance, 3-min sit-to-stand test, hyperventilation syndrome prevalence and quality of life significantly improved. CONCLUSION: Hyperventilation is frequent in long Covid and may explain persistent dyspnoea as well as altered quality of life. Our data support screening of hyperventilation syndrome and functional impairment in mild Covid-19 out-patients as both of these components may improve with ambulatory rehabilitation.

Reduced Requests for Medical Rehabilitation Because of the SARS-CoV-2 Pandemic: A Difference-in-Differences Analysis.

OBJECTIVE: To examine the extent to which medical rehabilitation requests decreased because of the pandemic in Germany. DESIGN: Data were retrieved from the German Pension Insurance, which is the main provider for rehabilitation of working-age people in Germany. Our data represented all medical rehabilitation requests in 2019 and 2020. These requests have to be approved to use a rehabilitation program. We used a difference-in-differences model to determine the reduction in rehabilitation requests attributable to the pandemic. SETTING: General community. PARTICIPANTS: We included 1,621,840 rehabilitation requests from working-age people across Germany in 2019 and 1,391,642 rehabilitation requests in 2020 (N=3,013,482). INTERVENTION: Medical rehabilitation in inpatient or outpatient facilities. MAIN OUTCOME MEASURES: Number of medical rehabilitation requests. RESULTS: The number of medical rehabilitation requests decreased by 14.5% because of the pandemic (incidence rate ratio, 0.855; 95% confidence interval, 0.851-0.859). The decline in requests was more pronounced among women and in Western Germany than among men and in Eastern Germany. The reduction in requests affected non-postacute rehabilitations more clearly than postacute rehabilitation services. After the pandemic declaration by the German Bundestag in March 2020, the reduction in requests was initially strongly associated with the regional incidence of infection. This association weakened in the following months. CONCLUSIONS: The reduction in requests will have a significant effect on the number of completed rehabilitation services. For many people with chronic diseases, failure to provide medical rehabilitation increases the risk of disease progression.

Medicare payment policy in skilled nursing facilities: Lessons from a history of mixed success.

The current policy environment for rehabilitation in skilled nursing facilities (SNFs) is complex and dynamic, and SNFs are facing the dual challenges of recent Medicare payment policy change that disproportionately impacts rehabilitation for older adults and the COVID-19 pandemic. This article introduces an adapted framework based on Donabedian's model for evaluating quality of care and applies it to decades of Medicare payment policy to provide a historical view of how payment policy changes have impacted rehabilitation processes and patient outcomes for Medicare beneficiaries in SNFs. This review demonstrates how SNF responses to Medicare payment policy have historically varied based on organizational factors, highlighting the importance of considering such organizational factors in monitoring policy response and patient outcomes. This historical perspective underscores the mixed success of previous Medicare policies impacting rehabilitation and patient outcomes for older adults receiving care in SNFs and can help in predicting SNF industry response to current and future Medicare policy changes.

Wsparcie w samodzielnej rehabilitacji po przebyciu choroby związanej z COVID-19

W broszurze przedstawiono podstawowe ćwiczenia oraz porady dla osób dorosłych,które przechodzą rekonwalescencję po COVID-19. Może być ona wykorzystywanazarówno przez osoby po hospitalizacji związanej z chorobą, jak i pacjentów, którzy nie wymagali hospitalizacji jako uzupełnienie standardowej opieki zapewnianej przezpracowników ochrony zdrowia. Jest to drugie wydanie broszury, której pierwsza wersja została opublikowana w połowie 2020 roku, zawierające zaktualizowane i nowe informacje opracowane na podstawie badań przeprowadzonych w przeciągu ostatniego roku dotyczących choroby i powrotudo zdrowia po COVID-19. Broszura została napisana przez specjalistów z dziedziny rehabilitacji w porozumieniuz osobami przechodzącymi rekonwalescencję po zakażeniu COVID-19. Dla ułatwieniaczytania w tekście nie są podawane dane bibliograficzne. Należy jednak pamiętać, żeopisane porady są oparte na dowodach naukowych. Wciąż pozostaje wiele aspektówdo zbadania dotyczących rekonwalescencji po przebyciu COVID-19. Na bieżącogromadzone są nowe dowody.