Rosen Kelsey, Patel Monika, Lawrence Cecelia, Mooney Brianne
Rehabilitation Department, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021 USA.
HSS J. 2020 Nov;16(Suppl 1):64-70. doi: 10.1007/s11420-020-09774-4. Epub 2020 Jul 16.
Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists' contact with patients when possible. Telehealth has been viewed as "electronic personal protective equipment" during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients.
Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program.
We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques.
Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home.
Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.
针对新冠肺炎住院患者的物理治疗管理指南建议，尽可能限制物理治疗师与患者的接触。在新冠肺炎疫情期间，远程医疗被视为“电子个人防护设备”；尽管远程康复已被证明对门诊患者有效，但对于住院患者而言，它是否是一种可行的选择尚不清楚。
我们的机构开发了一种针对新冠肺炎住院患者的物理治疗远程康复计划使用算法。我们试图研究该计划的安全性和可行性。
我们对诊断为新冠肺炎且仅接受远程康复或同时接受远程康复与面对面康复的患者进行了回顾性病历审查。根据该算法，如果新冠肺炎住院患者能够独立行走、会使用技术设备、生命体征稳定、所需补充氧气量极少且认知功能正常，就会被选择接受远程康复。我们分析了仅接受远程康复的住院患者的数据，其中包括患者教育、治疗性锻炼和呼吸技巧。
在33名接受远程康复、面对面康复或两者结合的新冠肺炎住院患者中，12名患者仅接受了远程康复（年龄范围为33至65岁；除1名女性外均为男性）。他们在一到两个疗程中就能够独立完成个性化的家庭锻炼计划，无需面对面康复咨询，不需要增加氧气供应，症状没有加重，并出院回家。
对于部分新冠肺炎住院患者而言，住院远程康复似乎是一种可行的选择，并且可能是为隔离或高危人群提供住院康复的安全方式。在我们医院，住院远程康复的使用减少了工作人员的接触风险，同时为患者提供了重要的教育和服务。据我们所知，尚无研究调查远程康复在住院患者（包括新冠肺炎患者）中的应用情况。我们的研究结果表明，这种创新方法值得进一步研究。
