Solon Kathryn, Larson Allison, Ronnebaum Julie, Stevermer Catherine
Therapy Department, MercyOne Clive Rehabilitation Hospital 1401 Campus Dr Clive, IA 50325 (USA).
Therapy Department, MercyOne Clive Rehabilitation Hospital Clive, Iowa.
J Acute Care Phys Ther. 2021 Jul;12(3):115-121. doi: 10.1097/JAT.0000000000000153. Epub 2020 Dec 14.
To provide an outline of the timeline from acute care admission to inpatient rehabilitation facility discharge and describe the functional progress and tolerance of 2 individuals who were hospitalized but not intubated because of COVID-19.
Retrospective data were collected from the electronic medical record to describe the rehabilitation course of the first 2 consecutive patients admitted to the rehabilitation facility who were recovering from COVID-19. Both patients were octogenarian men who experienced functional decline while hospitalized for symptoms of COVID-19 and were recommended for further inpatient rehabilitation services. Progress during inpatient rehabilitation was tracked using the following outcome measures: Centers for Medicare & Medicaid Services Quality Indicators (QI), 6-Minute Walk Test, 10-Meter Walk Test, Timed Up and Go, and Berg Balance Scale.
Patient 1 had an 18-day acute care stay, a 13-day inpatient rehabilitation facility stay, and was discharged to home. Patient 2 had an interrupted 19-day acute care stay, a 15-day inpatient rehabilitation facility stay, and was discharged to a skilled nursing facility. Patient 1 improved 160.98 m in the 6-Minute Walk Test, 0.08 m/s in self-selected walking speed, and 85 points in the total Quality Indicators score. Patient 2 improved 115.22 m in the 6-Minute Walk Test, 0.14 m/s in self-selected walking speed, and 39 points in the total Quality Indicators score.
The patients made clinically meaningful improvements in each outcome measure during their length of stay for inpatient rehabilitation. This reveals the positive rehabilitation potential of 2 older adult patients with COVID-19 and demonstrates the patients' ability to maintain inpatient rehabilitation facility level of activity. With individualized care and discharge planning, similar patients may make significant gains in function despite advanced age and comorbid conditions.
概述从急性护理入院到住院康复机构出院的时间线，并描述2名因COVID-19住院但未插管患者的功能进展和耐受性。
从电子病历中收集回顾性数据，以描述康复机构收治的前2例从COVID-19康复的连续患者的康复过程。两名患者均为八旬男性，因COVID-19症状住院期间出现功能衰退，并被推荐接受进一步的住院康复服务。住院康复期间的进展通过以下结局指标进行跟踪：医疗保险和医疗补助服务中心质量指标（QI）、6分钟步行试验、10米步行试验、定时起立行走试验和伯格平衡量表。
患者1急性护理住院18天，住院康复机构住院13天，出院回家。患者2急性护理住院19天，期间有中断，住院康复机构住院15天，出院至专业护理机构。患者1在6分钟步行试验中提高了160.98米，自选步行速度提高了0.08米/秒，总质量指标得分提高了85分。患者2在6分钟步行试验中提高了115.22米，自选步行速度提高了0.14米/秒，总质量指标得分提高了39分。
患者在住院康复期间，各项结局指标均取得了具有临床意义的改善。这揭示了2例COVID-19老年患者积极的康复潜力，并证明了患者维持住院康复机构活动水平的能力。通过个性化护理和出院计划，类似患者尽管年龄较大且伴有合并症，但仍可能在功能上取得显著进步。
