From the Department of Rehabilitation Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, New York (NP, CS, RP, CC, AJ); Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York (GD, LL, AJ); and Department of Psychiatry, Weill Cornell Medicine, New York, New York (AJ).
Am J Phys Med Rehabil. 2021 Dec 1;100(12):1124-1132. doi: 10.1097/PHM.0000000000001897.
The aims of the study were to describe an interdisciplinary inpatient rehabilitation program for patients recovering from COVID-19 and to evaluate functional outcomes.
This is an analysis of retrospective data captured from the electronic health record of COVID-19 patients admitted to the rehabilitation unit (N = 106). Rehabilitation approaches are described narratively. Functional gain was evaluated using the Activity Measure for Postacute Care 6 Clicks, basic mobility and daily activities.
Interdisciplinary approaches were implemented to address the medical, physical, communication, cognitive, and psychosocial needs of COVID-19 patients. COVID-19 patients exhibited significant improvements in basic mobility (Activity Measure for Postacute Care for basic mobility, P < 0.001, Cohen d = 1.35) and daily activities (Activity Measure for Postacute Care for daily activities, P < 0.001, Cohen d = 1.06) from admission to discharge. There was an increase in ambulatory distance as well as the percentage of the patients who were able to breathe on room air. At discharge, fewer patients required supplemental oxygen on exertion. Eighty percent of the patients were discharged home after an average length of stay of 17 days. Greater functional improvement was associated with younger age, longer intubation duration, and participation in psychotherapy, but not a history of delirium during hospitalization.
Early rehabilitation is associated with improved mobility and independence in activities of daily living after COVID-19.
本研究旨在描述一个针对 COVID-19 康复患者的跨学科住院康复项目，并评估其功能结局。
这是一项对 COVID-19 患者入院康复单元电子病历数据（N=106）的回顾性分析。康复方法以叙述性方式描述。使用急性后期护理 6 点击活动量表、基本移动能力和日常生活活动来评估功能增益。
为满足 COVID-19 患者的医疗、身体、沟通、认知和心理社会需求，采用了跨学科方法。COVID-19 患者在基本移动能力（急性后期护理基本移动能力量表，P<0.001，Cohen d=1.35）和日常生活活动（急性后期护理日常活动量表，P<0.001，Cohen d=1.06）方面，从入院到出院均有显著改善。活动距离增加，能够在室内空气中呼吸的患者比例增加。出院时，活动时需要补充氧气的患者减少。80%的患者在平均住院 17 天后出院回家。功能改善程度更大与年龄较小、插管时间较长以及接受心理治疗有关，但与住院期间是否出现谵妄无关。
早期康复与 COVID-19 后移动能力和日常生活活动独立性的改善相关。
