Vakil Palak, Ferré Perrine, Higgins Johanne, Beaulieu Louis-David, Milot Marie-Helene, Boudrias Marie-Hélène
School of Physical and Occupational Therapy, McGill University Faculty of Medicine and Health Sciences, Montréal, Québec, Canada.
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Québec, Canada.
BMJ Open. 2025 Jan 28;15(1):e082602. doi: 10.1136/bmjopen-2023-082602.
During the COVID-19 pandemic, designated rehabilitation centres were established in the province of Québec, where strict sociosanitary measures such as isolation and mandatory personal protection equipment requirements were followed. This study aimed to describe the impact of the pandemic on rehabilitation care indicators for poststroke users with (COV+) and without (COV-) COVID-19 infection in designated rehabilitation centres compared with those admitted in the previous year (pre-COV).
A retrospective analysis of 292 medical files was performed in 3 rehabilitation centres. Demographic characteristics were collected, as well as indicators routinely collected in acute care and rehabilitation such as length of stay (LOS), the Functional Independence Measure and a number of physical/occupational therapy (PT/OT) sessions. Non-parametric statistical tests were used to compare variables among the three groups.
COV+ users were older than COV- and pre-COV ones (p<0.01) and were more disabled on admission to a rehabilitation centre (p<0.01). They also exhibited longer LOS in acute care prior to rehabilitation (p<0.001) and were more often rehospitalised (p<0.002) during the course of their stay in the rehabilitation centre. Despite longer rehabilitation stays (p<0.001) and more PT/OT sessions, COV+ users remained more disabled at discharge (p<0.002). COV- users showed rehabilitation care indicators resembling the ones of pre-COV despite spending less time in rehabilitation.
Patients who had a stroke infected with COVID-19 exhibited greater vulnerability on admission to rehabilitation. They required more care and services during their rehabilitation period. However, this additional support did not enable them to achieve the same level of recovery as COV- and pre-COV users. This underscores the added impact of the disease on already impaired patients and highlights the specific needs of COV+ users undergoing rehabilitation.
在新冠疫情期间，魁北克省设立了指定康复中心，这些中心遵循严格的社会卫生措施，如隔离和强制要求使用个人防护装备。本研究旨在描述疫情对指定康复中心中感染新冠病毒（COV+）和未感染新冠病毒（COV-）的中风后患者康复护理指标的影响，并与上一年入院的患者（疫情前，pre-COV）进行比较。
对3家康复中心的292份病历进行回顾性分析。收集了人口统计学特征，以及急性护理和康复中常规收集的指标，如住院时间（LOS）、功能独立性测量和物理/职业治疗（PT/OT）疗程数。使用非参数统计检验比较三组之间的变量。
COV+组患者比COV-组和疫情前组患者年龄更大（p<0.01），入院时残疾程度更高（p<0.01）。他们在康复前的急性护理中住院时间也更长（p<0.001），在康复中心住院期间再次住院的频率更高（p<0.002）。尽管康复住院时间更长（p<0.001）且接受的PT/OT疗程更多，但COV+组患者出院时残疾程度仍然更高（p<0.002）。COV-组患者的康复护理指标与疫情前组相似，尽管其康复时间较短。
感染新冠病毒的中风患者入院康复时表现出更大的脆弱性。他们在康复期间需要更多的护理和服务。然而，这种额外的支持并未使他们达到与COV-组和疫情前组患者相同的恢复水平。这凸显了该疾病对已有损伤患者的额外影响，并突出了感染新冠病毒的康复患者的特殊需求。
