Early Outpatient Tele-rehabilitation Improves Functional Outcomes in Patients Following Hospitalization for COVID-19: A Case Series

Abstract

Introduction: This study assesses the impact of early outpatient telerehabilitation on patients following hospitalization for COVID-19. To date, there have not been studies assessing this type of program, despite significant documentation of functional deficits that would benefit from outpatient rehabilitation services. Objective: To determine whether outcomes support the utilization of an early outpatient telerehabilitation based protocol. Design: Retrospective analysis, nonrandomized controlled trial. Setting: Academic healthcare center, secondary care. Patients: All patients discharged following hospitalization with COVID-19 between April and September of 2020 (n=50) were contacted to participate; 26 accepted, 19 completed the rehabilitation protocol. Inclusion criteria were: patient diagnosed with and hospitalized for COVID-19, patient willing to participate in study. Interventions: Patients were seen for 2-4 visits of physical therapy where they were assessed, screened to assess need for mental health, occupational therapy, and speech therapy services and placed into predetermined activity tolerance categories with corresponding exercises given. Main Outcome Measures: Outcome measures assessed were Borg Rating of Perceived Exertion (RPE) on selected tasks, 30 Second Sit to Stand Test, Daily Fatigue Impact Scale score, Resting Respiratory Rate, activity tolerance (based on averaging severity levels of previously identified functional scale scores), and patient-rated feelings of dyspnea on exertion. Results: Statistically significant improvements were found in resting respiratory rate (p<0.05), 30 Second Sit to Stand score (p<0.001), Daily Fatigue Impact Scale score (p<0.05), Borg RPE (p<0.05), and overall severity rating (p<0.01). Patient-rated dyspnea was not significantly different from first to last visit. Conclusions: 2-4 visits of telerehabilitation provided soon after hospital discharge resulted in significant improvements in functional outcome measures. This supports the utilization of outpatient rehabilitation following hospitalization for COVID-19 as well as the use of telerehabilitation to provide these services.