Physical Rehabilitation Services Research Articles

Post-COVID-19 syndrome symptoms after mild and moderate SARS-CoV-2 infection

BackgroundPost-COVID-19 Syndrome (PCS) is characterized by residual symptoms following the initial recovery from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The prevalence of PCS is known to be the highest among severe and critical forms of the disease. However, the occurrence and risk factors for PCS after mild or moderate SARS-CoV-2 infection has not been extensively investigated.MethodsOnline and offline via both paper or mailed questionnaires distributed among Jordan collected between 1st and 21st August 2021, including a total number of 800 respondents, of whom 495 had previous mild to moderate COVID-19 infection. The Newcastle post-COVID syndrome Follow-up Screening Questionnaire was modified, translated, and used as a standard instrument for data collection regarding psychological, medical, and socio-economic symptoms post-infection. The primary outcome was the prevalence of PCS after mild to moderate COVID-19 in Jordan. Secondary outcome was the identification of PCS risk factors.ResultsThe most common PCS symptom was mood disturbance followed by fatigue, anxiety, and myalgia. Female gender significantly increased the risk for multiple PCS symptoms. Age < 30 years was found to be an independent risk factor for myalgia (p = 0.001).ConclusionPCS is highly prevalent among COVID-19 survivors in Jordan, especially in females and patients with comorbidities. Planning physical and mental rehabilitation services is recommended for those patients with PCS symptoms after mild to moderate COVID-19 infection.

Environmental impact of telerehabilitation visits in an urban setting

• Travel cost and time burden are reduced using telehealth. • Telehealth positively impacted the environment by eliminating travel related gas emissions. • Patients and providers report high satisfaction with care delivered by SVV. Climate change has been described as the largest public health concern of the 21st century. In response to climate change over 50 countries have pledged to go carbon neutral in the provision of health care services and telemedicine can be an integral part of decreasing emissions related travel associated with health care. While telemedicine rapidly expanded to increase access to care during the Covid-19 pandemic, the impact of telerehabilitation on climate change as part of the provision of physical rehabilitation services has not been assessed. This study focuses on physical medicine and rehabilitation physicians in an urban physical medicine and rehabilitation (PM&R) department and assesses patient satisfaction with synchronous video visits (SVVs) as well as the estimated value of SVVs in travel savings and carbon emissions. We conducted a retrospective chart review, implemented a patient survey, and conducted a commuter analysis to report our experience using SVVs to provide follow-up care across multiple rehabilitation sub-specialties A total of 154 SVVs were conducted before the pandemic over an 18-month period. The most commonly addressed issues during the SVVs were rehabilitation and medication management, followed by equipment, lab and imaging results. About one-third of the patients (31%) were non-ambulatory at the time of their SVV. On average, SVVs reduced travel distance (95 miles), travel time (2.23 h), travel cost ($15) and carbon emissions. The use of telerehabilitation should be an integral part of decreasing the carbon footprint of provision of physical medicine and rehabilitation services.

Access indicators in physical rehabilitation services for musculoskeletal disorders in Belo Horizonte (MG)

RESUMO A crescente demanda por atendimento nos serviços de reabilitação física do Sistema Único de Saúde (SUS) excede a oferta, o que resulta em longas filas de espera. Neste estudo, realizou-se uma pesquisa quantitativa de cunho exploratório que teve por objetivo a apresentação de indicadores para facilitar o acesso aos serviços de reabilitação física no que tange às desordens musculoesqueléticas. Os dados foram colhidos dos prontuários de usuários residentes nas regiões noroeste e oeste de Belo Horizonte (MG), com mais de 18 anos de idade, submetidos a acolhimento no Centro Especializado em Reabilitação IV no ano de 2019. Obtiveram-se os seguintes indicadores: absenteísmo no momento da avaliação; tempo médio para início do tratamento de acordo com a prioridade; tempo médio de tratamento; e média de usuários atendidos ao mês. A análise deste estudo foi pautada em 362 prontuários. O tempo médio para início de tratamento foi de aproximadamente 69 dias e o período médio de tratamento, de 94 dias. O serviço absorveu cerca de 30 novos usuários ao mês e apresentou índice de absenteísmo de 16,8%. Acredita-se que os indicadores apresentados possivelmente favorecerão a gestão e o controle das filas de espera dos serviços de reabilitação do SUS.

VP.07 Lived experience of functioning of patients with nemaline myopathy and related disorders in Finland

Nemaline myopathy (NM) and related disorders (NMr) are ultrarare congenital myopathies with severity varying from mild muscle- or muscle group-specific weakness to a neonatally lethal disorder. Medical and biomedical studies of NM and NMr have dominated the research field, whereas little is known about coping in everyday life among persons with NM. To study the lived experience of physical, psychological and social functioning of adult NM and NMr patients in Finland, we conducted a survey using items primarily from PROMIS® (Patient Reported Outcomes Measurement Information System) questionnaires. The impact of the COVID-19 pandemic on functioning was also assessed. The items were linked to the International Classification of Functioning, Disability and Health (ICF) categories. In total, 20 persons aged 19-75 years and resident in Finland participated in the study; 12 had NM and eight NMr; 15 were women and five men. Sixteen were ambulatory and four used wheelchairs. Non-ambulatory patients reported more problems in all areas of functionality. However, there was a large variability in the functioning of the participants. The differences were smaller in the psychological and social functioning. In addition, the COVID-19 pandemic had affected the functioning of non-ambulatory patients more than that of ambulatory patients. The results indicate that patients using wheelchairs and patients dependent on the help of others might be more vulnerable and prone to impairments in general and social functioning especially during pandemics. Possible explanations include further restriction of their participation in social life and restricted access to physical rehabilitation services due to the pandemics. To our knowledge, this pilot study is the first study on self-experienced functioning of persons with rare congenital muscle disorders, and the results indicate on the need for expanding this study nationally and internationally.

Degree of pain, most frequent musculoskeletal disorders and sociodemographic characteristics of patients treated at a physical therapy and rehabilitation center located in Villa El Salvador, Lima, Peru

Objective: To describe the socioeconomic characteristics of, the most frequent pathologies and symptoms of, and the subjective pain assessment by patients treated at a physical therapy and rehabilitation center located in the district of Villa El Salvador, Lima, Peru.Materials and methods: A descriptive, prospective and cross-sectional study conducted in 366 patients over 18 years of age, of both sexes, who attended their first physical therapy. Results: The patients reported moderate pain intensity in the pre-physical therapy and rehabilitation sessions assessment. Low back pain was the most frequent pathology, followed by neck pain and painful shoulder. Regarding the education level, most patients had secondary and technical education. Moreover, a statistical association was found between pain intensity and sex (p = 0.049), as well as between pain intensity and profession/occupation (p = 0.012).Conclusions: The patients who attended the physical therapy and rehabilitation service reported moderate pain before beginning their sessions. Based on the results of the socioeconomic characteristics, it is necessary to keep up preventive and promotional health measures to avoid possible risk factors that exacerbate musculoskeletal disorders which may interfere with patients’ future recovery and possible relapse.

Provision and use of physical rehabilitation services for adults with disabilities in Rwanda: A descriptive study.

BackgroundPhysical rehabilitation interventions address functional deficits caused by impairments that affect someone’s performance. Whilst rehabilitation is important, it is assumed that these services are either minimal or nonexistent in low-resource settings. Our data expand on the data from the Situation Assessment of Rehabilitation in the Republic of Rwanda report to describe rehabilitation services and who access them at public and semiprivate facilities (primarily funded by the private sector).ObjectivesThis article describes the use of the outpatient physical rehabilitation services across nine health facilities, the characteristics of adults attending these health facilities and some of the facilitators and barriers they encounter when attending rehabilitation.MethodData were collected between September and December 2018 from the heads of departments and adult patients attending outpatient rehabilitation services funded by the government, international nongovernmental organisations or faith-based organisations.ResultsTwo hundred and thirteen adults were recruited from nine facilities. There is a sixfold difference in the number of rehabilitation personnel between public and semiprivate hospitals in these facilities’ catchment areas. However, most participants were recruited at public facilities (186 [87%]), primarily with physical disorders. Patients reported that family support (94%) was the most crucial facilitator for attending rehabilitation, whilst transportation cost (96%) was a significant barrier.ConclusionRehabilitation service availability for Rwandan adults with disabilities is limited. Whilst family support helps patients attend rehabilitation, transportation costs remain a significant barrier to people attending rehabilitation. Strategies to address these issues include developing triage protocols, training community health workers and families.ContributionData on rehabilitation service provision in Rwanda and most African countries are either non-existent or very limited. These data contain important information regarding the services provided and the people who used them across different health facilities (public versus private) and urban versus rural settings). To improve rehabilitation service provision, we first need to understand the current situation. These data are an important step to better understanding rehabilitation in Rwanda.

Mental health and psychosocial support during physical rehabilitation in Eastern Democratic Republic of Congo: a retrospective cohort study

Purpose This study explores the relevance of integrating mental health and psychosocial support (MHPSS) into physical rehabilitation services in conflict settings. Material and Methods Symptoms of psychological distress and daily functioning of 132 physical rehabilitation service users in Eastern Democratic Republic of Congo were assessed before and after MHPSS. Logistical regression models were used to identify factors associated with these symptoms. Results Prior to receiving MHPSS, “extreme” symptoms of depression were reported by 64% of the service users. Amputation predicted high levels of depression (aOR 5.12, p = 0.021), anxiety (aOR 7.09, p = 0.004) and stress (aOR 3.37, p = 0.035), while having witnessed violence predicted high symptoms of stress (aOR 3.65, p = 0.014). Lack of social support was associated with high symptoms of stress prior to MHPSS (aOR 3.17, p = 0.046) as well as a large reduction in symptoms of depression following MHPSS (aOR 3.91, p = 0.019). Most physical rehabilitation service users reported a reduction in symptoms of depression (100.00%), anxiety (98.03%) and stress (100.00%) along with improved functioning (81.13%) after MHPSS. Conclusion MHPSS needs of physical rehabilitation service users in conflict settings stem from the combined impact of disability and exposure to violence. MHPSS care, particularly the mobilization of peer support, appears necessary and relevant. Implications for rehabilitation In conflict settings, mental health and psychosocial support (MHPSS) needs of physical rehabilitation service users must address the combined impact of physical disability and exposure to violence. Physical rehabilitation service users who lacked social support prior to receiving MHPSS were more likely to report a large reduction in symptoms of depression following MHPSS. The study underlines the importance of social support, particularly peer support, in addressing MHPSS needs.

THE IMPORTANCE OF INFORMING THE PATIENTS RECEIVING PHYSICAL THERAPY AND REHABILITATION SERVICES FOR CERVICAL DISC HERNIA ABOUT HEALTHY LIFESTYLE BEHAVIORS: A SAMPLE STUDY FROM TURKEY

Background: Considering the risk factors of cervical disc hernia, morbidity can be reduced and the recurrence of the disease can be prevented by the acquisition of Healthy Lifestyle Behaviors (HLSB). Aim: The aim is to evaluate the relationship between the cause of the disease and the risk factors, knowledge, attitudes, and behaviors of the patients, who received physical therapy and rehabilitation (PTR) service upon the diagnosis of cervical disc hernia, regarding HLSB with ethical information.&#x0D; Method: Data were obtained from 222 patients at the Department of PTR at Eskisehir Yunus Emre State Hospital (EYEDH) in Turkey. The Healthy Lifestyle Behavior Scale II (HLSBS II) was administered to the participants by using a questionnaire form. Descriptive statistics, Chi-square Test of Independence, Unpaired T Test were used to evaluate the data.&#x0D; Results: There was a significant difference between the general scale and sub-scale scores of HLSBS II of the participants and the state of knowing the cause of the disease (p &lt;0.05). There is a significant difference between informing the participants about their diseases, treatments, medical treatments as an alternative to PTR (surgical, medical), and the risk factors and reflecting such information to their behaviors (p &lt;0.05). It is observed that the participants informed have changed their behaviors.&#x0D; Conclusion: It can be seen that the participants consider the information provided and try to carry out their actions, are willing to learn about HLSB, are open to behavioral changes, and want to receive training on this matter.

Mapping evidence of community health workers delivering physical rehabilitation services in sub-Saharan Africa: a scoping review protocol.

IntroductionSub-Saharan Africa (SSA) is one of the low-income regions in the world which is affected by the critical shortage of human resources for health amid a high disease burden, including physical disability. Community health workers are viewed as the possible solution to increase population access to health services, including rehabilitation at the community level. The purpose of this scoping review is to map the evidence and scope of physical rehabilitation services delivered by community health workers in SSA.Methods and analysisThe framework by Arksey and O’Malley will be used to guide the scoping review protocol. Database searching will be conducted using PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. Other sources of literature will include reference lists, conference presentations and publications on organisational websites such as WHO, Ministries of Health, and Non-governmental Organisations in SSA. The screening will be guided by the inclusion and exclusion criteria. Thematic content analysis aided by NVivo V.12 will be done to present the narrative account of the review. The Mixed Methods Appraisal Tool version 2018 will be used to evaluate the methodological quality of the studies.Ethics and disseminationThe review is part of a larger study that has received ethical clearance. The result will be disseminated using print and electronic media.

Validation of a semiological maneuver for the evaluation of spastic dynamic clubfoot: an approach based on the judgment of experts in physical medicine and rehabilitation.

The evaluation of spasticity of the plantar flexors in dynamic clubfoot is difficult due to the almost invariable concomitance of Achilles clonus, which is a semiological artifact. No description was found in the literature of a technique for inhibiting or reducing the discharge generated by Achilles clonus to allow a correct assessment of spasticity in this segment. Validation of a semiological maneuver that reduces or eliminates Achilles clonus for the adequate evaluation of spastic dynamic clubfoot. Multicenter cross-sectional study. The study was conducted by 12 experts in physical medicine and rehabilitation from various clinics and hospitals in Colombia. Thirty-five adults with dynamic spastic clubfoot and Achilles clonus secondary to upper motor neuron syndrome who attended outpatient consultation at physical medicine and rehabilitation services in eight cities Colombia from August 2020 to February 2021. The usual method for examining spastic plantar flexors was compared to the proposed semiological maneuver to evaluate the proposed maneuver contributed to the reduction or elimination of Achilles clonus to allow a more accurate measure of spasticity in this segment. Four dimensions were evaluated by the experts: time required for application, simplicity, effectiveness and clinical utility. A cutoff point was established to identify whether the maneuver was unacceptable, acceptable or excellent. The application of the maneuver was able to reduce or eliminate Achilles clonus as a masking sign of spasticity in the plantar flexors in 100% of the patients and was considered excellent in 77.1% of the cases for the four dimensions evaluated. A decrease in the degree of spasticity of the plantar flexors was observed when the maneuver was applied. The proposed maneuver reduces or eliminates Achilles clonus, which could allow a more precise evaluation of spasticity in this segment. All of the experts recommended including the maneuver in routine examinations of this population. Applying the proposed maneuver could improve the selection of patients with spastic dynamic clubfoot who require specific treatment.

Assistance Gaps in Physical Rehabilitation: Spatial Analysis of Physical Therapy Services and Users' Households in a Brazilian Capital.

The aim of this study was to analyze the spatial distribution of outpatient physical therapy rehabilitation services and associate it with the geographic location of users' households. The public physical therapy rehabilitation services and addresses of users' households in Campo Grande (MS) were georeferenced in 2017-2019. Five physical therapy clinics were identified to supply the demand of 31,774 scheduled users. Most services are in the most central regions of the city, while most users reside in peripheral areas. An assistance gap in Physical therapy care was identified, with a restricted supply of services to meet demands and a geographic barrier, since the services are far from the users' households. Physical rehabilitation must be a priority in the country's public health, especially nowadays, where demands for rehabilitation of a significant number of Brazilians who evolved with sequelae of COVID-19 are so present.

Vazios assistenciais na reabilitação física: análise espacial dos serviços de fisioterapia e dos domicílios dos usuários em uma capital brasileira

ABSTRACT: Objective: The aim of this study was to analyze the spatial distribution of outpatient physical therapy rehabilitation services and associate it with the geographic location of users’ households. Methods: The public physical therapy rehabilitation services and addresses of users’ households in Campo Grande (MS) were georeferenced in 2017-2019. Results: Five physical therapy clinics were identified to supply the demand of 31,774 scheduled users. Most services are in the most central regions of the city, while most users reside in peripheral areas. Conclusion: An assistance gap in Physical therapy care was identified, with a restricted supply of services to meet demands and a geographic barrier, since the services are far from the users’ households. Physical rehabilitation must be a priority in the country’s public health, especially nowadays, where demands for rehabilitation of a significant number of Brazilians who evolved with sequelae of COVID-19 are so present.

Surgical Treatment Patterns, Healthcare Resource Utilization, and Economic Burden in Patients with Tenosynovial Giant Cell Tumor Who Underwent Joint Surgery in the United States.

Background: Tenosynovial giant cell tumors (TGCT) are rare and locally aggressive neoplasms in synovium, bursae, and tendon sheaths, which cause pain, joint dysfunction, and damage to the affected joints.Objective: To evaluate the surgical patterns and economic burden among patients with TGCT who underwent joint surgery in the United States.Methods: Patients newly diagnosed with TGCT, aged 18-64 years, who underwent joint surgery post-TGCT diagnosis were identified from the OptumHealth Care Solutions, Inc database (Q1/1999-Q1/2017). Patients were required to be continuously enrolled for ≥1 year before and ≥3 years after the first TGCT diagnosis (index date). Surgical patterns were assessed post-index. Healthcare resource utilization and associated healthcare costs, and indirect costs related to work loss in year 1, year 2, and year 3 post-index, were compared with those at baseline.Results: Of 835 eligible TGCT patients, 462 (55%) patients who had ≥1 joint surgery post-index were included. During a median follow-up of 5.7 years, 78% of patients underwent their first joint surgery in year 1 and 41% had ≥1 repeat surgery. Magnetic resonance imaging utilization was highest during baseline (46%) and declined afterward (28%, 17%, and 19% in years 1, 2, and 3, respectively). Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy, occupational therapy, and rehabilitation services, were commonly used during baseline (45%, 40%, and 30%, respectively). More patients used opioids in year 1 vs baseline (78% vs 45%; P<0.0001), while its utilization return to baseline levels in year 2 (41%) and year 3 (42%). A similar pattern was observed for NSAIDs and physical/occupational therapy/rehabilitation services. Healthcare resource utilization and associated healthcare costs surged in year 1 and returned to baseline or lower in years 2 and 3. A similar pattern was observed for indirect costs associated with work loss.Discussion: The high proportion of patients undergoing repeat surgeries and prevalent use of opioids, NSAIDs, and physical/occupational therapy/rehabilitation services suggests an unmet medical need after surgical treatment.Conclusions: Surgical resection alone might be inadequate to control TGCT. New treatment options may complement surgery and alleviate the clinical and economic burden experienced by patients with TGCT who had received prior surgery.

Access to rehabilitation services for road traffic injury patients in Namibia

Purpose Road traffic injuries (RTIs) are a major public health issue worldwide. The importance of physical rehabilitation following RTI is well documented. However, globally there has been very little research on the accessibility of rehabilitation services following road injury. Namibia is one of the five African countries with a fuel tax levy fund (Motor Vehicle Accident Fund, MVAF), a system of case managers, medical care, and case management system for coordination of long-term care. Materials and methods We investigated the availability of physical rehabilitation services to RTI injured in Namibia, through interviews with RTI patients and health care workers. Results Unlike the few other studies done in Sub-Saharan Africa (SSA), most RTI injured individuals in Namibia report they are able to access some rehabilitation following injury. In large measure, this is due to the effective MVAF system which they felt ensures follow up care for many after having an RTI. However, we found that access to rehabilitation is skewed in favour of those living in Windhoek and other urban areas compared with those in non-urban areas. Conclusions The MVAF model seems to enhance access to rehabilitation and is a model which could be replicated in other SSA countries and other low and middle income countries. Implications for rehabilitation Road traffic injuries (RTIs) are a major global public health challenge with over 1.2 million people killed and a high burden of disability and Namibia is one of the worst affected countries globally. There is lack of knowledge on the availability to physical rehabilitation following road injury in Namibia. Our study shows the Motor Vehicle Accident Fund (MVAF) model seems to enhance access to rehabilitation and is a model which could be replicated in Sub-Saharan Africa and other low and middle income countries.

Physical Rehabilitation and Mental Health Care After Burn Injury: A Multinational Study.

While remarkable improvements have been made to acute hospital burn care in recent decades, it is not matched by improvements in post-acute care, including physical rehabilitation and mental health. Progress in acute hospital treatment of burn survivors now highlights the next important step-addressing care once a patient leaves intensive treatment and is discharged to the community. Long-term physical rehabilitation and mental health services are vital to improving quality of life for burn survivors. Using qualitative methods, we apply an adapted Reeve framework to assess and compare post-acute physical rehabilitation and mental health care across 13 countries on 6 continents. Twenty semistructured interviews were conducted with burn surgeons and rehabilitation specialists. One major theme that emerged was the importance of training and resources to the quality of post-acute care. This exploratory study suggests the value of investing scarce resources in a range of low-cost interventions to improve follow-up burn care. One intervention identified here is short-term training in post-acute rehabilitation and mental health to upgrade and standardize best clinical practices to address as-yet unmet post-discharge needs of burn survivors.

Needs for information about lifestyle and rehabilitation in long-term young adult cancer survivors

BackgroundHealthy lifestyle and rehabilitation may mitigate late effects after cancer treatment, but knowledge about lifestyle and rehabilitation information needs among long-term young adult cancer survivors (YACSs) (≥ 5 years from diagnosis) is limited. The present study aimed to examine such information needs among long-term YACSs, and identify characteristics of those with needs.Material and methodsThe Cancer Registry of Norway identified long-term YACSs diagnosed with breast cancer, colorectal cancer, non-Hodgkin lymphoma, leukemia, or malignant melanoma at the age of 19–39 years, between 1985 and 2009. Survivors were mailed a questionnaire, in which respondents reported their information needs on physical activity, diet, and rehabilitation services 5–30 years post-diagnosis. Descriptive statistics and logistic regression analyses were used to examine the prevalence of information needs and associated factors.ResultsOf 1488 respondents (a response rate of 42%), 947 were included. Median age at diagnosis was 35 years (range 19–39) and median observation time since diagnosis was 14 years (range 5–30). In total, 41% reported information needs for information about physical activity, 45% about diet, and 47% about rehabilitation services. Information needs were associated with higher treatment intensity, increasing number of late effects, and an unhealthy lifestyle.ConclusionA large proportion of long-term YACSs report information needs regarding lifestyle and/or rehabilitation more than a decade beyond treatment. Assessments of such information needs should become a part of long-term care of these cancer survivors.

Symptoms, complications and management of long COVID: a review.

Globally, there are now over 160 million confirmed cases of COVID-19 and more than 3 million deaths. While the majority of infected individuals recover, a significant proportion continue to experience symptoms and complications after their acute illness. Patients with ‘long COVID’ experience a wide range of physical and mental/psychological symptoms. Pooled prevalence data showed the 10 most prevalent reported symptoms were fatigue, shortness of breath, muscle pain, joint pain, headache, cough, chest pain, altered smell, altered taste and diarrhoea. Other common symptoms were cognitive impairment, memory loss, anxiety and sleep disorders. Beyond symptoms and complications, people with long COVID often reported impaired quality of life, mental health and employment issues. These individuals may require multidisciplinary care involving the long-term monitoring of symptoms, to identify potential complications, physical rehabilitation, mental health and social services support. Resilient healthcare systems are needed to ensure efficient and effective responses to future health challenges.

Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis - United States, January 2020-March 2021.

As of June 30, 2021, 33.5 million persons in the United States had received a diagnosis of COVID-19 (1). Although most patients infected with SARS-CoV-2, the virus that causes COVID-19, recover within a few weeks, some experience post-COVID-19 conditions. These range from new or returning to ongoing health problems that can continue beyond 4 weeks. Persons who were asymptomatic at the time of infection can also experience post-COVID-19 conditions. Data on post-COVID-19 conditions are emerging and information on rehabilitation needs among persons recovering from COVID-19 is limited. Using data acquired during January 2020-March 2021 from Select Medical* outpatient rehabilitation clinics, CDC compared patient-reported measures of health, physical endurance, and health care use between patients who had recovered from COVID-19 (post-COVID-19 patients) and patients needing rehabilitation because of a current or previous diagnosis of a neoplasm (cancer) who had not experienced COVID-19 (control patients). All patients had been referred to outpatient rehabilitation. Compared with control patients, post-COVID-19 patients had higher age- and sex-adjusted odds of reporting worse physical health (adjusted odds ratio [aOR]=1.8), pain (aOR=2.3), and difficulty with physical activities (aOR=1.6). Post-COVID-19 patients also had worse physical endurance, measured by the 6-minute walk test† (6MWT) (p<0.001) compared with control patients. Among patients referred to outpatient rehabilitation, those recovering from COVID-19 had poorer physical health and functional status than those who had cancer, or were recovering from cancer but not COVID-19. Patients recovering from COVID-19 might need additional clinical support, including tailored physical and mental health rehabilitation services.

Factors Related to Greater Functional Recovery after Suffering a Stroke.

Background: In a stroke, the importance of initial functional status is fundamental for prognosis. The aim of the current study was to investigate functional status, assessed by the Functional Independence Measure (FIM) scale, and possible predictors of functional outcome at discharge from inpatient rehabilitation. Methods: This is a retrospective study that was carried out at the Physical Medicine and Rehabilitation Service in A Coruña (Spain). A total of 365 consecutive patients with primary diagnosis of stroke were enrolled. The functional assessments of all patients were performed through the FIM. A descriptive and a bivariate analysis of the variables included in the study was made and a succession of linear regression models was used to determine which variables were associated with the total FIM at discharge. Results: Prior to having the stroke, 76.7% were totally independent in activities of daily living. The FIM scale score was 52.5 ± 25.5 points at admission and 83.4 ± 26.3 at hospital discharge. The multivariate analysis showed that FIM scores on admission were the most important predictors of FIM outcomes. Conclusions: Our study indicates that the degree of independence prior to admission after suffering a stroke is the factor that will determine the functionality of patients at hospital discharge.

Role of Telerehabilitation in the Rehabilitation Medicine Training Program of a COVID-19 Referral Center in a Developing Country.

This article describes the impact of the pandemic on physical medicine and rehabilitation in a COVID-19 referral center of a developing country. It describes how telerehabilitation can be leveraged to fill in the gaps in service, training, and research arms of the physical medicine and rehabilitation specialty. The ITAWAG ("to call") telerehabilitation program is the response of the Department of Rehabilitation Medicine at Philippine General Hospital, which is the country's national university hospital, to the ongoing COVID-19 crisis that continues to limit face-to-face access to physical medicine and rehabilitation services throughout the country. With the significant decline in the number of patients served since the start of the pandemic, the ITAWAG program aimed to bridge the physical distance between patients and clinicians after a set of eligibility criteria for teleconsultation or teletherapy and a step-by-step process used before, during, and after each virtual encounter. However, because many physical medicine and rehabilitation consultants, residents, and therapists were not trained for the virtual approach to patient care, a telerehabilitation curriculum was developed to help in providing quality and competent services. Finally, despite the growing awareness of telerehabilitation throughout the country, several research gaps about this emerging technology are identified to determine its acceptance, applicability, and cost-effectiveness among others.