Impact of the COVID-19 Pandemic on Post-Stroke Outpatient Rehabilitation at a Mediterranean Rehabilitation Center
DOI:
https://doi.org/10.25759/spmfr.435Keywords:
COVID-19, Stroke Rehabilitation, Surveys and QuestionnairesAbstract
Introduction: Stroke is one of the most common causes of death and acquired disability worldwide. Temporary interruptions to outpatient rehabilitation programs due to the COVID-19 pandemic have negatively impacted stroke patients.
Our objective was to evaluate the impact of outpatient rehabilitation programs interruption on stroke patients and their caregivers during the lockdown.
Methods: An observational study was conducted at a European Rehabilitation Center. We selected patients that suspended outpatient treatments from March to May 2020, due to the COVID-19 pandemic. A telephone questionnaire was applied in June 2020 evaluating muscle strength, spasticity, pain, independence level, anxiety, depression, caregiver burden, absenteeism, and financial concerns.
Results: Ninety five patients were included in the study. The mean age was 59±13.1 years, and 57 were male. During the lockdown, 94.7% of participants did not receive rehabilitation, and 83.2% of respondents reported that the COVID-19 pandemic harmed their independence. A percentage of 71.1% of caregivers reported higher levels of burden assistance to the patient. The more autonomous patients (FIM≥80) had greater repercussions on walking and climbing stairs (p<0.05), while more dependent patients (FIM<80) showed greater repercussions in feeding and transfers (p<0.05).
Conclusion: The interruption of outpatient rehabilitation was detrimental both to stroke survivors and caregivers. This study highlights the need for intensive rehabilitation and tailored follow-up of stroke patients on outpatient, even after the post-acute phase. New strategies, such as telerehabilitation, might prevent future limitations in access to rehabilitation.
Downloads
References
Stroke Collaborators. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019. 18: 439–58.
Winstein CJ, Stein J, et al. Guidelines for Adult Stroke Rehabilitation and Recovery. A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 2016. 47(6): 98-169.
Buntin MB, Colla CH, Deb P, Sood N, Escarce JJ. Medicare spending and outcomes after postacute care for stroke and hip fracture. Med Care, 2010. 48:776–784.
Stinear CM, Lang CE, et al. Advances and challenges in stroke rehabilitation. Lancet Neurol, 2020. 19(4):348-360.
Jun Z. SARS-CoV-2: an emerging coronavirus that causes a global threat. Int J Biol Sci. 2020. 16:1678-85.
Stephan L, Alexander Z. Coronaviruses and SARS-CoV-2: a brief overview. Anesth Analg. 2020.131:93-6.
Boldrini P, Kiekens C, et al. First impact on services and their preparation. “instant paper from the field” on rehabilitation answers to the Covid-19 emergency. Eur J Phys rehabil Med 2020; 56:000–000.
Chaler J, Gil-fraguas L, et al. Impact of coronavirus disease 2019 (covid-19) outbreak on rehabilitation services and physical medicine and rehabilitation (PM&R) physicians’ activities: perspectives from the spanish experience. Eur J phys rehabil Med 2020; 56:000–000.
Singh R, burn J, sivan M. The impact of covid-19 on rehabilitation services and activities. Letter to the editor in response to official document of simfer. Eur J phys rehabil Med 2020; 56:000–000.
Leocani L, Diserens K, et al. Disability through COVID-19 pandemic: neurorehabilitation cannot wait. Eur J Neurol. 2020 Sep;27(9): e50-e51.
Boldrini P, Garcea M, et al. Living with a disability during the pandemic. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency. Eur J Phys Rehabil Med. 2020 Jun;56(3):331-334.
Boldrini P, Bernetti A, et al. Impact of COVID-19 outbreak on rehabilitation services and Physical and Rehabilitation Medicine physicians' activities in Italy. An official document of the Italian PRM Society (SIMFER). Eur J Phys Rehabil Med, 2020.56(3):316-318.
Laxe S, Ferri J, et al. Neurorehabilitation in the times of Covid-19: insights from the Spanish Neurorehabilitation Society (SENR). Brain Inj,2020.14;34(12):1691-1692.
Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID- 19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA, 2020. 28;323(16):1545-1546.
Minghelli B, Soares A, et al. Physiotherapy services in the face of a pandemic. Rev Assoc Med Bras, 2020. 66(4):491-497.
Cramer SC, Dodakian L, et al. Efficacy of Home-Based Telerehabilitation vs In-Clinic Therapy for Adults After Stroke. JAMA Neur, 2019. 76(9): 1079–1087.
Chang MC, Boudier.Revéret M. Usefulness of telerehabilitation for stroke patients during the COVID-19 pandemic. Am J Phys Med Rehabil., 2020. 11: 10.1097.
Tenforde AS, Borgtrom H, et al. Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic. Am J Phys Med Rehabil, 2020. 99(11):977-981.
Laver KE, Wakeling ZA, et al. Telerehabilitation services for stroke. Cochrane Database Syst Ver,2020. 31;1(1):CD010255.
Negrini S, Grabljevec K, et al. Up to 2.2 million people experiencing disability suffer collateral damage each day of COVID-19 lockdown in Europe. Eur J Phys Rehabil Med, 2020.56(3):361-365.
Leira EC, Russman A, et al. Preserving stroke care during the COVID-19 pandemic: Potential issues and solutions. Neurology, 2020. 21;95(3):124-133.
Chun MH, Chang MC. The effects of forest therapy on depression and anxiety in patients with chronic stroke. Int J Neurosci, 2017. 127(3):199-203.
Schottke H, Giabbiconi CM. Post-stroke depression and post-stroke anxiety: prevalence and predictors. Int Psychogeriatr,2015. 27(11):1805-12.
Ren H, Liu C, Li J, et al. Self-perceived burden in the young and middle-aged in- patients with stroke: a cross-sectional survey. Rehabil Nurs 2016;41(2):101–11.
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright statement
Authors must also submit a copyright statement (as seen below) on article submission.
To the Editor-in-chief of the SPMFR Journal:
The below signed author(s) hereby state that the article
________________________________________ (ref. MFR_________) is
an original unpublished work and all facts stated are a product of the author(s) investigation. This article does not violate any copyright laws or privacy statements. The author(s) also hereby confirm that there is no conflict of interest's issues in this article.
By submitting this article the author(s) agree that after publication all copyrights belong to the SPMFR Journal.
Signed by all authors
Date:
Names (capital letters):
Signatures:
The SPMFR Journal’s contents are follow a Creative Commons licence. After publication the authors can hand out the articles as long as the SPMFR Journal is credited.