Impact of the COVID-19 Pandemic on Post-Stroke Outpatient Rehabilitation at a Mediterranean Rehabilitation Center
DOI :
https://doi.org/10.25759/spmfr.435Mots-clés :
COVID-19, Stroke Rehabilitation, Surveys and QuestionnairesRésumé
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.
Téléchargements
Références
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.
Téléchargements
Fichiers supplémentaires
Publiée
Comment citer
Numéro
Rubrique
Licence
Os manuscritos devem ser acompanhados de declaração de originalidade, Autoria e de cedência dos direitos de propriedade do artigo, assinada por todos os Autores.
Quando o artigo é aceite para publicação é obrigatória a submissão de um documento digitalizado, assinado por todos os Autores, com a partilha dos direitos de Autor entre Autores e a Revista SPMFR, conforme minuta:
Declaração Copyright
Ao Editor-chefe da Revista da Sociedade Portuguesa de Medicina Física e Reabilitação
O(s) Autor(es) certifica(m) que o manuscrito intitulado:
____________________________________________________________________ (ref.Revista da SPMFR_________) é original, que todas as afirmações apresentadas como factos são baseados na investigação do(s) Autor(es), que o manuscrito, quer em parte quer no todo, não infringe nenhum copyright e não viola nenhum direito da privacidade, que não foi publicado em parte ou no todo e que não foi submetido para publicação, no todo ou em parte, noutra revista, e que os Autores têm o direito ao copyright.
Todos os Autores declaram ainda que participaram no trabalho, se responsabilizam por ele e que não existe, da parte de qualquer dos Autores conflito de interesses nas afirmações proferidas no trabalho.
Os Autores, ao submeterem o trabalho para publicação, partilham com a Revista da SPMFR todos os direitos a interesses do copyright do artigo.
Todos os Autores devem assinar
Data:
Nome(maiúsculas)
Assinatura
Relativamente à utilização por terceiros a Revista da SPMFR rege-se pelos termos da licença Creative Commons “Atribuição – uso Não-Comercial – Proibição de Realização de Obras derivadas (by-nc-nd)”.
Após publicação na Revista SPMFR, os Autores ficam autorizados a disponibilizar os seus artigos em repositórios das suas instituições de origem, desde que mencionem sempre onde foram publicados.
OS AUTORES DEVERÃO SUBMETER UMA DECLARAÇÃO DE CONTRIBUIÇÃO / CONTRIBUTORSHIP STATEMENT INDICANDO O TIPO DE PARTICIPAÇÃO DE CADA AUTOR NO ARTIGO. Mais informações: https://authors.bmj.com/policies/bmj-policy-on-authorship/