Table I. Features and main content of the 9 articles included in this rapid review of rehabilitation needs due to Covid-19 outbreak. Publication window: up to March 31st, 2020.

 

N.

Authors, Journal, Year

Aim of the study

Study population or target population

Study setting or target setting

Country or geographical area involved

Main content

1

Boldrini P, et al. Eur J Phys Rehabil Med. 2020.11

To provide national recommendations on the rehabilitation care considering the Covid-19 outbreak in Italy.

Covid-19 patients, any subject in need of rehabilitation interventions and rehabilitation professionals.

Acute care wards, inpatient and outpatient rehabilitation facilities, and home environment.

Italy.

The SIMFER provided recommendations for care of Covid-19 patients (ensuring the adequate interventions in acute care, inpatient rehabilitation settings, outpatient and home-based rehabilitation settings), protection of patients and professionals (preventing the spread of the infection), and activation of a remote support service of “tele-rehabilitation-medicine” (providing information and advice to persons with disabling conditions).

2

Chen P, et al. J Sport Health Sci. 2020.12

To provide recommendations on the prevention of complications due to quarantine/ prolonged mobility restriction.

People quarantined at home or with restricted mobility due to the lockdown.

Home-based setting.

China.

There is a strong health rationale for continuing physical activity at home to stay healthy and maintain immune system function in the current risky environment.

Physical training at home should include strengthening and balance exercises, stretching or a combination of these.

3

Choon-Huat Koh G & Hoenig H. Arch Phys Med Rehabil. 2020.13

To alert and provide advice to the rehabilitation community so that it understands what to do to face the Covid-19 pandemics

Covid-19 patients, any subject in need of rehabilitation interventions and rehabilitation professionals.

Acute care wards, inpatient and outpatient rehabilitation facilities, and home environment.

Singapore / United States of America (USA).

Rehabilitation patients are at higher risk of severe and fatal Covid-19 infection. Practical advices include:

-  continuation of home exercises last prescribed and continued attendance at rehabilitation centres if well but with stepped-up infection control measures such as patient screening for fever and flu symptoms at the entrance.

- tele-rehabilitation is the first option for people capable of performing rehabilitation at home with guidance from PRM specialists. 

-fever and flu symptoms should be monitored for patients who need centre-based or inpatient rehabilitation, to separate the well from the unwell; symptomatic patients should be quarantined and tested for coronavirus, and isolated and treated if positive.

4

Cui H-T, et al. Trad Med Res. 2020.14

To summarize the Covid-19 pathogenesis, clinical outcomes, and current applications of traditional Chinese Medicine (TCM) for the treatment of Covid-19.

Covid-19 patients.

Acute care wards, inpatient and outpatient rehabilitation facilities, and home environment.

China.

The use of TCM decoctions is recommended as a means to reduce fever, cough, expectoration, fatigue and difficulty with breathing in Covid-19 patients.

5

Jiménez-Pavón D, et al. Prog Cardiovasc Dis. 2020.15

To promote physical activity and exercise in order to counteract the mental and physical consequences of Covid-19 quarantine in older people.

People quarantined at home or with restricted mobility due to the lockdown.

Home-based setting.

Spain.

A proper exercise program might counteract the negative consequences of several diseases (diabetes, hypertension, cardio-vascular diseases, respiratory diseases), to reduce the risk of frailty, sarcopenia, and dementia, and to prevent the psychological effects of quarantine. A multicomponent rehabilitative program, including aerobic, resistance, balance, coordination and mobility training exercises, for 5-7 days/week, at moderate intensity, could maintain an adequate health status in older people.

6

Jin X, et al. Engineering. 2020.16

To develop a Core Outcome Set for clinical trials on Covid-19 (COS-Covid).

Covid-19 patients.

Acute care wards, inpatient and outpatient rehabilitation facilities, and home environment.

China.

The COS-Covid consists of 8 different outcome measures to be used in the different scenarios of Covid-19 infection:

1. time to 2019-nCoV RT-PCR negativity

     (mild, ordinary and severe cases)

2 clinical symptom score (ordinary cases)

3 length of hospital stay (ordinary and severe cases)

4 composite events ((total number of patients diagnosed

    as severe, critical and all-cause death), (ordinary and severe cases)

5 PaO2/FiO2, (severe cases)

6 duration of mechanical ventilation, (severe cases)

7 all-cause mortality (critical cases)

8 pulmonary function (rehabilitation phase)

7

Lazzeri M, et al. Arch Chest Dis. 2020.17

To share information with

physical therapists involved in the management of patients affected by Covid-19 in acute stages, worldwide.

Covid-19 patients.

Acute care setting.

Italy

The following advices are given to physical therapists involved in the management of patients affected by Covid-19 in acute stages:

- to monitor the clinical condition closely and prepare early for invasive mechanical ventilation;

- to consider the feasibility of each treatment, based on available equipment,  and adopt shared strategies performed by a multidisciplinary team;

- to monitor patients’ clinical condition carefully after a postural change, as this event can affect suddenly patients’ ability to exchange gas;

- to reduce any unnecessary manoeuvre, particularly procedures that can generate a reduction in the positive end-expiratory pressure and lead to lung de-recruitment;

- to check for side effects determined by prolonged prone position during ventilation;

- to perform passive mobilization as early as possible to avoid immobilization sequelae;

- to limit bronchial hygiene techniques to selected cases;

- to reduce unnecessary manoeuvres, particularly procedures that can generate droplets/aerosol;

- to organize job activities so to limit the risk of personnel contamination as much as possible

8

McNeary L, et al. PM R. 2020.18

To develop a Conditions Actions Needs (CAN) report for Inpatient Rehabilitation Facilities.

Covid-19 patients.

Acute care and inpatient rehabilitation settings.

USA.

The CAN model is important to prepare for emergency situations, including the Covid-19 pandemic. Rehabilitation services must prioritize patients and staff safety.

9

Negrini S, et a. Eur J Phys Rehabil Med. 2020. 7

To define a call for action about the need of timely answers for clinical questions to PRM clinicians.

Covid-19 patients, any subject in need of rehabilitation interventions and rehabilitation professionals.

Acute care, inpatient rehabilitation, outpatient rehabilitation, and home-based settings.

Italy.

The EJPRM will provide provisional but immediate responses to PRM community. Because of the urgent need of timely answer, they will publish a collection of “instant papers”, regarding the result of the webinars about the first clinical experiences in Italy and trying to give crucial fast answers to PRM clinicians.

 

Abbreviations:PRM= Physical and Rehabilitation Medicine; RT-PCR = reverse transcriptase-polymerase chain reaction; PaO2/FiO2= ratio between partial pressure of oxygen in arterial blood and fraction of inspired oxygen; EJPRM= European Journal Physical Rehabilitation Medicine

Reference: Ceravolo MG, de Sire A, Andrenelli E, Negrini F, Negrini S. Systematic rapid “living” review on rehabilitation needs due to COVID-19: update to March 31st, 2020. Eur J Phys Rehabil Med 2020;56:347-53.
DOI: 10.23736/S1973-9087.20.06329-7