Authors (including presenting author) :
Kwok CF(1), O HH(1), Chui KW(1), Mok YT(1), Leung YYC(1), Wong TWL(2)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
(2)Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University
Introduction :
Physical deconditioning and pulmonary dysfunction are the common problems of COVID-19 patients especially for the elderly after prolonged hospitalization.
Physiotherapy department in the Lai King Building (LKB) of Princess Margaret Hospital provides extended rehabilitation service to post-acute COVID-19 patients. A comprehensive rehabilitation program including tailor-made mobilization, strengthening, aerobic exercise, mobility training and pulmonary rehabilitation are given.
Our services also provide home exercise education, proactive care-giver training and multidisciplinary discharge planning, which aim to facilitate patients’ early discharge and re-integration to the community.
Objectives :
The present paper aims to review the rehabilitation outcomes for post-acute COVID-19 patients in extended rehabilitation ward of LKB.
Methodology :
Patients diagnosed with COVID-19 and transferred to LKB with physiotherapy services from July 2020 to Sept 2021 were included. They all met the de-isolation criteria with improved clinical conditions, afebrile, tested positive for SARS-CoV-2 antibody, 7 days after symptom onset and CT value ≥ 30. Clinical outcome measures including Elderly Mobility Scale (EMS), Time Up and Go test (TUGT), Six Minute Walk Test (6MWT) and Modified Functional Ambulation Category score (MFAC) were evaluated.
Comparison was made between scores taken at the initial and last treatment session using SPSS.
Result & Outcome :
10 patients (7 males and 3 females) aged between 60 to 82 years (mean age: 69.9 ±7.72 years old) were included. None of them have received the COVID-19 vaccine before admission.
Paired sample t-test showed that the patients had significant improvement in the 6MWT (mean distance in meter: pre: 159.6; post: 224.4) (p<0.05); and significant improvement in TUGT (mean time in seconds: pre:24; post: 19.2) (p<0.05) after rehabilitation. Furthermore, Wilcoxon Signed Rank Test showed significant improvement in EMS score before (mean: 9.8) and after (mean:14) receiving physiotherapy treatments (p<0.05).
Upon discharge, the percentage of patients with MFAC 6-7 (independent walker) was increased by 40% (from 0% to 40%); and the categories of lier & sitter (MFAC 1-2) was reduced by 20% (from 20% to 0%).
The average length of stay (LOS) was 25.7 ±27.71 days. There was an age-dependent variation in LOS: For patients under 70 years old, the average LOS was 7 ±4.3 days. While for those aged above 70 years old was 44.4 ±28.9 days, and all of them received care giver training, Geriatric Day Hospital (GDH) and Integrated Care Model (ICM) service for further rehabilitation and community support post discharge, except one patient who was discharged to her premorbid old age home.
In conclusion, post-acute COVID-19 patients who received physiotherapy treatments in LKB wards showed significant improvements in mobility and functional level. There was an age-dependent variation in hospital LOS for the patients, which may be contributed by the pre-existing medical conditions, underlying declining physical and cognitive functions, affecting the rehabilitation progress. Further studies may focus on the respiratory and psychological aspects of those post-acute COVID-19 patients.
