Article Text

Rehabilitation post-COVID-19: cross-sectional observations using the Stanford Hall remote assessment tool
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  1. Oliver O’Sullivan1,2,
  2. R M Barker-Davies1,3,
  3. K Thompson2,
  4. S Bahadur4,
  5. M Gough4,
  6. S Lewis4,
  7. M Martin4,
  8. A Segalini4,
  9. G Wallace4,
  10. R Phillip4 and
  11. M Cranley4
  1. 1Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, LE12 5BL, UK
  2. 2Headquarters Army Medical Services (HQ AMS), Camberley, UK
  3. 3School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
  4. 4Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, UK
  1. Correspondence to Dr R M Barker-Davies, Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, LE12 5BL, UK; robert.barker-davies{at}nhs.net

Abstract

Introduction The multisystem COVID-19 can cause prolonged symptoms requiring rehabilitation. This study describes the creation of a remote COVID-19 rehabilitation assessment tool to allow timely triage, assessment and management. It hypotheses those with post-COVID-19 syndrome, potentially without laboratory confirmation and irrespective of initial disease severity, will have significant rehabilitation needs.

Methods Cross-sectional study of consecutive patients referred by general practitioners (April–November 2020). Primary outcomes were presence/absence of anticipated sequelae. Binary logistic regression was used to test association between acute presentation and post-COVID-19 symptomatology.

Results 155 patients (n=127 men, n=28 women, median age 39 years, median 13 weeks post-illness) were assessed using the tool. Acute symptoms were most commonly shortness of breath (SOB) (74.2%), fever (73.5%), fatigue (70.3%) and cough (64.5%); and post-acutely, SOB (76.7%), fatigue (70.3%), cough (57.4%) and anxiety/mood disturbance (39.4%). Individuals with a confirmed diagnosis of COVID-19 were 69% and 63% less likely to have anxiety/mood disturbance and pain, respectively, at 3 months.

Conclusions Rehabilitation assessment should be offered to all patients suffering post-COVID-19 symptoms, not only those with laboratory confirmation and considered independently from acute illness severity. This tool offers a structure for a remote assessment. Post-COVID-19 programmes should include SOB, fatigue and mood disturbance management.

  • COVID-19
  • telemedicine
  • rehabilitation medicine

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information. Relevant, anonymised data are uploaded as supplemental files. Further requests for data will need to be done through the Ministry of Defence.

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Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information. Relevant, anonymised data are uploaded as supplemental files. Further requests for data will need to be done through the Ministry of Defence.

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Footnotes

  • Contributors MC, OOS and RB-D conceived the idea of the study. MC, MM, SL, AS and GW made up the working group for the tool design. MC, MG, SB and RP performed the assessments. OOS drafted and edited the manuscript. KT reviewed and coded all consultations. RB-D edited the manuscript and performed statistical analysis. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.