Physical Therapy for Hospitalized Patients With COVID-19 in Isolation: Feasibility and Pilot Implementation of Telehealth for Delivering Individualized Therapy

Abstract

Objective: To optimize the ability of hospitalized patients isolated because of coronavirus disease 2019 (COVID-19) to participate in physical therapy (PT). Design: This was a prospective quality improvement trial of the feasibility and acceptability of a “hybrid” in-person and telerehabilitation platform to deliver PT to hospitalized adults. Setting: Inpatient wards of a tertiary care, multispecialty academic medical center in the greater New York City metropolitan area. Participants: A convenience sample of 39 COVID-19–positive adults (mean age, 57.3y; 69% male) all previously community dwelling agreed to participate in a combination of in-person and telerehabilitation sessions (N=39). Interventions: Initial in-person evaluation by physical therapist followed by twice daily PT sessions, 1 in-person and 1 via a telehealth platform meeting Health Insurance Portability and Accountability Act confidentiality requirements. The communication platform was downloaded to each participant's personal smart device to establish audiovisual contact with the physical therapist. Main Outcome Measures: We used the 6-clicks Activity Measure of Post-Acute Care (AM-PAC) to score self-reported functional status premorbidly and by the therapist at baseline and discharge. Results: Functional status measured by AM-PAC 6-clicks demonstrated improvement from admission to discharge. Barriers to participation were identified and strategies were planned to facilitate use of the platform in the future. Conclusions: A consistent and structured protocol for engaging patient participation in PT delivered via a telehealth platform was successfully developed. A process was put in place to allow for further development, recruitment, and testing in a randomized trial.

Keywords

• Coronavirus
• COVID-19
• Pandemics
• Physical therapy modalities
• Rehabilitation
• Telemedicine