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

Abstract

\n Objective\n To optimize the ability of hospitalized patients isolated due to COVID-19 to participate in physical therapy.\n \n Design\n This was a prospective, quality improvement trial of the feasibility and acceptability of a “hybrid” in-person and telerehabilitation platform to deliver physical therapy to hospitalized adults.\n \n Setting\n Inpatient wards of a tertiary care, multi-specialty academic medical center in the greater New York City metropolitan area.\n \n Participants\n A convenience sample of 39 COVID-19+ adults, mean age 57.3 years, 69% male, all previously community dwelling agreed to participate in a combination of in-person and telerehabilitation sessions (TR).\n \n Intervention\n Initial in-person evaluation by physical therapist followed by twice daily PT sessions, one in-person and one via a telehealth platform meeting Health Insurance Portability and Accountability Act (HIPAA) confidentiality requirements. The communication platform was downloaded to each participant s personal smart device to establish audiovisual contact with the Physical Therapist.\n \n Measures\n The 6-clicks Activity Measure for Post-Acute Care (AM-PAC) was used to score self-reported functional status pre-morbidly by, and by the therapist at baseline and discharge.\n \n Results\n Functional status measured by AM-PAC 6-clicks demonstrated improvement from admission to discharge. Barriers to participation were identified and strategies are planned to facilitate use of the platform in future.\n \n Conclusions\n 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.\n