Nursing home residents can tolerate moderate-to-high amounts of physical rehabilitation while ill with symptomatic COVID-19 in order to decrease the odds of long-term atrophy and improve functional outcomes, a new study finds.
Despite symptoms such as fever, lethargy and even dehydration, rehabilitation during COVID-19 illness is beneficial for this population, the researchers reported.
The study took place among residents of a nursing home operated by The New Jewish Home, New York, NY, a senior care health system. Investigators followed 71 long-term and 177 post-acute patients with symptomatic COVID-19 for 30 days between March and May 2020. They recorded physical, occupational and speech therapy minutes and sessions along with the highest BUN/creatinine levels from symptom onset to 30 days post-symptom onset. The researchers also tracked functional independence levels before, during and after COVID-19 using electronic health records and the Minimum Data Set 3.0.
Post-acute patients received more rehab
Post-acute patients were more likely to receive rehabilitation than long-term care residents, the researchers found. Occupational and physical therapy were used for nearly 60% of the ill residents overall, while speech therapy was provided to 13% of residents.
Residents who received rehabilitation were more dependent in overall functional status when ill than their peers who did not receive therapeutic care. But the rehabilitation group’s functional status declined less from baseline during their COVID-19 illness when compared to those not prescribed rehabilitation.
Despite systemic, cognitive and respiratory symptoms of COVID-19, most study participants tolerated moderate-to-high amounts of rehabilitation for both occupational and physical therapy, the data analysis showed.
More symptoms, greater decline
Since an increased number of COVID-19 symptoms predict functional decline, the fact that these residents were able to participate in the therapy consistently despite their symptoms is promising, the researchers said. “[H]igher therapy amounts predict improved functional independence recovery (or maintenance) and successful discharge” from the facility, they said.
Although the study is limited to a single nursing home, the findings support therapy in these patients, the researchers added.
“[C]linicians should feel comfortable prescribing rehabilitation at moderate amounts to COVID-19 patients in nursing facilities, if consistent with goals of care,” they concluded.
Full findings, including the frequencies of COVID-19 symptoms, dehydration and rehabilitation amounts, were published in JAMDA.