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T. Murakami1,2, Y. Higuchi1, T. Ueda1, E. Todo1, R. Hatanaka1, W. Kouzuki1, A. Kitamura1, A. Gen1
1Osaka Prefecture University, Graduate School of Comprehensive Rehabilitation, Osaka, Japan, 2Japan Community Health Care Organization Hoshigaoka Medical Center, Physical Medicine and Rehabilitation Department, Hirakata, Japan
Background: The coronavirus disease (COVID-19) pandemic has affected non-COVID-19 medical resources and treatment. The Japanese government announced a state of emergency in response to the COVID-19 pandemic from April 7th to May 25th, 2020, asking individuals to reduce their contact with others. In several rehabilitation hospitals, the ordinary frequency of physical and occupational therapy was limited in order to reduce contact with patients. In addition, hospitals implemented the following infection control measures: prohibition of visits to inpatients, postponement of conferences involving family members of patients at the hospital, and postponement of in-home evaluations.
Purpose: The aim of this study was to compare the rehabilitation length per day during the COVID-19 pandemic period to that during the same period last year and to investigate the impact of restrictions due to infection control measures on improvements in activities of daily living (ADL).
Methods: This was an observational study (historical control, retrospective cohort). The setting was a single-center, rehabilitation hospital in Osaka, Japan. The subjects were divided into two groups: the restriction group was hospitalized for at least 2 weeks from April 7th to May 25th, 2020, and the control group was hospitalized during the same period in 2019. ADL was evaluated using the functional independence measure (FIM). The main outcomes were the rehabilitation length per day and ADL improvements adjusted for age, sex, days since stroke onset, and FIM motor and cognitive scores at baseline.
Results: Among the 95 patients (45 men and 50 women), the mean ages were 70.6±15.9 years in the restriction group (n=41) and 73.3±11.4 years in the control group. The rehabilitation lengths per day were 108.5±21.9 min in the restriction group and 136.8±19.0 min in the control group. There was a significant difference in the rehabilitation length (p < 0.001). There were significantly lower improvements in FIM scores per month in the restriction group {median, 6.0 [interquartile range (IQR), 2.0 to 13.5]} than in the control group [11.5 (IQR, 4.8 to 26.3)]. As a result of multiple regression analysis, the restrictions due to the infection control measures had a significant adverse effect on FIM score improvements. It was suggested that the FIM improvement had decreased by approximately 5.3 points in the restriction group.
Conclusion(s): The state of emergency in response to the COVID-19 pandemic adversely affected stroke rehabilitation during hospitalization. The rehabilitation length per day and ADL improvements decreased during the COVID-19 pandemic.
Implications: It is necessary to consider measures for non-COVID-19 rehabilitation.
Funding, acknowledgements: none
Keywords: COVID-19, stroke, rehabilitation
Topic: COVID-19
Did this work require ethics approval? Yes
Institution: Hoshigaoka Medical Center
Committee: Hoshigaoka Medical Center
Ethics number: HG-IRB2055
All authors, affiliations and abstracts have been published as submitted.
