Impacto de la pandemia por COVID-19 en los Servicios de Rehabilitación de España / Pandemic COVID-19 impact in Rehabilitation Services in Spain

Introducción: El presente estudio tiene como objetivo describir la adaptación de los servicios de Rehabilitación al rápido y significativo incremento de pacientes con COVID-19 con necesidad de valoración y tratamiento rehabilitador. Material y métodos: Estudio transversal. Se realizó una encuesta online entre los principales servicios de Rehabilitación de España entre el 22-12-2020 y el 27-02-2021. Un comité de expertos de SORECAR desarrolló la encuesta. El análisis se realizó utilizando SPSS v22.0. Objetivo: Definir las necesidades y los cambios surgidos a raíz de la pandemia SARS-CoV-2 en los servicios de Medicina Física y Rehabilitación (SMFyR). Resultados: Participaron 38 servicios de Rehabilitación de 18 ciudades (se enviaron encuestas a 49 centros hospitalarios). La demanda asistencial media en Unidad de Cuidados Intensivos fue de 7,84 ± 6,8 hojas de interconsulta (HIC)/semana, planta de hospitalización: 9,63 ± 6,21 HIC/semana de media. En horas de trabajo por semana, el tiempo médico dedicado fue 6,59 h/semana y el tiempo de fisioterapeutas fue de 16,43 h/semana. Ahora el tiempo medio de dedicación en médicos es 10,38 h/semana y en fisioterapeutas es de 25,95 h/semana. Solo 7 hospitales de la muestra (16,7%) cuentan con terapeutas ocupacionales con dedicación media de 5 h/semana.El 59,1% (n = 23) de los casos hay una consulta específica de Rehabilitación post-COVID. El 64,3% (n = 24) de los hospitales afirmaban haber desarrollado un protocolo específico asistencial en el servicio para pacientes COVID-19. Un 48,5% (n = 18) de centros no dispone de rotación específica en Rehabilitación en cuidados intensivos ni en rehabilitación respiratoria para los médicos internos residentes. Solo en rehabilitación respiratoria (15,7%, n = 6), en ambas disciplinas en un 38,4% (n = 14).(AU)

Introduction: The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. Material and methods: Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. Objective: To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. Results: 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average.(AU)

[Pandemic COVID-19 impact in Rehabilitation Services in Spain]. / Impacto de la pandemia por COVID-19 en los Servicios de Rehabilitación de España.

INTRODUCTION: The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. MATERIAL AND METHODS: Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. OBJECTIVE: To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. RESULTS: 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents. CONCLUSIONS: The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.

Satisfacción y utilidad del tratamiento rehabilitador a través de material educativo en pacientes con COVID-19 / Satisfaction and utility of rehabilitative treatment through educational material in patients with COVID-19

Objetivo: En Madrid, durante la pandemia por COVID-19, debido a la saturación hospitalaria se precisó la medicalización de hoteles para traslado de pacientes infectados por SARS-CoV-2 con evolución favorable. Su situación clínica tipo era de fatiga y desacondicionamiento físico, precisando y beneficiándose de un abordaje rehabilitador. El Servicio de Rehabilitación desarrolló material educativo en formato de papel sobre ejercicio terapéutico adaptado a las diferentes situaciones funcionales detectadas. El objetivo es describir el perfil de pacientes ingresados en un hotel medicalizado y analizar el grado de satisfacción y adherencia al ejercicio pautado durante el ingreso y en domicilio y los factores relacionados. Material y método: Estudio descriptivo de pacientes ingresados en el Hotel Colón durante dos meses de 2020, con análisis de variables socio demográficas, y de cuestionarios con respecto al grado de adherencia y satisfacción del tratamiento rehabilitador durante ingreso y al alta. Resultado: Participaron 100 pacientes con una edad media de 52 años±14.5, donde el 61% (n=61) fueron mujeres. El 99% (n=99) refirió comprender los ejercicios, los realizaron durante el ingreso el 90% (n=90), mientras un 58% (n=58) los continuó al alta. El 92% (n=92) se mostró «muy satisfecho» con el material educativo, considerándolo fácil de realizar en el 100% (n=100) de los casos. Conclusión: Los pacientes se mostraron satisfechos con el material educativo, fueron ejercicios comprensibles y tuvieron adherencia durante el ingreso y en domicilio. El material educativo en formato papel podría considerarse una herramienta útil para el manejo de pacientes con infección por SARS-CoV-2.(AU)

Objective: In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors. Material and method: We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge. Results: 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were “very satisfied” with the educational material and considered it easy to perform in 100% (n=100) of cases. Conclusion: The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff.(AU)

[Satisfaction and utility of rehabilitative treatment through educational material in patients with COVID-19]. / Satisfacción y utilidad del tratamiento rehabilitador a través de material educativo en pacientes con COVID-19.

OBJECTIVE: In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors. MATERIAL AND METHOD: We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge. RESULTS: 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were "very satisfied" with the educational material and considered it easy to perform in 100% (n=100) of cases. CONCLUSION: The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff.