Neurorehabilitation

Disability through COVID-19 pandemic: Neurorehabilitation cannot wait

Why we need neurorehabiliation now more than ever, and how to deal with this.

Coronavirus disease 2019 (CoViD-19) pandemic has strongly impacted all domains of our healthcare systems, including rehabilitation, with most hospital accesses being postponed. However, in the next months, while CoViD-19 is still circulating, we will be facing increased neurorehabilitation needs, not only as a consequence of prolonged immobilization and acute neurological complications from COVID-19, but also of mitigation healthcare and civil measures (e.g., reduced physical activity during lockdown, postponing of medical care including rehabilitation). We discuss possible points of action for neurorehabilitation. In particular, telerehabilitation platforms for physical, language and cognitive rehabilitation, exergaming, allowing remote supervision and collection of patient-reported outcomes, should be offered when adequate. Robotic-based and exoskeleton interventions need to be implemented more efficiently. Physical distancing, separate pathways for CoViD-19 positive and negative patients, and proper personal protection equipment (PPE) will continue. We have to take action now to produce long-term healthcare effects to prevent, or at least promptly counteract, future outbreaks or their consequences.

 

Key points:

  • We need to take action to face increasing neurorehabilitation needs, as a direct and indirect consequence of COVID-19
  • Delaying neurorehabilitation for time-dependent neurological conditions may lead to lose the proper time window for the best possible recovery - and to a longer time spent in acute care units, reducing their bed availability
  • Delaying for people with progressive neurological disorders may put them at risk of further worsening
  • Digital technology should be used to deliver neurorehabilitation remotely when appropriate
  • Specific logistic and safety measure should be implemented for patients who need to attend neurorehabilitation units

 

References:

Leocani L, Diserens K, Moccia M, Caltagirone C. Disability Through COVID-19 Pandemic: Neurorehabilitation Cannot Wait. Eur J Neurol. 2020. https://pubmed.ncbi.nlm.nih.gov/32402100/

Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020. https://pubmed.ncbi.nlm.nih.gov/32275288/

Hosseiniravandi M, Kahlaee AH, Karim H, Ghamkhar L, Safdari R. Home-based telerehabilitation software systems for remote supervising: A systematic review. Int J Technol Assess Health Care. 2020. https://pubmed.ncbi.nlm.nih.gov/32151291/