Practice Considerations for Adapting In-Person Groups to Telerehabilitation

The Coronavirus-2019 (COVID-19) pandemic has shifted research and healthcare system priorities, stimulating literature on implementation and evaluation of telerehabilitation for a variety of patient populations. While there is substantial literature on individual telerehabilitation, evidence about group telerehabilitation remains limited despite its increasing use by rehabilitation providers. Therefore, the purpose of this manuscript is to describe our expert team’s consensus on practice considerations for adapting in-person group rehabilitation to group telerehabilitation to provide rapid guidance during a pandemic and create a foundation for sustainability of group telerehabilitation beyond the pandemic’s end. &nbsp

Disparities in the Allocation of Inpatient Physical and Occupational Therapy Services for Patients with COVID-19

Background Survivors of the novel coronavirus (COVID-19) experience significant morbidity with reduced physical function and impairments in activities of daily living. The use of in-hospital rehabilitation therapy may reduce long-term impairments. Objective To determine the frequency of therapy referral and treatment amongst hospitalized COVID-19 patients, assess for disparities in referral and receipt of therapy, and identify potentially modifiable factors contributing to disparities in therapy allocation. Design, Setting and Participants Retrospective cohort study using data collected from the University of Colorado Health Data Compass data warehouse assessing therapy referral rates and estimated delivery based on available administrative billing. Measurements Multivariable logistic regression was used to determine the association between sex and/or underrepresented minority race with therapy referral or delivery. Results Amongst 6239 COVID-19-related hospitalization, a therapy referral was present in 3952 patients (51.9%). Hispanic ethnicity was independently associated with lower odds of receipt of therapy referral (adjusted OR [aOR]: 0.78, 95% confidence interval [CI]: 0.67–0.93, p = .001). Advanced age (aOR: 1.53, 95% CI: 1.46–1.62, p \u3c .001), greater COVID illness severity (aOR for intensive care unit admission: 1.63, 95% CI: 1.37–1.94, p \u3c .01) and hospital stay (aOR: 1.14, 95% CI: 1.12–1.15, p \u3c .01) were positively associated with referral. Conclusions and Relevance In a cohort of patients hospitalized for COVID-19 across a multicenter healthcare system, we found that referral rates and delivery of physical therapy and/or occupational therapy sessions were significantly reduced for patients of Hispanic identity compared with patients of non-Hispanic, Caucasian identity after adjustment for potential confounding by available demographic and illness severity variables