Ebrahimi Takamjani, I.

Shahabi, S.

ShahAli, S.

eprints Iran University of Medical Sciences

Full Terms & Conditions of access and use can be found athttps://www.tandfonline.com/action/journalInformation?journalCode=iejp20European Journal of PhysiotherapyISSN: 2167-9169 (Print) 2167-9177 (Online) Journal homepage: https://www.tandfonline.com/loi/iejp20COVID-19 and Iranian older people: rehabilitationperspectiveShabnam ShahAli, Shiva ShahAli, Ismail Ebrahimi Takamjani & SaeedShahabiTo cite this article: Shabnam ShahAli, Shiva ShahAli, Ismail Ebrahimi Takamjani & SaeedShahabi (2020) COVID-19 and Iranian older people: rehabilitation perspective, European Journal ofPhysiotherapy, 22:5, 309-310, DOI: 10.1080/21679169.2020.1783112To link to this article:  https://doi.org/10.1080/21679169.2020.1783112Published online: 02 Jul 2020.Submit your article to this journal Article views: 128View related articles View Crossmark dataLETTER TO THE EDITORCOVID-19 and Iranian older people: rehabilitation perspectiveWorld Health Organisation (WHO) announced coronavirusdisease 2019 (COVID-19) as a pandemic on 11 March 2020.As of 20 May 2020, COVID-19 is affecting 215 countries andterritories around the world. The COVID-19 initially was con-firmed in Qom, Iran, on 19 February 2020, and rapidly spreadin all provinces. The coronavirus outbreak poses a consider-able challenge to human health, especially to vulnerablegroups such as older people. According to the IslamicRepublic News Agency (IRNA) [1], the mortality rate in thepatients over 60 years old was higher than other age groups,that indicates a serious threat to aged people’s life andhealth. The purpose of this paper is to find out what hap-pens to older people in Iran based on our professional obser-vations and comments which are heard from these people.Based on the WHO report [2], older people have manyhealth problems such as hearing loss, cataract, back andneck pain, osteoarthritis, chronic obstructive pulmonary dis-ease (COPD), diabetes, stroke and myocardial infarction (MI)that necessitate them rehabilitating. Some common healthproblems in older people, such as stroke, MI or COPD, needdaily and early rehabilitation. Early rehabilitation followingthese disorders has beneficial effects on elderly patient’sphysical function and prevents disability [3,4]. Delayed treat-ment may cause serious and irreversible complications forolder patients. Rehabilitation centres in Iran are commonlyout-hospital clinics, the in-hospital clinics are mostly limitedto university hospitals. The nursing homes and elder daycarecentres (either privately funded or government funded) arecritical sources of care for older people who can no longerlive in their own home. In the wake of the COVID-19 pan-demic, most of the private rehabilitation facilities havereduced the number of their employees, working hours orhave been closed. As a result, in-hospital rehabilitation facili-ties have become too crowded and can be sources for virustransmission.Aging is associated with the reduction in physical functionand increasing sedentary behaviour [5,6]. Regular physicalactivity benefits both the body and mind, it can reduce highblood pressure, help to manage weight, reduce the risk ofheart disease, stroke, type 2 diabetes, and various cancers.All these conditions make patients susceptible to COVID-19[7]. Due to reduction of muscle strength and coordination ofthe lower extremities, gait and balance control will beimpaired in older people. These impairments increase therisk of disability and falling among older people [5,8]. Fallingis one of the sources of death and nonfatal injuries in olderpeople [9]. In many big cities of Iran, to deal with this prob-lem, older people have daily walking and aerobic exerciseprogramme in the parks. Walking is a common form of phys-ical activity in healthy older people [10]. Since the COVID-19outbreak, all city parks and walking trails have been closed.It may possibly increase the risk of physical inactivity andsocial isolation in older people. Substituting traditional face-to-face approach with feasible alternative approaches suchas tele-rehabilitation, can be helpful [11]. This approach isnow used in some rehabilitation centres for therapy, assess-ment and follow up. Also, video-conferencing can be usedfor implementing some types of rehabilitation services andproviding video consultation and instructions.Older people need more health care and rehabilitationservices [12,13] than other age groups and this requires highfunds. In Iran, some old people, especially old women arefinancially dependent on their families [14]. The current situ-ation has affected most people’s jobs and caused an eco-nomic recession, considering that some Iranian old peopledo not have any type of health insurance coverage [14],many families need to be supported financially. Due to finan-cial problems, some families provide rehabilitation cares fortheir aged relatives themselves, without receiving any train-ing. As a result, family education through educational CDs orvideo-conferencing can prevent further health problems, dis-abilities and reduces the expenditures.Another aspect of the problems is assistive products. Theuse of assistive products increases with age [15,16].Spectacles, hearing aids, wheelchairs, canes, crutches, walkersand prostheses are examples of assistive products used byolder people. Repairing or buying these devices is difficult inthe current situation.Considering the challenges and problems that some ofthem are highlighted in this paper, the rehabilitation systemand services should be considered as an important need forIranian older people.Author contributionsAll authors have contributed to preparing the manuscript.Disclosure statementNo potential conflict of interest was reported by the author(s).ORCIDShabnam ShahAli http://orcid.org/0000-0002-5126-9929References[1] Coronavirus disease 2019 (COVID-19); 2020 [cited 2020 May 15].Available from: https://www.irna.ir/news/83712959/%D8%A8%DB%8C%D8%B4%DB%8C%D9%86%D9%87-%D9%88-%DA%A9%D9%85%DB%8C%D9%86%D9%87-%D8%B3%D9%86-%D8%A7%D8%A8%D8%AA%D9%84%D8%A7-%D9%88-%D9%81%D9%88%D8%AEUROPEAN JOURNAL OF PHYSIOTHERAPY2020, VOL. 22, NO. 5, 309–310https://doi.org/10.1080/21679169.2020.1783112A-%D9%86%D8%A7%D8%B4%DB%8C-%D8%A7%D8%B2-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D8%AF%D8%B1-%D8%A7%DB%8C%D8%B1%D8%A7%D9%86.[2] World Health Organization. Global health and aging; 2020 [cited2020 May 15]. Available from: URL: https://www.who.int/ageing/publications/global_health.pdf[3] Lui SK, Nguyen MH. Elderly stroke rehabilitation: overcoming thecomplications and its associated challenges. Curr Gerontol GeriatrRes. 2018;2018:9853837.[4] Bruun IH, Maribo T, Norgaard B, et al. The effect of systematicfunctional assessment and immediate rehabilitation on physicalperformance in acutely admitted older adults with reduced func-tional performance: a randomised clinical trial. Disabil Rehabil.2020;42(1):53–62.[5] Thomas E, Battaglia G, Patti A, et al. Physical activity programsfor balance and fall prevention in elderly: a systematic review.Medicine (Baltimore). 2019;98(27):e16218.[6] Freire Junior RC, Fernandes TG, Borges GF, et al. Factors associ-ated with low levels of physical activity among elderly residentsin a small urban area in the interior of the Brazilian Amazon.Arch Gerontol Geriatr. 2018;75:37–43.[7] World Health Organization. HealthyAtHome – physical activity;2020 [cited 2020 May 19]. Available from: URL: https://www.who.int/news-room/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome—physical-activity.(Accessed May 19, 2020).[8] Matsuda PN, Eagen T, Hreha KP, et al. Relationship between fearof falling and physical activity in people aging with a disability.PM R. 2020;12(5):454–461.[9] Dellinger AM, Stevens JA. The injury problem among older adults:mortality, morbidity and costs. J Safety Res. 2006;37(5):519–522.[10] Okubo Y, Osuka Y, Jung S, et al. Walking can be more effectivethan balance training in fall prevention among community-dwell-ing older adults. Geriatr Gerontol Int. 2016;16(1):118–125.[11] Jalali M, Shahabi S, Bagheri Lankarani K, et al. COVID-19 and dis-abled people: perspectives from Iran. Disabil Soc. 2020;35(5):844–844.[12] Joseph O, Mary T, Stephanie S, et al. Hazzard’s geriatric medicineand gerontology, 6th ed. New York: McGraw-Hill; 2009.[13] Vincent C, Deaudelin I, Robichaud L, et al. Rehabilitation needsfor older adults with stroke living at home: perceptions of fourpopulations. BMC Geriatr. 2007;7:20.[14] Amini R, Ingman S, Sahaf R. Aging in Iran: past, present andfuture. J Aging Emerg Econ. 2013;4:17–34.[15] Kraskowsky LH, Finlayson M. Factors affecting older adults’ use ofadaptive equipment: review of the literature. Am J Occup Ther.2001;55(3):303–310.[16] H€aggblom-Kronl€of G, Sonn U. Use of assistive devices – a realityfull of contradictions in elderly persons’ everyday life. DisabilRehabil Assist Technol. 2007;2(6):335–345.Shabnam ShahAliRehabilitation Research Center, Department of Physiotherapy,School of Rehabilitation Sciences, Iran University of MedicalSciences, Tehran, IranShiva ShahAliMedical Faculty, Ahvaz Jundishapur University of MedicalSciences, Ahvaz, IranIsmail Ebrahimi TakamjaniRehabilitation Research Center, Department of Physiotherapy,School of Rehabilitation Sciences, Iran University of MedicalSciences, Tehran, IranSaeed ShahabiHealth Policy Research Center, Institute of Health, ShirazUniversity of Medical Sciences, Shiraz, IranSaeedshahabi1@gmail.comReceived 3 June 2020; revised 7 June 2020; accepted 9 June 2020 2020 Informa UK Limited, trading as Taylor & Francis Group310 S. SHAHALI ET AL.

COVID-19 and Iranian older people: rehabilitation perspective

http://eprints.iums.ac.ir/34052/1/COVID%2019%20and%20Iranian%20older%20people%20rehabilitation%20perspective%281%29.pdf

COVID-19 and Iranian older people: rehabilitation perspective

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eprints Iran University of Medical Sciences