Physical Therapy for Hospitalized Patients With COVID-19 in Isolation: Feasibility and Pilot Implementation of Telehealth for Delivering Individualized Therapy

ObjectiveTo optimize the ability of hospitalized patients isolated due to COVID-19 to participate in physical therapy.DesignThis was a prospective, quality improvement trial of the feasibility and acceptability of a “hybrid” in-person and telerehabilitation platform to deliver physical therapy to hospitalized adults.SettingInpatient wards of a tertiary care, multi-specialty academic medical center in the greater New York City metropolitan area.ParticipantsA convenience sample of 39 COVID-19+ adults, mean age 57.3 years, 69% male, all previously community dwelling agreed to participate in a combination of in-person and telerehabilitation sessions (TR).InterventionInitial in-person evaluation by physical therapist followed by twice daily PT sessions, one in-person and one via a telehealth platform meeting Health Insurance Portability and Accountability Act (HIPAA) confidentiality requirements. The communication platform was downloaded to each participant's personal smart device to establish audiovisual contact with the Physical Therapist.MeasuresThe 6-clicks Activity Measure for Post-Acute Care (AM-PAC) was used to score self-reported functional status pre-morbidly by, and by the therapist at baseline and discharge.ResultsFunctional status measured by AM-PAC 6-clicks demonstrated improvement from admission to discharge. Barriers to participation were identified and strategies are planned to facilitate use of the platform in future.ConclusionsA consistent and structured protocol for engaging patient participation in PT delivered via a telehealth platform was successfully developed. A process was put in place to allow for further development, recruitment and testing in a randomized trial.