Rehabilitation Outcomes and Infection Control in the Early Stage of the COVID-19 Pandemic

  1. Yukimasa Igawa
  2. Takahiro Sugimoto

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Abstract

Introduction: Understanding how infection control measures were devised and the outcomes of rehabilitation in the early stage of an emerging infectious disease pandemic is important. This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on inpatient rehabilitation, and to determine the effectiveness of the original infection control measures implemented for the rehabilitation team. Material and Methods: In this single-center, retrospective, observational study, we calculated multiple rehabilitation indices of patients discharged from our rehabilitation ward between February 28 and May 25, 2020 when Hokkaido was initially affected by COVID-19, and compared them with those calculated during the same period in 2019. Fisher’s exact test and the Mann-Whitney U test were used for statistical analysis. We also verified the impact of implementing the original infection control measures for the rehabilitation team on preventing nosocomial infections. Results: A total of 93 patients (47 of 2020 group, 46 of 2019 group) were included. The median age was 87 and 88 years, respectively, with no differences in age, sex, and main disease between the groups. Training time per day in the ward in 2020 was significantly lower than that in 2019 (p = 0.013). No significant differences were found in the qualitative evaluation indices of Functional Independence Measure (FIM) score at admission, FIM gain, length of ward stay, FIM efficiency, and rate of discharge to home. None of the patients or staff members had confirmed COVID-19 during the study period. Conclusions: Early COVID-19 pandemic affected the quantitative index for inpatient rehabilitation but not the qualitative indices. No symptomatic nosocomial COVID-19 infections were observed with our infection control measures. Doi: 10.28991/SciMedJ-2021-03-SI-6 Full Text: PDF

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  1. Version published to 10.28991/scimedj-2021-03-si-6
  2. ScreenIT

    SciScore for 10.1101/2021.01.20.21250145: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the Ethics Committee of Aizen Hospital (permission number: 2020-003).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    ) These staffing limitations might have affected the capability to provide training time during the study period. The sudden suspension of rehabilitation therapists from work appears to have had the effect of pushing down the distribution of dots per patient per day in 2020 (Fig.1). However, it is not possible to determine from this study whether the statistically significant reduction in training time had any clinical significance. Even so, the fact that COVID-19 pandemic had a significant impact on training time in inpatient rehabilitation indicates that in the uncertain future of this pandemic, telemedicine and self-training must be enhanced to complement the reduced training time.12 ) None of the patients or staff members were observed with clinically apparent nosocomial COVID-19 during the study period. Nosocomial infection control is a top priority during the COVID-19 outbreak. Centers for Disease Control and Prevention published successive updates to guidelines intended for medical institutions.13 ) However, there was little mention of rehabilitation medicine or facilities in the guidelines. This had led the physicians and administrators involved to develop their own infection control measures. Infection control in rehabilitation medicine is complicated by the considerable amount of contact with patients, close physical proximity, frequency of conversations, frequent production of droplets during speech therapy training or eating and swallowing training, frequent crowd...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.01.20.21250145 on medRxiv