{"id":9365,"date":"2020-08-07T06:00:03","date_gmt":"2020-08-07T05:00:03","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=9365"},"modified":"2020-08-02T10:37:10","modified_gmt":"2020-08-02T09:37:10","slug":"socially-distanced-rehabilitation-supported-by-technology-a-potential-new-normal-for-post-itu-deconditioning","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2020\/08\/07\/socially-distanced-rehabilitation-supported-by-technology-a-potential-new-normal-for-post-itu-deconditioning\/","title":{"rendered":"Socially distanced rehabilitation supported by technology: a potential new normal for post-ITU deconditioning?"},"content":{"rendered":"
One way to get patients back on their feet after COVID19 infection<\/strong><\/em><\/h5>\n

Coronavirus disease 2019 (COVID-19) has dramatically affected global society and it is unclear when its effects will subside. There have been over\u00a0500,000 deaths and 13.5 million documented infections as of the 15th<\/sup> July. The UK has seen over 45,000 deaths and over 291,000 documented cases (1). Although a large number of cases have a self-limiting illness, a significant proportion become critically ill, with 13,132 patients admitted to UK critical care units as of 10th<\/sup> July. Of these 5,985 have been discharged alive, with a subsequent surge in demand for rehabilitation projected to follow.\u00a0 Following a critical care admission, individuals frequently suffer from deconditioning, psychological symptoms and have a reduced functional status that can take significant time to recover (2).<\/p>\n

Current post ITU rehabilitation standards and barriers<\/u><\/p>\n

The National Institute of Health and Care Excellence recommends that patients who have a critical care admission greater than four days, receive information about rehabilitation at discharge, arrangements for ongoing rehabilitation and follow up at 2-3 months, to identify and address ongoing recovery needs (3). The need for holistic rehabilitation of COVID-19 survivors has been identified as a major challenge facing heath care providers (2). There have also been suggestions of increased multi-disciplinary working including Respiratory and Sports and Exercise Medicine specialties to help individuals recover from COVID-19 (4).<\/p>\n

Ordinarily, physical rehabilitation might take place through community physiotherapy and\u00a0involve face to face contact. However, clinical services across the UK have been forced to limit the amount of face to face work they perform due to the Government\u2019s social distancing measures. This may present a barrier to rehabilitation in this group of patients and a strain on rehabilitation services.<\/p>\n

The wearable based COVID19 remote rehabilitation MDT<\/u><\/p>\n

In an attempt to overcome these barriers, the Critical Care department at Worthing Hospital (UK), along with The University of Brighton are piloting the use of smartwatches (FitBit) given to patients at discharge to augment rehabilitation. At discharge, physical assessments and baseline characteristics are assessed to guide delivery of an individualised exercise plan. Patients are provided with information about the smartwatch and how to increment activity. Data from the smartwatches are then monitored remotely and reviewed monthly by a team, with the following members;<\/p>\n