Progressive exercise and early mobilisation are among the elements of rehabilitation programmes that may improve recovery for people who are hospitalised with severe COVID-19, new research has concluded.
A team at the University of Exeter led a review of all the available evidence on whether rehabilitation benefitted patients who were admitted to intensive or critical care with respiratory illness, as information on people with COVID-19 was not available when the research began.
The study, published in Physiotherapy and supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South West Peninsula, found that progressive exercise and getting people mobile early may both help people recover from severe respiratory illness, and those findings could be applied to COVID-19 care. They also found that rehabilitation programmes with a number of different components could be beneficial.
Study lead Vicki Goodwin MBE, Associate Professor of Ageing and Rehabilitation at the University of Exeter Medical School, said: "COVID-19 can have a devastating impact on people's lives, long after they leave hospital. We urgently need to find the best ways to support people to regain their health, both in hospital and when they return home. Our research found that getting people moving early on is a key component that can help shape rehabilitation programmes, to get people back on their feet as swiftly as possible".
The rapid systematic review included 24 systematic reviews, 11 randomised control trials and eight qualitative studies, which interviewed patients about their rehabilitation, to explore their views and experience. From these interviews, the team found that rehabilitation can give hope and confidence to patients, although approaches need to be tailored to the individual.
One rehabilitation programme after hospital discharge from intensive care was found to give people a boost and a different outlook for the future. One patient said: "I just feel full of life. I can't wait for tomorrow, you know . . . Before it was just day after day, but now it's- I'm looking forward to tomorrow."
In another study, the recognition of setting goals to achieve small steps as an important part of recovery. A patient reported: "Well, I was shocked at how little I could do, but now, it's the other way, I'm actually shocked at how much I can do and I am doing. It's really good."
Study co-author Sallie Lamb, Mireille Gillings Professor of Health Innovation at the University of Exeter Medical School, said: "Rehabilitation is a crucial element of COVID-19 care that must not be over-looked. As COVID-19 is still so new, there's no evidence that evaluate the benefits of rehabilitation programmes for those in recovery. We now urgently need research to evaluate the benefit of programmes to patients with COVID-19 specifically."
The paper is entitled "Rehabilitation to enable recovery from COVID-19: a rapid systematic review." Collaborators were Nottingham Universities NHS Trust, the University of East Anglia and the University of Nottingham.
The paper will publish at the following link once the embargo lifts: https://doi.org/10.1016/j.physio.2021.01.007
About the University of Exeter Medical School
The University of Exeter Medical School is part of the University of Exeter's College of Medicine and Health. Our mission is to improve the health of the South West and beyond, through the development of high quality graduates and world-leading research that has international impact.
As part of a Russell Group university, we combine this world-class research with very high levels of student satisfaction. Exeter has over 19,000 students and is ranked 12th in The Times and Sunday Times Good University Guide 2020.
The University of Exeter Medical School's Medicine course is in the top 10 in the Complete University Guide 2020.
The College's Medical Imaging programme is ranked in the top 5 in the Guardian Guide 2020 and the Complete University Guide 2020.
The University of Exeter entered the world top 20 for Biomedical and Health Sciences in the CWTS Leiden Ranking 2019, based on the percentage of publications ranked in the top 10 per cent most cited. https://medicine.exeter.ac.uk/
About the NIHR
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
- Funds, supports and delivers high quality research that benefits the NHS, public health and social care
- Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- Partners with other public funders, charities and industry to maximise the value of research to patients and the economy
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit of people in low- and middle-income countries, using UK aid from the UK government.
For further information:
Press and Media Manager
University of Exeter Medical School
+44 (0)1392 724927 or 07768 511866