Although evidence from the management of other viral respiratory infections suggest that early multidisciplinary rehabilitation could mitigate the adverse effects of the severe form of the illness, and reduce the length of hospital stays (LOS), specific data for COVID-19 are lacking. Hence, in response to the current pandemic, we propose to implement and assess the impact of an early standardized multidisciplinary rehabilitation program tailored to frail older adults on 1) LOS, 2) post-discharge destination, 3) prognostic index and 4) functional capacity. With a pragmatic multicenter controlled study, the COvid Rehabilitation Program for the Elderly (CORE) trial will allow to measure the effectiveness of a multidisciplinary program to minimize the effects of hospitalization and provide the required tools to rapidly implement an innovative strategy of care for older adults. Indeed, based on the results of this study, and with the support of scientific and professional organizations, a standardized program tailored to older adults with COVID-19 will be disseminated in Canada for all medical units dedicated to the management of the disease. Because of its pragmatic approach, this study will provide a sustainable multidisciplinary intervention that can be quickly implemented in any Canadian (or abroad) COVID-19 medical unit. Finally, given that COVID-19 is the third coronavirus infection in the last 20 years, the expected results will provide guidelines, with decision tree algorithms, for implementation should another coronavirus or for that matter, any other such type of infection that surface in the future.
Study Type
OBSERVATIONAL
Enrollment
124
In the intervention unit, two teams (core team: physiotherapists and service healthcare workers; specialized team: occupational therapist, registered dietician, social worker) are dedicated to the patients hospitalized in COVID-19 unit. To prevent malnutrition, caused by disease-associated inflammation, the Nutrition as Medicine program (prescribed small doses (30 or 60 mL; 2 kcal/mL) of oral nutrition supplement dispensed with medication pass, 1 to 4 times a day), has been systematically implemented (collective prescription). To improve muscle strength, balance and tissue oxygenation and concomitantly reduce immobilization and risk of falls, each patient has a private pedal exerciser, resistance elastic bands and free weights to perform a progressive, monitored and individualized rehabilitation program thrice a day.
CIUSSS de l'Estrie-Centre hospitalier universitaire de Sherbrooke (CHUS)
Sherbrooke, Quebec, Canada
Centre hospitalier affilié universitaire régional (CHAUR)
Trois-Rivières, Quebec, Canada
Length of stay
Length of stay in COVID and subacute unit (days)
Time frame: 1 day after discharge
Post-discharge destination
(home; long-term care facilities; death) or transfer to a specialized subacute unit (e.g., rehabilitation geriatric unit)
Time frame: 1 day after discharge
Readmission rate 30 days after discharge
Time frame: 30 days after discharge
Change in patient prognosis
Evaluated using the COVID-19 vulnerability index (symptoms, medical history, and sociodemographic data)
Time frame: At baseline (± 2 days after admission in the COVID-19 unit) and before discharge (± 3 days)
Change in functional capacity (lower limb function)
Lower limb function is assessed using the 5-repetition sit-to-stand test (reported in seconds)
Time frame: At baseline (± 2 days after admission in the COVID-19 unit) and before discharge (± 3 days)
Change in functional capacity (handgrip strength)
Handgrip strength is measured using a handgrip dynamometer (reported in kg)
Time frame: At baseline (± 2 days after admission in the COVID-19 unit) and before discharge (± 3 days)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.