System Evaluation

Rehab Resources Specific to COVID-19

Please note: Due to the volume of resources in this category, resources published prior to June/July can be found on the following pages:

Resources published since June 2020 (Updated: September 21, 2022)
Clinical management of patients with COVID-19: Rehabilitation of patients with COVID-19 The WHO has developed seven course modules to address the varied rehabilitation needs of patients recovering from COVID-19, including patients with cognitive impairment, physical deconditioning and weakness, respiratory impairment, swallow impairment, communication impairment and challenges in completing Activities of Daily Living (ADLs). Techniques for rehabilitation also are addressed. The course series includes video lectures and downloadable presentations that have been updated with the latest guidance and evidence. Each course contains 5-8 modules, and each module includes a quiz to evaluate knowledge acquisition.
 Recovery & Rehabilitation After COVID-19: Resources for Health Professionals (updated regularly) Resource webpage outlining provider and patient resources. Published by Alberta Health Services.
NEW Clinical management of COVID-19: living guidance (September 15, 2022) The WHO COVID-19 Clinical management: living guidance contains the WHO’s most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is important. This updated (fifth) version contains 16 new recommendations for the rehabilitation of adults with post COVID-19 condition (see Chapter 24).
 Rehabilitation & Allied Health Practice Considerations Post COVID-19 (June 2022) Resource developed by Alberta Health Services intended to provide guidance to support rehabilitation and allied health providers across the care continuum who are working with patients recovering from symptoms of COVID-19.
 Prevalence of long-term effects in individuals diagnosed with COVID-19: a living systematic review (June 2021) Systematic review of the prevalence of post COVID-19 conditions (4-12 and >12 weeks), including the frequency of symptoms, sequelae and difficulties individuals living with post COVID-19 conditions have conducting usual activities.
 Care Models for Long COVID: A Rapid Systematic Review (June 2021) This review was funded by Alberta Health Services, the SPOR Evidence Alliance (SPOR EA), and the COVID-19 Evidence Network to support Decision-making (COVID-END). Authors identified international care models describing the integration of primary care, rehabilitation services and specialized assessment clinics for Long COVID.
World Physiotherapy response to COVID-19 Briefing paper 9 (June 2021) Provides an overview of safe rehabilitation approaches for people living with Long COVID
UPDATED  Rehabilitation & Allied Health Practice Considerations Post COVID-19 (June 2022) Resource developed by Alberta Health Services intended to provide guidance to support rehabilitation and allied health providers across the care continuum who are working with patients recovering from symptoms of COVID-19.
Early experiences of rehabilitation for individuals post-COVID to improve fatigue, breathlessness exercise capacity and cognition – A cohort study (May 2021) Observational study of 32 individuals that completed rehabilitation program of 6 weeks (sessions 2x/week) following COVID-19 infection. Study included both individuals post discharge and those who were managed solely in the community and reported improvements in exercise capacity and symptoms of breathlessness, fatigue and cognition.
The COVID rehabilitation paradox: why we need to protect and develop geriatric rehabilitation services in the face of the pandemic (May 2021) Commentary article indicates there will be an expected growth in demand for geriatric rehabilitation given the aging population and as a result of the pandemic; however, the author notes available capacity and resources in geriatric rehabilitation have decreased because of the pandemic.
NEW Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field (April 2021) Rapid systematic review updated bi-monthly. Publication by the European Journal of Physical and Rehabilitation Medicine. Indicates information about short and long-term sequelae of COVID-19 indicating a need for rehabilitation is increasing. Evidence of trends in common post-COVID impairments, activity limitations and participation restrictions is growing, as is evidence regarding the effect of treatments for symptom relief, quality of life, increasing capacity and function.
Feasibility of an Outpatient Training Program after COVID-19 (April 2021) This study presents data for a physiotherapy-led, comprehensive outpatient pulmonary rehabilitation (PR) program. Preliminary findings suggest that the PR protocol used may be both feasible, and confer benefits to a small subgroup of patients recovering from COVID-19.
 The Canadian COVID-19 Prospective Cohort Study and CANCOV Consortium (April 2021) Presentation slide deck from Co-lead Principal Investigators: Dr. Angela Cheung and Dr. Margaret Herridge.

Joint webinar presentation with Michelle Kho, Canada Research Chair in Critical Care Rehabilitation and Knowledge Translation

 Understanding the COVID-19 patient: Acute care to long term recovery (April 2021) Presentation slide deck from Michelle Kho, Canada Research Chair in Critical Care Rehabilitation and Knowledge Translation.

Joint webinar presentation with Dr. Angela Cheung and Dr. Margaret Herridge.

Physical Therapy & Rehabilitation Journal COVID-19 Virtual Issue (April 2021) In response to the global pandemic, PTJ has fast-tracked the publication of articles on COVID-19 as it relates to physical therapy and rehabilitation. All COVID-19 articles in an up-to-date virtual collection are available for free.
A COVID-19 Rehabilitation Prospective Surveillance Model for Use by Physiotherapists (April 2021) This study presents a prospective surveillance model to facilitate early identification and management of long-term COVID-19 sequelae.
Effectiveness of a telerehabilitation program for COVID-19 survivors (TERECO) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: a randomized controlled trial (March 2021) As compared to a control group, authors reported those who participated in a telerehab program for COVID-19 survivors had improved exercise capacity, lower-limb muscle strength, and physical quality of life.
 Characteristics and outcomes of COVID-19-Positive Individuals Admitted for Inpatient Rehabilitation in Toronto, Canada (March 2021) Article describes the sociodemographic features, impairments, and functional changes of COVID-19-positive individuals who underwent inpatient rehabilitation at three rehabilitation hospitals in Toronto, Canada.
 How to Support Your Recovery and Rehabilitation after COVID-19 (March 2021) Resource for patients on common symptoms people may have after COVID-19 published by Alberta Health Services Neuroscience, Rehabilitation & Vision Strategic Clinical Network.
Living with COVID-19 – Second review (March 2021) A dynamic review of the evidence around ongoing COVID-19 (often called Long COVID) published by the National Institute for Health Research (NIHR)
The “Rehabilitation Research Framework for COVID-19 patients” defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme (March 2021) This paper introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development. The CRRF offers a comprehensive view of the research areas relevant to rehabilitation in the context of COVID-19 that is necessary to inform best practice and ensure rehabilitation services and health systems can best serve the COVID-19 population.
Functional outcomes in the inpatient rehabilitation setting following severe COVID-19 infection (March 2021) The authors of this study conclude that patients admitted to inpatient rehabilitation after hospitalization with COVID-19 demonstrated deficits in mobility, cognition, speech and swallowing at admission and improved significantly in all of these domains by discharge. However, a significant number of patients exhibited residual deficits at discharge highlighting the post-acute care needs of this patient population.
Outcomes of a COVID-19 recovery program for patients hospitalized with SARS-CoV-2 infection in New York City: A prospective cohort study (February 2021) Study reported virtual rehabilitation to be an efficacious method of treatment delivery for recovering COVID-19 patients.
Outcomes of a COVID‐19 recovery program for patients hospitalized with SARS‐CoV‐2 infection in New York City: A prospective cohort study (February 2021) Study evaluated if a virtual rehab program would lead to improvements in strength and cardiopulmonary endurance when compared with no intervention in patients discharged home with persistent COVID‐19 symptoms.
Rehabilitation and COVID-19: A rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020 (February 2021) Publication by the European Journal of Physical and Rehabilitation Medicine
Returning to physical activity after covid-19 (January 2021) This article offers a pragmatic approach to help patients safely return to physical activity after symptomatic SARS-CoV-2 infection, focusing on those who have lost fitness or had a prolonged period of inactivity but who do not have an enduring post-acute covid-19 illness. It is based on current evidence and consensus statements, and the authors’ experience in sports and exercise medicine, rehabilitation, and primary care.
 COVID-19 Guidance for Hip Fracture/TJR Rehab (October 2020) To ensure that best practice rehabilitative care continues in this new context, the RCA has developed additional recommendations that align with current pandemic restrictions while complementing the existing RCA best practice frameworks (Rehabilitative Care Best Practices for Patients with Hip Fracture and Rehabilitative Care Best Practices for Patients with Hip & Knee Replacement).
Living with COVID: NIHR publishes dynamic themed review into ‘ongoing COVID’ (October 2020) First dynamic themed review of the scientific evidence on, and lived experience of, long-term ‘ongoing’ COVID-19.
Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field (September 2020) This living systematic review presents the most current and seminal information coming from the scientific literature. It is the monthly update of the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER Action Steering Committee.
Rehabilitation and COVID-19: the Cochrane Rehabilitation 2020 rapid living systematic review (September 2020) This rapid living systematic review is an update as of July 31, 2020 of the one the latest scientific literature informing rehabilitation of patients with COVID-19 and/or describing consequences of the disease and its treatment, as they relate to limitations in functioning of rehabilitation interest.
Management of post-acute covid-19 in primary care (August 2020) This article, intended for primary care clinicians, relates to the patient who has a delayed recovery from an episode of COVID-19 that was managed in the community or in a standard hospital ward, including patients who may have serious sequelae (such as thromboembolic complications) and those with a non-specific clinical picture, often dominated by fatigue and breathlessness.
The Stanford Hall consensus statement for post-COVID-19 rehabilitation (August 2020) A review of evidence around rehabilitation following previous coronavirus infections which provides 32 evidence-based recommendations for post-Covid19 rehabilitation.
The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19 (July 2020) Letter to the editor that encourages use and validation of ordinal scales such as the one proposed (PCFS) for determining functional recovery from COVID-19. The PCFS is an ordinal tool to monitor the course and impact of symptoms on the functional status of patients. Tool is not validated.
Systematic Review of Changes and Recovery in Physical Function and Fitness After Severe Acute Respiratory Syndrome–Related Coronavirus Infection: Implications for COVID-19 Rehabilitation (July  2020) Study comparing the Physical function and fitness in people infected with COVID-19 to healthy controls and duration of impairment post infection.
Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak (July 2020) Outlines specific infection countermeasures that should be implemented in the treatment of patients with dysphagia.
Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 rehabilitation unit and proposal of a treatment protocol. A cross-sectional study (July 2020) The authors characterize pulmonary function and disability status in post acute COVID-19 patients admitted to an Italian Rehabilitation Unit and propose an early patient-tailored rehabilitation protocol according to their pulmonary function.
Perspectives on Research and Health Practice in Physical and Occupational Therapy in Geriatrics during and Post COVID-19 (July 2020) Editorial commentary on how physical and occupational therapy in geriatrics may consider changing assessment and treatment practices within the context of the COVID-19 pandemic.
The Post-COVID-19 Functional Status (PCFS) Scale: a tool to measure functional status over time after COVID-19 (July 2020) This correspondence is a call for action to use and validate ordinal scales such as the one proposed by the authors for determining functional recovery of COVID-19. The full manual for patients and physicians or study personnel is available from  (free of charge).
Injury-Prone: Peripheral nerve injuries associated with prone positioning for COVID-19-related acute respiratory distress syndrome (July 2020) Article reviews 11 cases in a Chicago inpatient rehab program where prone positioning, associated with mechanical ventilation due to COVID-19 in acute care, resulted in focal/multifocal peripheral nerve injury. Highlights the need to refine standard prone positioning protocols to reduce this risk of associated injury.
Rehabilitation after COVID-19: an evidence-based approach (July 2020) Article discusses how the medical aspects of COVID-19 relate to rehabilitation and when referral to rehabilitation is appropriate; outlines rehabilitation interventions with supporting evidence; and discusses how COVID-19 might precipitate change and improve UK rehabilitation services so that most COVID-19 patients could receive rehabilitation.
 Rehabilitation After Critical Illness in People With COVID-19 Infection (June 2020) Outlines anticipated impact of COVID-19 related cognitive, physical and psychosocial impairments. Suggests rehabilitation providers will serve as an important link in the continuum of care, helping move patients on from acute sites to eventual discharge to the community.
 Frail Seniors: Guidance on Best Practice Rehabilitative Care in the Context of COVID-19 (June 2020) Provides best practice recommendations to guide provision of rehabilitative care services to frail seniors and what should be considered as these services are reopened.
 Frail Seniors: Guidance on Best Practice Rehabilitative Care in the Context of COVID-19 (June 2020) RCA Guidance Document providing best practice recommendations to guide provision of rehabilitative care services to frail seniors and guidance on what should be considered as these services are reopened.
Support for Rehabilitation Self-Management after COVID-19- Related Illness (June 2020) Leaflet published by the WHO provides basic exercises and advice on: managing breathlessness, exercising after leaving hospital, problems with voice, managing stress and other issues related to COVID-19 recovery
 Toronto Star feature story (June 2020) Story describing the important role rehab will play for individuals recovering from COVID-19.
Personalized recovery of severe COVID19: Rehabilitation from the perspective of patient needs (June 2020) Editorial article published out of the Netherlands. Provides an overview of the impact that long term hospitalization or ICU treatment due to COVID-19 can have on patients’ pulmonary, physical, psychological and cognitive status. The authors stress the need for patient centred rehab assessment and intervention.
Systematic rapid living review on rehabilitation needs due to COVID-19: update to May 31st 2020 (June 2020) This is the third systematic ‘living review’ of papers published in May 2020 that address rehabilitation needs due to the COVID-19 pandemic. Reviewers indicate that patients with disability, regardless of COVID-19 infection, are suffering because of restrictions imposed to rehab service delivery. Neurological involvement is often present during the acute and post-acute stage, illustrating the risk of a long-lasting disability. Reviewers found the main gap in the available scientific literature is the lack of high quality primary studies and that experimental studies on the effects of rehabilitation are still warranted.
Guide for treating community dwelling older people post COVID-19 Isolation (“Cocooning”) (June 2020) Guidance document developed by the Chartered Physiotherapists in Neurology and Gerontology in Ireland for physiotherapists looking to support their patients to be active and self-manage long term conditions during the pandemic where access to face-to-face healthcare is extremely limited.
Guide for treating older people post COVID-19 in hospital, post-acute care and the community (June 2020) Document by the Irish Society of Chartered Physiotherapists outlining the management of older people and their recovery pathway post COVID-19. The document is divided into three sections: initial presentation and identification of COVID-19 in older people including acute hospital management; post-acute rehabilitation and community based management and includes recommendations for outcome measures.
Neurological Manifestation of COVID-19 and the Enhanced Role of Physiatrists (June 2020) Provides an overview of the neurological symptoms associated with COVID-19 in hospitalized patients and discusses the impact of the findings on the practice for physiatrists.
Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study (May 2020) Study looked at the impact of a 6 week respiratory rehab program on respiratory function, quality of life and anxiety of older adults with COVID-19.
Rehabilitation self-management after COVID-19 A series of brief videos from the WHO for patients re: how to manage activities of daily living after COVID-19.
Cochrane Rehabilitation REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) action To update the rehabilitation community on the growing evidence for the role of rehabilitation in management of COVID-19 patients, Cochrane Rehabilitation launched the REH-COVER action. The aim of this action is to focus on the timely collection, review and dissemination of summarized and synthesized evidence relating to COVID-19 and rehabilitation.
 Patient Oriented Discharge Summary (PODS) for COVID-19 Resources from UHN Patient Education and partners include a COVID-19 PODS template, patient education handout and PODS best practices.
 Provincial COVID-19 educational resource Information on infection control, bioethics, palliative care, team-based models of care, rehabilitation, wellness & resilience. Content will be updated periodically. Login required.
 COVID-19 resources provided by the Regional Geriatric Program of Toronto and the RGPs of Ontario Resources include information on delirium, communication and immobility.