TELEREHABILITATION INTERVENTION PROTOCOLS FOR COVID-19 PATIENTS: A SCOPING REVIEW

Introduction: Since the start of the pandemic, it became clear to physical therapists through emerging studies that there are better outcomes in managing the symptoms of COVID-19 patients if they undergo physical therapy; however, face-to-face rehabilitation of COVID-19 patients placed physical therapists at risk of cross-infection. To address this issue, the use of telerehabilitation as a mode of delivery of instruction and patient monitoring was considered. Recent studies have expressed its effectiveness; however, there are still no available standardized protocols for the telerehabilitation of COVID-19 patients. Thus, this study seeks to conduct a comprehensive search of the published literature regarding COVID-19 physical therapy interventions and to map out the current evidence and knowledge gaps surrounding telerehabilitation protocols for COVID-19 patients. Methods: The study has a Scoping Review Design in accordance with the PRISMA-ScR guidelines. In this study, 939 articles were found through searching in the following databases with specific MeSH Terms: PEDRO, PubMed, BioMed Central, & Cochrane Central. These 939 articles were then screened and assessed for their eligibility, specifically, to match the inclusion criteria of the study. Specific details of each of the studies included the following: Title, Author & Country, Digital Technology Used, Research Design, Methodology, Intervention/Program, and Key Findings/Results. Similar details between studies were tallied and were then compared to their existing forms of literature. Results: A total of 9 studies were reviewed after the 939 articles were screened and similar details were tallied as well. A majority of the studies were RCTs followed by Systematic Reviews/Meta- Analysis. The most common interventions used in order were (1) Strengthening Exercises, (2) Deep Breathing Exercises, and (3) Aerobic Exercises. The most used telerehabilitation technology was any internet-connected device that had access to video conferencing. Four of the studies have shown better outcomes as a result of telerehabilitation. Gaps in literature, specifically the lack of studies conducted in developing nations and unevidenced claims of better cost-effectiveness, were consistent in all studies. Discussion: This study was able to map out the available research and the surrounding protocols conducted through telerehabilitation for COVID-19 patients. The current literature shows the most common interventions and outcome measures used during telerehabilitation and that some patients have become better as a result of telerehabilitation. The findings can be used as a basis for creating a telerehabilitation treatment plan and may be used to systematically compare said studies in turn would create a standardized protocol for COVID-19 telerehabilitation.