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This consensus guidance statement reflects input from patient communities and the authors thank the following organizations and individuals for their input during the Collaborative writing process: the Patient-Led Research Collaborative, Angela Meriquez Vazquez, MSW, Long Covid Patient and Advocate, and Lauren Nichols, Long Covid Patient and Chronic Illness Advocate. For example, patients with MS may be on disease modifying therapy (DMT), and both the MS and the DMT may put them at higher risk for COVID-19 acute infections as well as more severe course, though in a recent systematic review these were not consistent findings.58 The review included more than 80 reports involving 2493 MS patients and 37 Neuromyelitis Optica Spectrum Disorder patients with COVID-19. Larger number of beds and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths.56 This multicenter cohort study showed that delirium was the sixth most common of all presenting symptoms and signs of acute COVID-19 infection, and factors associated with delirium were age older than 75 years, living in a nursing home or assisted living, vision impairment, hearing impairment, stroke, and Parkinson disease.57Though the studies in children are evolving, long COVID is recognized and should be considered at all ages. Patients with GBS/MFS benefit further from intravenous immunoglobulin and plasma exchange.[7] Most patients with isolated cranial neuropathies have a favorable outcome with supportive care compared to patients with multiple cranial neuropathies with GBS, who may achieve partial recovery and experience longer symptom duration. [Extracted from the article]

Background: Coronavirus disease 2019 (COVID-19) guidelines endorse early rehabilitation to improve outcomes in hospitalized patients, but the evidence base to support this recommendation is lacking. We examined the association between early rehabilitation and in-hospital deaths in COVID-19 patients.Method: A single-center retrospective study, involving 990 COVID-19 patients (42.4% women, mean age 67.8 years) admitted between March 1, 2020 and May 31, 2020 to a community hospital, was conducted. Association of rehabilitation during hospitalization with in-hospital mortality was examined using logistic regression analysis adjusted for demographics, length of stay, body mass index, comorbid illnesses, functional status as well as for COVID-19 presentations, treatments, and complications.Results: Over the 3-month study period, 475 (48.0%) inpatients were referred for rehabilitation. Patients who received rehabilitation were older (73.7 ± 14.0 vs 62.3 ± 17.2). There were 61 hospital deaths (12.8%) in the rehabilitation group and 165 (32.0%) in the nonrehabilitation group. Receiving rehabilitation was associated with an 89% lower in-hospital mortality (odds ratio [OR]: 0.11, 95% confidence interval [CI]: 0.06-0.19) after adjusting for multiple confounders and COVID-19 disease markers. In sensitivity analyses, the results were significant in subpopulations defined by age group, sex, race, length of hospitalization, or pulmonary presentations. Each additional rehabilitation session was associated with a 29% lower risk of in-hospital mortality (OR per session: 0.71, 95% CI: 0.64-0.79) in the fully adjusted model.Conclusion: Among hospitalized COVID-19 patients, receiving early rehabilitation was associated with lower in-hospital mortality. Our findings support implementation of rehabilitation services for COVID-19 patients in acute care settings, but further research from randomized clinical trials is needed. [ABSTRACT FROM AUTHOR]

Beyond cognitive symptoms, case studies provide evidence that patients with COVID-19 can develop a range of neurological complications including those arising from stroke, encephalopathies, inflammatory syndrome, microbleedsm and autoimmune responses.53 Future PASC Collaborative Consensus Guidance Statements will further examine and offer guidance on mental health and neurology symptoms in patients with PASC. Exercise prescriptions may be impacted by symptoms such as excessive vomiting and weight loss in the first trimester and large girth, back pain, or pre-eclampsia in the third trimester.GenderExample: WomenThere may be differences in the reporting of PASC-related symptoms by gender.Women may report PASC-related symptoms more than men, with a common symptom being cognitive impairment.HE-CI-3,HE-CI-4,HE-CI-5More studies are needed to better determine the incidence and prevalence of post-COVID cognitive symptoms across the gender spectrum (eg, men, women, nonbinary and gender nonconforming identities). PASC COGNITIVE SYMPTOM TREATMENT RECOMMENDATIONS It is important for clinicians to recognize individual patient symptom timelines vary widely and it is possible that initiating treatment earlier will result in earlier resolution of symptoms. PASC CONSENSUS GUIDANCE STATEMENT METHODS The American Academy of Physical Medicine and Rehabilitation (AAPM&R) Multi-Disciplinary PASC Collaborative (PASC Collaborative) was created, in part, to develop expert recommendations and guidance from established PASC centers with extensive experience in managing patients with PASC. [Extracted from the article]

Background: Cancer rehabilitation is an integral part of the continuum of care for survivors. Due to the increasing number of survivors, physiatrists commonly see cancer patients in their general practices. Essential to guiding the field is to understand the current training and practice patterns of cancer rehabilitation physicians.Objectives: To assess current trends in training and practice for cancer rehabilitation physicians, including the level of burnout among providers in this field.Design: Cross-sectional descriptive survey study.Setting: Online survey.Participants: American physicians who are affiliated with the Cancer Rehabilitation Physician Consortium (CRPC) of the American Academy of Physical Medicine and Rehabilitation (AAPM&R). The CRPC is a group of cancer rehabilitation providers (both fellowship-trained and not fellowship-trained) with the mission of furthering cancer rehabilitation medicine through education, research, and networking.Methods: All CRPC physicians were invited to complete a voluntary and anonymous 43-question online survey. The survey was conceived by a group of eight experts interested in providing additional information to the current literature regarding the training and practice in the cancer rehabilitation field.Main Outcome Measurements: Training, practice, opioid prescribing, and professional support.Results: Thirty-seven of 50 physicians participated (response rate = 74%). Respondents were from various states, the three most common being New York (16%, n = 6), Texas (16%, n = 6), and Massachusetts (11%, n = 4). About 57% (n = 21) of the respondents were employed in an academic medical center and 73% (n = 27) reported their primary departmental affiliation was Physical Medicine and Rehabilitation (PM&R). Approximately 78% (n = 29) credited mentorship early in training for their interest in the field. More than half (54%, n = 20) either strongly agreed or agreed that cancer rehabilitation fellowship training is necessary for graduating physiatrists who plan to treat oncology patients/survivors. National PM&R meetings were the primary source of continuing education for 86% (n = 31). Sixty-five percent (n = 24), strongly agreed or agreed that cancer rehabilitation physiatrists should know how to prescribe opioids, and 35% (n = 13) reported prescribing them when appropriate. About 54% (n = 20) rated their level of burnout as low or very low, and more than half (51%, n = 19) believed their burnout level was lower than physiatrists treating other rehabilitation populations.Conclusions: Cancer rehabilitation is a growing subspecialty in PM&R, and most physiatrists in general practice will treat many survivors-often for neurologic or musculoskeletal impairments related to cancer or its treatment. Cancer rehabilitation physicians perceive that they have relatively low levels of burnout, and early mentorship and fellowship training is beneficial. Professional conferences and mentorship are a primary source for continuing education.Level Of Evidence: IV. [ABSTRACT FROM AUTHOR]

Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30–40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. Falls account for 87 % of all fractures in the elderly. These fractures are almost always due to low impact injuries in osteoporotic bones. Several organizations have recommended screening older patients to identify those with a high risk of falling and, or fractures. The present review provides a brief summary and update of the relevant literature, summarizing screening tools and interventions to prevent falls and fractures. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to screen and prevent falls in older patients are also summarized. [ABSTRACT FROM AUTHOR]

Abstract: Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30–40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. The direct costs alone from fall related injuries are a staggering 0.1% of all healthcare expenditures in the United States and up to 1.5% of healthcare costs in European countries. This figure does not include the indirect costs of loss of income both to the patient and caregiver, the intangible losses of mobility, confidence, and functional independence. Numerous studies have attempted to define the risk factors for falls in older adults. The present review provides a brief summary and update of the relevant literature, summarizing demographic and modifiable risk factors. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to manage falls in older patients are also summarized. [Copyright &y& Elsevier]

The article offers information on the mild traumatic brain injury (mTBI) and mentions that it is one of the most common neurologic disorders in the U.S. It mentions that it is very difficult to diagnose the mTBI and most often cause of MTBI are improvised explosive devices (IEDs), landmines, blunt force injury to the head from objects in motion, motor vehicle accidents and high pressure waves from blasts.