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1. Rehabilitation Characteristics and Outcomes for Lung Transplantation for COVID-19: A Case Series

Author

Clancy, Malachy J., Adler, Joe, Tevald, Michael A., Zaleski, Derek, Fluehr, Lindsay, Wamsley, Carol, Bermudez, Christian A., Crespo, Maria M., Balar, Priya, Oyster, Michelle L., Courtwright, Andrew M., and Diamond, Joshua M.

Subjects
Lungs -- Transplantation
Abstract

Objective. Severe coronavirus disease 2019 (COVID-19) can result in irreversible lung damage, with some individuals requiring lung transplantation. The purpose of this case series is to describe the initial experience with the rehabilitation and functional outcomes of 9 patients receiving a lung transplant for COVID-19. Methods. Nine individuals, ranging in age from 37 to 68 years, received bilateral orthotopic lung transplantation (BOLT) for COVID-19 between December 2020 and July 2021. Rehabilitation was provided before and after the transplant, including in-hospital rehabilitation, postacute care inpatient rehabilitation, and outpatient rehabilitation. Results. Progress with mobility was limited in the pretransplant phase despite rehabilitation efforts. Following transplantation, 2 individuals expired before resuming rehabilitation, and 2 others had complications that delayed their progress. The remaining 5 experienced clinically important improvements in mobility and walking capacities. Conclusion. Considerable rehabilitation resources are required to care for individuals both before and after BOLT for COVID-19. Rehabilitation can have a profound impact on both functional and clinical outcomes for this unique patient population. Impact. There is limited literature on the rehabilitation efforts and outcomes for patients who received BOLT for COVID-19. Occupational therapists and physical therapists play an important role during the pretransplant and posttransplant recovery process for this novel patient population. Lay Summary. Patients with a bilateral orthotopic lung transplant due to COVID-19 require a unique rehabilitation process. They have significant difficulties with activities of daily living and functional mobility across the pretransplant and posttransplant continuum of care, but progressive gains in functional performance may be possible with a comprehensive multidisciplinary rehabilitation program. Keywords: Acute Care, Cardiovascular System, COVID-19, Critical Care, Lung Transplantation, Rehabilitation, Respiratory System, Introduction The coronavirus disease 2019 (COVID-19) pandemic continues to be a global health emergency, with over 645 million cases and 6.6 million deaths worldwide. (1) Despite widely available vaccines, individuals [...]

Published
2023
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3. Rehabilitation Characteristics and Outcomes for Lung Transplantation for COVID-19: A Case Series

Author

Clancy, Malachy J, primary, Adler, Joe, additional, Tevald, Michael A, additional, Zaleski, Derek, additional, Fluehr, Lindsay, additional, Wamsley, Carol, additional, Bermudez, Christian A, additional, Crespo, Maria M, additional, Balar, Priya, additional, Oyster, Michelle L, additional, Courtwright, Andrew M, additional, and Diamond, Joshua M, additional

Published
2023
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5. List of contributors

Author

Ad Adams, Ebenezer, Adebowale, Akintunde, Agrawal, Abha, Aguilar, Javier Sánchez, Akgul, Yusuf Sinan, Akinniyi, Oluwasegun T., Asongafac, Ayenowowan, Sunday O., Ayodele, Kayode P., Badhal, Suman, Balasubramanian, Sivakumar, Baldwin, Jakita, Balivada, Santosh, Barger, Cori, Barkana, Duygun Erol, Behzadipour, Saeed, Bello, Abiodun H., Boldrini, Paolo, Bonaiuti, Donatella, Bui, Kevin Doan-Khang, Bustamante Valles, Karla D., Cao, Ning, Carrasquilla Batista, Arys, Chen, Zhen, Cifuentes, Carlos A., Comadurán Márquez, Daniel, Coto-Solano, Beatriz, Crocher, Vincent, Dillingham, Timothy, Djordjevic, Olivera C., Fawale, Michael B., Feingold-Polak, Ronit, Fong, Justin, García-Aracil, Nicolás, Garzón, Andrea, Goldberg, Carly, Hajjioui, Abderrazak, Hamilton, Taya, Hanapiah, Fazah Akhtar, Hirata, Yasuhisa, Hong (Zen), Koh Teck, Hua, Zikai, Idowu, Ahmed O., Iturralde-Duenas, Gabriel, Ivorra, Andrea Blanco, Jamisola, Rodrigo S., Jr, Johnson, Michelle J., Jubril, Abimbola M., Jung, Bong-Keun, Kachroo, Kavita, Kambou, Sinforian, Kebaetse, Maikutlo, Keyvanian, Shafagh, Khor, Kang Xiang, Khor, Yvonne Y.W., Kim, JiHyun, Kimmatudawage, Sumudu Perera, Klaic, Marlena, Kommula, Venkata P., Komolafe, Morenikeji A., Konstantinovic, Ljubica M., Krebs, Hermano I., Lamou, Eric Gueumekane Bila, Levy-Tzedek, Shelly, Loeza Magaña, Pavel, Mazzoleni, Stefano, Mbakile-Mahlanza, Lingani, McIntyre, Amanda, Mehr, Javad K., Mendonca, Rochelle J., Mitrovic, Sindi Z., Miyai, Ichiro, Mogorosi, Ntsatsi, Mohamad Hashim, Natiara, Moon, Inhyuk, Múnera, Marcela, Nafai, Said, Naqvi, Imama A., Ndlovu, Kagiso, Nehrujee, Aravind, Nilsen, Dawn M., Noda, Tomoyuki, Nthitu, Justus Mackenzie, Nyarko, Frank Kwabena Afriyie, Ocampo, Cassandra, Ogunba, Kolawole S., Ogunbona, Philip O., Ogundele, Abiola O., Oktay, Ayse Betul, Olaogun, Matthew O.B., Ortiz-Prado, Esteban, Orts, José María Catalán, Owen Tsai, Chung-Ying, Park, Jin-Hyuck, Pino, Angie, Posteraro, Federico, Quao, Benedict Okoe, Rahimi, Narges, Rakesh Srivastava, Saha, Shovan, Saikaley, Marcus, Sánchez, Jose López, Sanusi, Ahmad A., Savic, Andrej M., Song, Won-Kyung, Srinivasan, Sujatha, Su, Eileen L.M., Su, Hao, Tannor, Abena Yeboaa, Tarakci, Devrim, Tarakci, Ela, Tavakoli, Mahdi, Temgoua, Michael, Tonye, Philomène Synthia, Trejos, Ana Luisa, Tsima, Billy, Tsinda, Valery Labou, Uzun, Ismail, V., Guruprasad, Vidakovic, Aleksandra S., Wamsley, Carol A., Weiss, Patrice L., Winterbottom, Lauren, Wolfe, Dalton L., Yang, Dixon, Yeong, Che Fai, Zammouri, Amin, and Zollo, Loredana

Published
2024
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10. Using the Brief-BESTest paired with a novel algorithm to provide targeted balance interventions for people with subacute stroke: a feasibility study.

Author

Johns, Eric, Wamsley, Carol, and Whiting, Anne

Subjects
ALGORITHMS, POSTURAL balance, LENGTH of stay in hospitals, LIFE skills, LONGITUDINAL method, MEDICAL protocols, SCIENTIFIC observation, STATISTICAL sampling, THERAPEUTICS, WALKING, PILOT projects, BODY movement, TREATMENT effectiveness, STAIR climbing, STROKE rehabilitation, PHYSICAL therapy assessment
Abstract

Background: Balance is a common mobility limitation following stroke, but determination of the most effective balance-related plan of care can be difficult due to multiple balance impairments that vary between individuals. The Brief-BESTest is a validated outcome measure for balance based on six systems of postural control. It may also be a useful tool to guide clinicians in their balance plan of care design. Objective: The objective of this study was to determine the feasibility of a quantitative balance plan of care for patients with subacute stroke, using a novel algorithm that utilizes the scoring design of the Brief-BESTest. The authors hypothesized that this plan of care could create targeted balance interventions among this population. Methods: Eligible patients with subacute stroke at an inpatient rehab facility completed the Brief-BESTest within 1 week of admission. The subjects participated in specific interventions based on test section scores during their rehab stay. Results: Five subjects completed testing and participated in targeted balance interventions, addressing three to five systems of postural control. Subjects demonstrated improved Brief-BESTest overall scores by 2, 1, 7, 4, and 6 points from admission to discharge. Improvements in section scores were primarily seen in the systems of postural control identified by the algorithm. All subjects improved in Functional Independence Measure (FIM™)30 scores for locomotion (walking and stairs) by 5, 6, 7, 6, and 9 points, respectively. All subjects were discharged to the community. Conclusion: Our observational study found this method of assessment and intervention to be feasible in the subacute stroke population and was associated with improved balance scores and improved functional mobility. Further study is warranted to determine effectiveness and efficiency. [ABSTRACT FROM AUTHOR]

Published
2019
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12. Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation.

Author

Bui KD, Wamsley CA, Shofer FS, Kolson DL, and Johnson MJ

Abstract

There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a cross-sectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We developed three robot-based tasks trajectory tracking, N-back, and spatial span - to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined if these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between subjects' cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol - Coding (rho = 0.81), Montreal Cognitive Assessment - Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.

Published
2020
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