Outcome of a Telerehabilitation Program for a Home-bound Geriatric Patient with Post Covid-19 Syndrome in Indonesia:  A Case Report and Literature Review

Peggy Sunarjo; Rigina Nilandrani; Ferius  Soewito; Siti Chandra  Widjanantie; Carl Froilan D.  Leochico

Authors

Peggy Sunarjo Department of Rehabilitation Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital
Rigina Nilandrani Hermina Kemayoran Hospital
Ferius Soewito Flexfree Musculoskeletal Rehabilitation Center
Siti Chandra Widjanantie Department of Physical Medicine and Rehabilitation, Persahabatan General Hospital, Jakarta, Indonesia
Carl Froilan D. Leochico • Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila • Department of Physical Medicine and Rehabilitation, St. Luke’s Medical Center – Quezon City and Global City, Philippines

Keywords:

functional status, geriatrics, telerehabilitation, COVID-19, quality of life

Abstract

Objectives: This study aimed to share a local experience in imple-menting a telerehabilitation program for a geriatric patient with post-COVID-19 syndrome following the third-wave pandemic and to describe the clinical outcomes.

Study design: A case report and literature review.

Setting: Hermina Kemayoran General Hospital, Jakarta, Indonesia.

Subjects: An unvaccinated 80-year-old male patient diagnosed with post-COVID-19 syndrome from the Delta strain presented with desaturation.

Methods: The patient underwent an individualized telerehabilitation program for 4 weeks via video call.

Results: His pulmonary symptoms, functional capacity, functional independence, and quality of life improved following the tele-rehabilitation program. The investigators found the challenges to initiating telerehabilitation in Indonesia include inequality of access to the internet, portable medical and health-monitoring home devices, reliable telecommunication devices, home exercise equipment, and competent caregivers. Fortunately, the patient and his family presented in this case report were able to overcome these challenges.

Conclusions: Telerehabilitation is an option for patients who have difficulty visiting a hospital to access rehabilitation services. It is necessary to improve various aspects of health among patients infected with COVID-19.

References

Tan J. E-Health Care Information Systems: An introduction for students and professionals. Wiley and Sons; 2005. p. 219. [cited 2022 May 27]. Available from: https://www.yumpu.com/en/www.cse.hcmut.edu.vn

Paneroni M, Vitacca M, Bernocchi P, Bertacchini L, Scalvini S. Feasibility of tele-rehabilitation in survivors of COVID-19 pneumonia. Pulmonology. 2022 Mar [cited 2022 May 23]1;28(2):152-4. Available from: https://pubmed.ncbi.nlm.nih.gov/33893061/ doi:10.1016/j.pulmoe.2021.03.009

Keaton L, Pierce LL, Steiner V, Lance KM, Masterson M, Rice MS, et al. An E-rehabilitation Team Helps Caregivers Deal with Stroke. Internet J Allied Health Sci Pract [Internet]. 2004 [cited 2022 May 26];2(4). Available from: https://nsuworks.nova.edu/ijahsp/vol2/iss4/7/ doi:10.46743/1540-580X/2004.1057

Knepley KD, Mao JZ, Wieczorek P, Okoye FO, Jain AP, Harel NY. Impact of telerehabilitation for stroke-related deficits. Telemedicine and e-Health. 2021 Mar [cited 2022 May 22];27(3):239-46. Available from: https://www.liebertpub.com/doi/10.1089/tmj.2020.0019 https://doi.org/10.1089/tmj.2020.0019

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet. 2021 Jan [cited 2022 Jun 1]16;397 (10270):220-32. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext doi:https://doi.org/10.1016/S0140-6736(20)32656-8

van Haastregt JCM, Everink IHJ, Schols JMGA, Grund S, Gordon AL, Poot EP, et al. Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance. Eur Geriatr Med. 2022 Feb [cited 2022 Sep 23];13(1):291-304. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605452/ doi:10.1007/s41999-021-00575-4

Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA [Internet]. 2020 Aug 11 [cited 2022 Sep 25];324(6):603-5. Available from: https://jamanetwork.com/ on 09/25/2022 doi:10.1001/jama.2020.12603

Vieira AG da S, Pinto ACPN, Garcia BMSP, Eid RAC, Mól CG, Nawa RK. Telerehabilitation improves physical function and reduces dyspnoea in people with COVID-19 and post-COVID-19 conditions: a systematic review. J Physiother [Internet]. 2022 Apr 1 [cited 2022 May 29];68(2):90-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994568/ doi:10.1016/j.jphys.2022.03.011

Chen Y, Klein SL, Garibaldi BT, Li H, Wu C, Osevala NM, et al. Aging in COVID-19: Vulnerability, immunity and intervention. Vol. 65, Ageing Research Reviews [Internet]. Elsevier Ireland; 2021. [cited 2022 May 30]. Available from: https://www.sciencedirect.com/science/article/pii/S1568163720303408?via%3Dihub doi:10.1016/j.arr.2020.101205

Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, et al. COVID-19 sequelae in adults aged less than 50 years: A systematic review. Vol. 40, Travel medicine and infectious disease [Internet]. USA: Elsevier; 2021. [cited 2022 June 2]. Available from: https://www.sciencedirect.com/science/article/pii/S1477893921000363?via%3Dihub doi:10.1016/j.tmaid.2021.101995

Mendelson M, Nel J, Blumberg L, Madhi SA, Dryden M, Stevens W, et al. Long-COVID: An evolving problem with an extensive impact. S Afr Med J [Internet]. 2020 Nov 23 [cited 2022 Jun 1];111(1):10-2. Available from: http://www.samj.org.za/index.php/samj/article/view/13141 doi:10.7196/SAMJ.2020.v111i11.15433

Raman B, Cassar MP, Tunnicliffe EM, Filippini N, Griffanti L, Alfaro-Almagro F, et al. Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine [Internet]. 2021 Jan 7 [cited 2022 May 30];31:100683. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808914/ doi:10.1016/j.eclinm.2020.100683

Li P, Chen L, Liu Z, Pan J, Zhou D, Wang H, et al. Clinical features and short-term outcomes of elderly patients with COVID-19. International Journal of Infectious Diseases [Internet]. 2020 Aug 1 [cited 2022 May 9];97:245-50. Available from: https://www.ijidonline.com/article/S1201-9712(20)30415-X/fulltext doi.org/10.1016/j.ijid.2020.05.107

Neumann-Podczaska A, Al-Saad SR, Karbowski LM, Chojnicki M, Tobis S, Wieczorowska-Tobis K. COVID 19 - Clinical picture in the elderly population: A qualitative systematic review. Aging Dis [Internet]. 2020 Jul 23 [cited 2022 May 14];11(4):988-1008. Available from: http://www.aginganddisease.org/EN/10.14336/AD.2020.0620 doi.org/10.14336/AD.2020.0620

P S, Madhavan S, Pandurangan V. Prevalence, pattern and functional outcome of post covid-19 syndrome in older adults. Cureus [Internet]. 2021 [cited 2022 May 26];13(8). Available from: https://pubmed.ncbi.nlm.nih.gov/34422503/ doi:10.7759/cureus.17189

D Leochico CF. Adoption of telerehabilitation in a developing country before and during the COVID-19 pandemic. Ann Phys Rehabil Med [Internet]. 2020 Nov 1 [cited 2022 Jun 4 ];63(6):563-4. Available from: https://www.sciencedirect.com/science/article/pii/S1877065720301238?via%3Dihub doi./10.1016/j.rehab.2020.06.001

Oh-Park M, Lew HL, Raghavan P. Telerehabilitation for Geriatrics. Phys Med Rehabil Clin N Am [Internet]. 2021 May 1 [cited 2022 May 21];32(2):291-305. Available from: https://pubmed.ncbi.nlm.nih.gov/33814059/ doi:10.1016/j.pmr.2021.01.003

Handayani HW, Kusumaningtyas AP. Telemedicine di Indonesia: Langkah Menuju Layanan Kesehatan Universal? [Internet]. Center for Digital Society (CfDS). 2021 [cited 2022 Sep 23];1. Available from: https://cfds.fisipol.ugm.ac.id/id/2021/01/13/telemedicine-di-indonesia-langkah-menuju-layanan-kesehatan-universal/

Kementerian Kesehatan Republik Indonesia. Teknologi telemedis terintegrasi untuk layanan medis anda. TEMENIN, Telemedicine Indonesia [Internet]. 2017 [cited 2022 Sep 23];1. Available from: https://temenin.kemkes.go.id/

Sari DM, Wijaya LCG. Cardiac rehabilitation via telerehabilitation in COVID-19 pandemic situation. The Egyptian Heart Journal [Internet]. 2021 Dec 29 [cited 2022 Jun 7];73(1):31. Available from: https://pubmed.ncbi.nlm.nih.gov/33779873/ doi:10.1186/s43044-021-00156-7

Leochico C, Espiritu AI, Ignacio SD, Mojica J. Challenges to the emergence of telerehabilitation in a developing country: A systematic review. Frontiers in Neurology | www.frontiersin.org [Internet]. 2020 [cited 2022 June 4];1:1007. Available from: https://www.frontiersin.org/articles/10.3389/fneur.2020.01007/full doi:10.3389/fneur.2020.01007

Leochico CFD, Valera MJS. Follow-up consultations through telerehabilitation for wheelchair recipients with paraplegia in a developing country: a case report. Spinal Cord Ser Cases [Internet]. 2020 Dec 6 [cited 2022 May 30];6(1):58. Available from: https://pubmed.ncbi.nlm.nih.gov/32632104/ doi:10.1038/s41394-020-0310-9

Seron P, Oliveros MJ, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, et al. Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Phys Ther [Internet]. 2021 Jun 1 [cited 2022 June 3];101(6). Available from: https://academic.oup.com/ptj/article/101/6/pzab053/6131423 doi:10.1093/ptj/pzab053

Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. Telerehabilitation: review of the state-of-the-art and areas of application. JMIR Rehabil Assist Technol [Internet]. 2017 Jul 21 [cited 2022 May 29];4(2):e7. Available from: https://pubmed.ncbi.nlm.nih.gov/28733271/ doi:10.2196/rehab.7511

Shenoy MP, Shenoy PD. Identifying the challenges and cost-effectiveness of telerehabilitation: A narrative review. Vol. 12, Journal of Clinical and Diagnostic Research [Internet]. 2018 [cited 2022 May 30].; Available from: https://www.jcdr.net/articles/PDF/12311/36811_CE[Ra1]_F(AK)_PF1(AJ_AP)_PN(P).pdf doi:10.7860/JCDR/2018/36811.12311

Vellata C, Belli S, Balsamo F, Giordano A, Colombo R, Maggioni G. Effectiveness of telerehabilitation on motor impairments, non-motor symptoms and compliance in patients with Parkinson’s disease: A systematic review. Front Neurol [Internet]. 2021 Aug 26 [cited 2022 June 4];12:627999. Available from: https://pubmed.ncbi.nlm.nih.gov/34512495/ doi:10.3389/fneur.2021.627999

Bernocchi P, Vitacca M, la Rovere MT, Volterrani M, Galli T, Baratti D, et al. Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: A randomised controlled trial. Age Ageing [Internet]. 2018 Jan 1 [cited 2022 June 1];47(1):82-8. Available from: https://academic.oup.com/ageing/article/47/1/82/4097568 doi:10.1093/ageing/afx146

Torsney K. Advantages and disadvantages of telerehabilitation for persons with neurological disabilities. NeuroRehabilitation [Internet]. 2003 [cited 2022 May 30];18(2):183-5. Available from: https://content.iospress.com/articles/neurorehabilitation/nre00188 doi:10.3233/NRE-2003-18211

Hartantri W, Arfianti L. Combination of telerehabilitation with conventional therapy in the treatment of bilateral carpal tunnel syndrome: a case report. Surabaya Physical Medicine and Rehabilitation Journal [Internet]. 2020 Aug 31 [cited 2022 June 3];2(2):73. Available from: https://e-journal.unair.ac.id/SPMRJ/article/view/21162 doi:10.20473/spmrj.v2i2.21162