Implementing a Rehabilitation Program in Patients Recovering From Covid-19 Infection

The RAND 36-Item Health Survey taps eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. It also includes a single item that provides an indication of perceived change in health. All items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.

Assessment of shortness of breath using the modified MRC scale. The minimum score is 0 and maximum score is 4. Higher values mean more dyspnea.

The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.

Assessment of symptoms after COVID-19 using the Post-COVID-19 Functional Status scale (PCFSS). Minimum score is 0 and maximum score is 4. Patients with higher scores are more impaired. Patients with a score of 2 or more are considered significantly impaired after COVID-19 infection.

Assessment of lower extremity strength using a dynamometer.

The one minute sit to stand test assesses functional lower extremity strength, transitional movements, balance, and fall risk.The 1-minute STS test is performed with a chair of standard height of 46 cm without arm rests. The patient is ensured to be seated upright on the chair positioned against a wall. The patient sits with the knees and hips flexed to 90°, feet placed flat on the floor hip-width apart, and the hands placed on the hips. Every get up from the chair is validated to check if complete sit-to-stand-to-sit sequence is achieved. The number of repetitions is measured.

Short Physical Performance Battery is a simple test to measure lower extremity function using tasks that mimic daily activities. The SPPB examines 3 areas of lower extremity function; static balance, gait speed, and getting in and out of a chair. SPPB scores range from zero to 12 possible points, a score lower than 10 indicates one or more mobility limitations

The Impact of Event Scale - Revised (IES-R) is designed as a measure of post-traumatic stress disorder (PTSD) symptoms. It's a 22-item self report measure that assesses subjective distress caused by traumatic events. Items are rated on a 5-point scale ranging from 0 ("not at all") to 4 ("extremely"). The IES-R yields a total score (ranging from 0 to 88) and subscale scores can also be calculated for the Intrusion, Avoidance, and Hyperarousal subscales.

The Hospital Anxiety and Depression Scale (HADS) measures anxiety and depression in a general medical population of patients. HADS focuses on non-physical symptoms so that it can be used to diagnose depression and/or anxiety in people with significant physical ill-health.The questionnaire comprises seven questions for anxiety and seven questions for depression.

For both scales, scores of less than 7 indicate non-cases 8-10 Mild 11-14 Moderate 15-21 Severe

Assessment of lung diffusion capacity through measurement of diffusing capacity of the lung for carbon monoxide (CO) (DLCO)

Assessment of respiratory function measuring Forced Vital Capacity with spirometry.

The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).

The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.

The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative measure of health outcome that reflect the patient's own judgement.

International Physical Activity Questionnaire (IPAQ) is 27 item self report measure of physical activity for adults 15 to 69 years old. There two forms of output from scoring the IPAQ, in categories (low, moderate and high activity), or as continuous variables as MET minutes per week. MET minutes represent the amount of energy expended carrying out physical activity. The higher the score the more active the participant.

The Activities-Specific Balance Confidence (ABC) scale is used. Patients give their answers in % of confidence and score ranges from 0% (worst possible balance confidence) to 100% .

Assessment of respiratory function measuring Forced Expiratory Volume in 1 minute with spirometry.

The Montreal Cognitive Assessment (MoCA) is a widely used screening assessment for detecting cognitive impairment. The MoCA test is a one-page 30-point test, scores range between 0 and 30. A score of 26 or over is considered to be normal.

The Beck Depression Inventory (BDI, BDI-1A, BDI-II), is a 21-question multiple-choice self-report inventory for measuring the severity of depression.

When the test is scored, a value of 0 to 3 is assigned for each answer and then the total score is compared to a key to determine the depression's severity. The standard cut-off scores were as follows:

0-9: indicates minimal depression 10-18: indicates mild depression 19-29: indicates moderate depression 30-63: indicates severe depression. Higher total scores indicate more severe depressive symptoms.