About: How COVID-19 Patients Were Moved to Speak: A Rehabilitation Interdisciplinary Case Series

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	How COVID-19 Patients Were Moved to Speak: A Rehabilitation Interdisciplinary Case Series
Creator	Johnson, Elizabeth Lawrence, Cecelia Mooney, Brianne Ball, Karen Ndt, C Slaboden, Amanda
Source	PMC
abstract	BACKGROUND: Up to 36% of patients admitted to the ICU for COVID-19 require tracheostomy. While the literature recommends the use of multidisciplinary teams in the management of patients with tracheostomy for other diseases, little is known on the collaborative administration of physical therapy and speech language pathology services in the COVID-19 population. PURPOSE: We sought to determine the outcomes of a collaboration between physical therapy (PT) and speech language pathology (SLP) in the treatment of patients who underwent tracheostomy placement as part of their treatment for COVID-19 at our facility. METHODS: We conducted a retrospective case series on patients with COVID-19 who had a tracheostomy. We included patients who had undergone mechanical ventilation for 14 days or longer, had a surgical tracheostomy, been discharged from intensive care to a medical unit, and received PT and SLP referrals. We compiled retrospective data from electronic medical records, analyzing days from tracheostomy to achievement of PT and SLP functional milestones, including mobility, communication, and swallowing. Of six critically ill patients with COVID-19 who had tracheostomy placement at our facility, three met inclusion criteria: patient 1, a 33-year-old woman; patient 2, an 84-year-old man; and patient 3, an 81-year-old man. For all patients, PT interventions focused on breathing mechanics, secretion clearance, posture, sitting balance, and upper and lower extremity strengthening. SLP interventions focused on cognitive reorganization, verbal and nonverbal communication, secretion management, and swallowing function. Intensity and duration of the sessions were adapted according to patient response and level of fatigue. RESULTS: We found that time to tracheostomy from intubation for the three patients was 23 days, 20 days, and 24 days, respectively. Time from tracheostomy insertion to weaning from ventilator was 9 days for patient 1, and 5 days for patient 2 and patient 3. Regarding time to achieve functional PT and SLP milestones, all patients achieved upright sitting with PT prior to achieving initial SLP milestone of voicing with finger occlusion. Variations in progression to swallowing trials were patient specific and due to respiratory instability, cognitive deficits, and limitations in production of an effortful swallow. Patient participation in therapy sessions improved following establishment of oral verbal communication. CONCLUSION: Interdisciplinary cooperation and synchronized implementation of PT and SLP interventions in three COVID-19 patients following prolonged intubation facilitated participation in treatment and achievement of functional milestones. Further study is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11420-020-09778-0) contains supplementary material, which is available to authorized users.
has issue date	2020-08-26(xsd:dateTime)
bibo:doi	10.1007/s11420-020-09778-0
has license	cc-by
sha1sum (hex)	55f20749461af3266e96665a60fb2dc320a84cbd
schema:url	https://doi.org/10.1007/s11420-020-09778-0
resource representing a document's title	How COVID-19 Patients Were Moved to Speak: A Rehabilitation Interdisciplinary Case Series
has PubMed Central identifier	PMC7448406
schema:publication	HSS J
resource representing a document's body	covid:55f20749461af3266e96665a60fb2dc320a84cbd#body_text
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