Neurorehabilitation in the wake of Covid-19
30 April 2020
NRC Medical Experts welcomes the British Society of Rehabilitation Medicine’s recently published report Rehabilitation in the wake of Covid-19 - A phoenix from the ashes.
A high proportion of individuals living with chronic neurological conditions are considered clinically at high risk of Covid-19 complications by the NHS – including people with Parkinson’s disease, motor neurone disease, multiple sclerosis and cerebral palsy.
The Covid-19 virus is likely to lead to both complications for those already living with neurological conditions as well as an increase in demand for neuro rehabilitation services for previously healthy patients recovering from the virus and associated periods in intensive care.
Addressing the challenges for neurorehabilitation
The BRSM report addresses the many challenges facing the neurorehabilitation sector and potential impact on patients, including the diminished workforce due to sickness, shielding and redeployment to frontline services and the impacts of social distancing of patients from their families.
The European Academy of Neurology also recently highlighted the challenges faced by patients leaving ICU, with the need for respiratory and motor rehabilitation to counteract the consequences of prolonged immobilisation, suggesting the “need of implementing units not only dedicated to “neurocovid”, but also to neurorehabilitation for COVID-19 patients more generally.”
In April, Karen Middleton, Chief Executive of The Chartered Society of Physiotherapy (CSP) warned ‘as the country emerges from this crisis, there will be a ‘tidal wave’ of rehabilitation need’, due both to meeting the requirements of rehabilitation postponed or put on hold due to the Covid-19 crisis response, as well as the increased need for rehabilitation for patients leaving intensive care.
Post Covid-19 neurological conditions and recovery
It also explores, in detail, the as yet unquantifiable additional caseload of patients with post-Covid disability presenting with a wide range of problems due to cardio-pulmonary, musculoskeletal, neurological and psychological/psychiatric complications of the disease.
Early reports from colleagues across the globe have highlighted a link between some neurological conditions and Covid-19, including Guillain-Barré syndrome and Miller Fisher syndrome – causing difficulties with walking, swallowing and breathing. It has also been reported that younger people – aged 30 to 40 - with mild symptoms of the virus are suffering strokes more commonly seen in patients with a median age of 74.
Recovery and rehabilitation pathways post-infection are complicated by the need for Covid positive and Covid negative services, as well long-term pressures with an increase in those facing life-long complex disability requiring specialist nursing home care.
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