# Functional impact for indication and access to physical therapy after hospital discharge due to COVID-19

## TL;DR

This study examines how functional limitations after hospitalization for COVID-19 affect access to physical therapy and the importance of proper referral.

## Contribution

The study identifies functional limitations as a key factor in physical therapy referral and access after hospital discharge for severe COVID-19 cases.

## Key findings

- 67% of patients were indicated for physical therapy, but 53% could not access it 30 days after discharge.
- Functional limitations were associated with higher likelihood of physical therapy indication and access.
- Impairment in basic activities of daily living predicted access to physical therapy 30 days and 1 year after discharge.

## Abstract

•Functional impacts after hospitalization for Covid-19.•Continuity of physical therapy care after hospitalization for Covid-19.•Criteria for physical therapy after Covid-19.•Functionality as a criterion for physical therapy indication after hospital discharge.

Functional impacts after hospitalization for Covid-19.

Continuity of physical therapy care after hospitalization for Covid-19.

Criteria for physical therapy after Covid-19.

Functionality as a criterion for physical therapy indication after hospital discharge.

After hospitalization for COVID-19, patients may present impairment in functionality and require physical therapy after hospital discharge for functional recovery.

To understand the association between Covid-19 functional impacts and physical therapy indication and access 30 days and 1 year after hospital discharge of severely and critically ill patients.

Cross-sectional study with two assessments: 30 days and one year after hospital discharge, in individuals ≥ 18 years of age, admitted to a referral hospital in São Paulo between June 2020 and July 2021. A convenience sample of 345 patients was used. The Poisson test was used to estimate the prevalence ratio for the association between Covid-19 functional impacts and physical therapy indication and access, with ≤ 0.05 considered significant.

Of the 185 patients included, 67 % (n: 104) were indicated for physical therapy and the majority (53 %; n:79) could not access it 30 days after hospital discharge. Post-Covid-19 functional limitations were associated with physical therapy indication (PR: 1.69; 95 %CI 1.1–2.5) and impairment in basic activities of daily living (BADLs) with access 30 days (PR: 1.81; 95 %CI 1.2 -2.6) and 1 year after discharge (PR: 1.70; 95 %CI 1.2–2.3). Physical therapy indication was significant, with a 4.07 and 2.06 likelihood of access 30 days and 1 year after discharge.

Despite the lack of functional criteria at discharge, patients with poor functional performance perceived the need for physical therapy indication and referral. Indication was essential for access to physiotherapy within the healthcare network.