Innovative Care Delivery of Acute Rehabilitation for Patients With COVID-19: A Case Report

Tara Livingston, Elle K Sullivan, Grace Wilske, Allison M Gustavson

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: The novel coronavirus 2019 (COVID-19) has impacted acute rehabilitation delivery by challenging the reliance on in-person care and the standard practice of delivering separate physical and occupational therapy services. Health care systems are rapidly developing innovative models of care that provide essential acute rehabilitation services while mitigating viral spread. We present 2 case reports to illustrate how we used technology and COVID-19-specific decision-making frameworks to deliver acute rehabilitation. Methods: We iteratively developed 2 decision-making models regarding care delivery and discharge planning in the context of the challenges to delivering care in a pandemic. We leveraged use of video communication systems installed in all COVID-19 rooms to reduce the number of in-room providers and frequency of contact. Two patients were admitted to the hospital with symptomatic COVID-19 (males, ages 65 and 40 years). Results: With the use of a video communication system and the decision-making frameworks for care delivery and discharge planning, we avoided 7 in-person sessions. Both patients demonstrated functional gains and were dischargedhome. Conclusion: The 2 case reports highlight the innovative use of a technology and COVID-19-specific decision-making processes to provide patient-centered care given the challenges to care delivery during the COVID-19 pandemic. Impact: The use of technology and decision-making models allows for delivery of safe acute rehabilitation care that minimizes contact, conserves personal protective equipment, and prepares for COVID-19 surges. The discussion points raised have applicability to patients without COVID-19 and other health care systems. Future research is needed to determine the effectiveness, costs, and downstream effects of our novel approach to acute rehabilitation for patients with COVID-19.

Original languageEnglish (US)
Article numberpzaa204
JournalPhysical therapy
Issue number2
StatePublished - Feb 4 2021

Bibliographical note

Funding Information:
This project was funded in part by the Veterans Health Administration Office of Academic Affiliations Advanced Fellowship in Clinical and Health Services Research (TPH 67-000) (A.M.G.), and theMinneapolis Center of Innovation, Center for Care Delivery and Outcomes Research (CIN 13-406). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.

Publisher Copyright:
© 2020 Published by Oxford University Press on behalf of American Physical Therapy Association.


  • Acute Care
  • Patient-Centered Care
  • Rehabilitation
  • Technology
  • Pandemics
  • Humans
  • Middle Aged
  • COVID-19/rehabilitation
  • Male
  • Delivery of Health Care/methods
  • Clinical Decision-Making
  • Physical Therapy Modalities
  • Videoconferencing
  • Adult

PubMed: MeSH publication types

  • Case Reports
  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.


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