Physical Therapy Management for a Medically Complex Post-COVID-19 Patient: A Case Report

Background: With the recent emergence of coronavirus disease 2019 (COVID-19), millions of people have been infected and hospitalized. Those with pre-existing conditions are susceptible to facing more severe complications from the virus, requiring rehabilitation to address various physical function deficits that result. Thus, the purpose of this case report is to outline one example of applying personalized physical therapy treatment interventions implemented in an inpatient rehabilitation setting to improve the functional status of a medically complex patient with complications from COVID-19. Case Description: A 67-year old patient with a history of diabetes, cardiovascular conditions, obesity, and depression presented to an inpatient rehabilitation hospital following an extensive hospitalization due to severe complications from COVID-19. Functional deficits primarily included decreased cardiopulmonary endurance and generalized weakness in his lower extremities. Outcome Measures:  This report compared levels of assistance required for functional mobility tasks at initial evaluation and discharge as outlined by the Section GG codes. The 30-second sit to stand test was also assessed during the plan of care. Discussion: While this patient had a complex medical history and multiple post-COVID complications, he responded well to therapeutic mobility interventions without any adverse effects. By progressing ambulation distance, standing tolerance, dual-tasking, dynamic balance, transfers, bed mobility, and progressive strengthening exercises, the patient was able to discharge home with his wife with minimal assistance needed to perform activities of daily living. This case report provides clinicians an example of intervention progression for patients requiring intense rehabilitation following prolonged hospitalizations from COVID-19 complications.