Rehabilitation Associates of Crown Heights – A Letter To The Community
COVID-19 AND OUTPATIENT REHABILITATION
The COVID-19 virus presented many in our community with significant medical challenges. The most obvious signs and symptoms were fever, difficulty breathing, chest pain, gastrointestinal issues as well as weakness. If these issues went on for long enough the patient may have been left with difficulty walking, climbing stairs and performing daily chores. There could be difficulty with dressing and grooming as well as difficulty with shopping, carrying, lifting, etc.. (Examples may include putting on and taking off tallis and tefillin or putting dishes into a cabinet.)
As a provider in an outpatient Physical and Occupational Therapy Center in Crown Heights, I would like to raise awareness about other signs and symptoms of COVID-19 that we are seeing in patients with moderate to severe cases regardless of whether they were hospitalized or not. Two main issues that I would like to bring to your attention are Neuropathy and Deconditioning.
Neuropathy is defined as disease or dysfunction of the peripheral nerves (nerves outside of the brain and spinal cord). Those nerves include the motor and sensory nerves running through a person’s arms and legs. Peripheral Neuropathy can present itself as tingling and/or numbness in the affected limb (pins and needles to the fingers and toes), and/or weakness in the affected limb which can cause impaired balance and gait when it affects the legs and feet. This makes walking and climbing stairs difficult. When it affects the upper extremities it can impair fine motor/writing skills and can cause someone to drop objects, etc.
There are many different kinds of and causes of neuropathy. In the case of COVID-19 one main factor that we are seeing is the position that the patients who are incapacitated or unable to move are in for extended period of time. Prolonged pressure on areas such as the top of the thigh or the inner side of the elbow can compress the nerves resulting in numbness/weakness to different areas of the arms/hands and legs/feet. The other main cause of neuropathy in the patients that we are seeing is called Critical Illness Neuropathy. This occurs in patients suffering from severe illness and the reason for this issue is not really known. This can at times contribute to/cause contractures (tightening of joints), severe weakness, and incoordination.
We are also seeing that many patients are significantly deconditioned. Deconditioning is the loss/change in muscles (and other body systems) due to prolonged bed rest/inactivity. It has been shown in many studies that even one week of bed rest can cause a significant loss of muscle mass. Symptoms may include shortness of breath even with little or moderate exertion, fatigue and a general feeling of malaise. Patients may be having difficulty walking several blocks, climbing a flight of stairs, reaching overhead or even performing basic daily skills such as dressing and grooming. Rehabilitation is vital to patients with any of the above issues as they may require stretching, strength training and conditioning. Some patients may benefit from a PT and OT consult to evaluate their gait and balance, need for splinting, ergonomics and dexterity training. In some cases recommendations for consultation with other specialists is made to neurologists, orthopedists, orthotists, etc. to complement the care they are receiving in our facility. Feel free to stop by our office with your questions.
Wishing all health, and a return to our full strength.
The staff at Rehabilitation Associates of Crown Heights – 425 Kingston Ave – P: 718-659-5800
Mordechai Shedrowitzky PT
Daniel Friedman DPT
Rena Aminova OTR/L
Suri Schindler DPT Aurus Sanchez PTA Tzvi Malks OTR/L
