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Introduction/Background Technology may enable a higher dose of exercise to improve rehabilitation outcomes. Aim To evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation compared to usual care alone. Material and method A pragmatic, assessor-blinded, parallel-group randomised trial of 300 consenting rehabilitation inpatients. The intervention group received technology-based exercise prescribed by a physiotherapist to target mobility and physical activity problems for 6 months. Technology included video and computer games/exercises, tablet applications and activity monitors. The control group received no additional intervention and both groups received usual rehabilitation care. The co-primary outcomes were objectively assessed physical activity (average minutes per day spent upright using activPAL) and mobility (Short Physical Performance Battery, SPPB, 0–3 continuous score) at 6 months after randomisation. Linear models assessed the effect of group allocation with baseline scores entered as covariates. Results Participants (mean age 74 (SD14); 50% female; 54% with neurological conditions limiting mobility) received on average 11 (SD11) inpatient sessions using 4 (SD1) different technologies and 15 physiotherapy contacts to support technology use in the post-hospital phase. At 6-months physical activity was similar between groups (mean between group difference (95% CI) uptime in minutes: −3.1 (−39.4 to 33.2; P = 0.87)) and mobility was significantly better in the intervention group compared to the control group (mean SPPB between group change score 6-month to baseline 0.2 points (95% CI 0.1 to 0.3, P < 0.01)). Secondary outcomes of mobility also favoured the intervention group as did other aspects of physical activity (e.g. self-reported physical activity), particularly for younger participants. Conclusion A tailored intervention using technology, targeting specific mobility limitations and promoting physical activity in addition to usual rehabilitation, improved mobility and some aspects of physical activity and appears to have greater impact in younger people. [ABSTRACT FROM AUTHOR]

Introduction/Background The need for rehabilitation is growing although there are limited resources to meet this demand. Use of affordable technologies to enable health professionals to prescribe and monitor rehabilitation remotely may be one strategy to meet this demand. Aim: to describe physiotherapy support provided to participants using technology to improve mobility and physical activity in the post-hospital phase of the AMOUNT rehabilitation trial ( n = 300). Material and method Process evaluation including participants (mean age 70 (SD 18); 52% male; 54% with neurological conditions limiting mobility) randomised to the intervention group ( n = 149). Intervention was additional to standard rehabilitation, prescribed using a protocol which matched games/exercises from eight technologies to the participant's mobility limitations. Technologies included video and computer games/exercises, tablet applications and activity monitors. Participants were taught to use the technologies during inpatient rehabilitation and were then discharged home to use the technologies ≥ 5 days a week for the remainder of the 6-month trial. Trial protocol required the physiotherapist to provide support every 1–2 weeks using a health coaching approach. Intervention datasheets were audited to determine frequency, duration, mode and type of support provided. Results Participants used on average 2 (SD 1) technologies in the post-hospital phase, with 95% of participants using an activity monitor. Physiotherapists had contact with participants on average 15 (SD 5) times (approximately every 11 days), of which eight were phone calls (11 min duration), six home-visits (46 min duration) and one other. Contact primarily incorporated health coaching (68%) with 8% of contact specifically for technology support. Topics discussed during health coaching included discussing data from prescribed technologies (79%), physical activity and mobility status (70%), adherence (64%) and goal setting (47%). Conclusion A health coaching model to support technology-based rehabilitation post-hospitalisation is feasible. Some support can be provided remotely limiting the need for frequent home visits. [ABSTRACT FROM AUTHOR]

The aim of this study is to report the characteristic and mortality outcomes of lung transplant patients that contracted COVID19. A retrospective chart review was conducted of lung transplant recipients who tested positive for COVID19 from 6/1/2020 to 9/1/2021. Forty-five patients were included for mortality incidence review with 2 patients who were admitted to outside facilities during their COVID diagnosis with limited treatment data. Mortality incidence was 15.5% with cohort mean age of 62 (±11.7). Median time from transplant to infection was 1281 days (223-5800). Five patients required O2 and n=5 were intubated with 80% mortality (n=4) among those intubated. Baseline demographics of age, gender, indication for transplant or race were not statistically different among patients that died vs those that survived. Vaccinations (2 doses) prior to infection were evident in n=35 (77.8%) of the patients. Maintenance immunosuppressants and covid therapies (table 1) did not have an associated difference in survival from infection. A significant association with mortality was found from the time of reported symptoms to triage or hospitalization in those that survived vs died, 3.3 vs 9.4 days (p=0.003). This is one of the largest cohorts reporting lung transplant recipients who contracted COVID19, and despite lungs being the organ directly affected by COVID19, mortality rates are comparable to rates reported in other solid organ transplants. Time to triage from symptom onset to clinic management or hospital admission for COVID appears to be associated with improved mortality rates. [ABSTRACT FROM AUTHOR]