Challenges and Awareness in Long COVID Rehabilitation: Insights from a Cross-sectional Survey of U.S. Therapists

Research Objectives: To explore rehabilitation provider's awareness of long COVID and their application of relevant clinical practice guidelines (CPGs).

Design: Prospective cross-sectional survey of occupational therapists (OTs), physical therapists (PTs), and speech-language pathologists (SLPs) in the United States (U.S.).

Setting: Postal-based survey distributed to one representative state from each of the nine divisions within the contiguous U.S.

Participants: Three hundred individuals (100 from each discipline) were randomly selected from the licensing board of the state with the highest adult prevalence of long-COVID identified in the CDC Long-COVID Pulse Survey Database within each of the 9 primary divisions categorized by the U.S. Census Bureau. A total of 2700 individuals were invited to participate.

Interventions: n/a

Main Outcome Measures: A researcher-developed survey was reviewed by external experts and distributed to potential participants. Questions sought data pertaining to participant demographics, their familiarity with Long COVID symptomatology, awareness and use of relevant CPGs, and perceived challenges to Long COVID rehabilitation.

Results: A total of 299 participants (11.6% response rate) were included in the final analysis. Responses were received from all nine states, including 104 OTs, 114 PTs, and 81 SLPs (mean age: 44±12.8 years, mean years of experience: 17.4±11.7 years). Of the 33.4% of respondents who occasionally or frequently treat Long COVID, 89.7% report being aware of associated symptoms; however, only 30.9% were aware of relevant CPGs, with just 16.8% reporting the use of CPGs in practice, and 11.3% aware of standardized outcome measures. Differences were noted between disciplines in awareness and use of CPGs. Nearly all (90.5%) respondents believe Long COVID will be an ongoing condition treated within the rehabilitation community. The top five challenges in Long COVID rehabilitation included lack of knowledge (n=176), lack of experience (n=173), the ability to distinguish Long COVID from other disorders (n=125), unfamiliar with treatment approaches (n=93), and unfamiliar with standardized outcome measures (n=88).

Conclusions: There is a lack of awareness and use of CPGs related to Long COVID within the rehabilitation community that may lead to inconsistencies in care and negatively influence outcomes. Challenges to the rehabilitation of persons with Long COVID may be addressed through evidence-based strategies to promote the adoption of CPGs in clinical practice.

Author(s) Disclosures: none