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The Stanford Hall consensus statement for post-COVID-19 rehabilitation
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  1. Robert M Barker-Davies1,2,
  2. Oliver O'Sullivan1,3,
  3. Kahawalage Pumi Prathima Senaratne4,5,
  4. Polly Baker1,6,
  5. Mark Cranley4,
  6. Shreshth Dharm-Datta4,
  7. Henrietta Ellis4,
  8. Duncan Goodall4,7,
  9. Michael Gough4,
  10. Sarah Lewis4,
  11. Jonathan Norman4,
  12. Theodora Papadopoulou4,8,
  13. David Roscoe2,4,
  14. Daniel Sherwood4,
  15. Philippa Turner4,9,
  16. Tammy Walker4,
  17. Alan Mistlin4,
  18. Rhodri Phillip4,
  19. Alastair M Nicol4,10,
  20. Alexander N Bennett1,11,
  21. Sardar Bahadur4
  1. 1 Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, UK
  2. 2 School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
  3. 3 Headquarters Army Medical Directorate, Camberley, UK
  4. 4 Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom
  5. 5 Department of Sport and Exercise Medicine, Queen's Medical Centre Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK
  6. 6 University of Brighton, Brighton, East Sussex, UK
  7. 7 Medical Department, Nottinghamshire County Cricket Club, Nottingham, UK
  8. 8 British Association of Sport and Exercise Medicine, Doncaster, UK
  9. 9 Medical School, University of Nottingham, Nottingham, Nottinghamshire, UK
  10. 10 FASIC Sport and Exercise Medicine Clinic, University of Edinburgh, Edinburgh, UK
  11. 11 National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, London, UK
  1. Correspondence to Dr Oliver O'Sullivan, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, The Stanford Hall Rehabilitation Estate, Stanford on Soar, Loughborough, Nottingham, LE12 5QW, UK; oliver.o'sullivan{at}nhs.net

Abstract

The highly infectious and pathogenic novel coronavirus (CoV), severe acute respiratory syndrome (SARS)-CoV-2, has emerged causing a global pandemic. Although COVID-19 predominantly affects the respiratory system, evidence indicates a multisystem disease which is frequently severe and often results in death. Long-term sequelae of COVID-19 are unknown, but evidence from previous CoV outbreaks demonstrates impaired pulmonary and physical function, reduced quality of life and emotional distress. Many COVID-19 survivors who require critical care may develop psychological, physical and cognitive impairments. There is a clear need for guidance on the rehabilitation of COVID-19 survivors. This consensus statement was developed by an expert panel in the fields of rehabilitation, sport and exercise medicine (SEM), rheumatology, psychiatry, general practice, psychology and specialist pain, working at the Defence Medical Rehabilitation Centre, Stanford Hall, UK. Seven teams appraised evidence for the following domains relating to COVID-19 rehabilitation requirements: pulmonary, cardiac, SEM, psychological, musculoskeletal, neurorehabilitation and general medical. A chair combined recommendations generated within teams. A writing committee prepared the consensus statement in accordance with the appraisal of guidelines research and evaluation criteria, grading all recommendations with levels of evidence. Authors scored their level of agreement with each recommendation on a scale of 0–10. Substantial agreement (range 7.5–10) was reached for 36 recommendations following a chaired agreement meeting that was attended by all authors. This consensus statement provides an overarching framework assimilating evidence and likely requirements of multidisciplinary rehabilitation post COVID-19 illness, for a target population of active individuals, including military personnel and athletes.

  • rehabilitation
  • recovery
  • sports and exercise medicine
  • consensus
  • virus

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Footnotes

  • Twitter @pumisen, @Dora_Sportmed

  • Contributors RP and SB had the idea to create an internal document for guidance and selected panel members. RB-D and OOS had the idea for this study design. RB-D, OOS and KPPS were responsible for collating the bibliography, manuscript drafting, presenting proposed recommendations and checking levels of evidence. ANB and SB oversaw study design refined by RB-D, OOS and KPPS. SB chaired discussion of final recommendations with all authors. RB-D organised and collated voting results and was responsible for any statistical calculations. All authors edited the final manuscript and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information

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