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The Stanford Hall consensus statement for post-COVID-19 rehabilitation.

Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, UK.School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, UK oliver.o'sullivan@nhs.net.Headquarters Army Medical Directorate, Camberley, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Department of Sport and Exercise Medicine, Queen's Medical Centre Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK.Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, UK.University of Brighton, Brighton, East Sussex, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Medical Department, Nottinghamshire County Cricket Club, Nottingham, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.British Association of Sport and Exercise Medicine, Doncaster, UK.School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Medical School, University of Nottingham, Nottingham, Nottinghamshire, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.FASIC Sport and Exercise Medicine Clinic, University of Edinburgh, Edinburgh, UK.Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, UK.National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, London, UK.Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom.

British journal of sports medicine. 2020;(16):949-959
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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.

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