Summary
Background: Since the beginning of the SARS-CoV-2 epidemic in Poland, 6,128,006 people have been diagnosed, of which 116,798 died. Patients who recovered from COVID-19 and require rehabilitation due to varied impairments should be provided an opportunity to participate in an individualized, complex rehabilitation program starting from acute care and being continued in the post-acute and long-term rehabilitation phase. It is recommended to offer out-patient and in-hospital rehabilitation procedures depending on the type and persistence of symptoms and dysfunctions.

The aim of this paper is to present the qualification process of post-COVID19 patients for an in-hospital complex rehabilitation program developed on the basis of pulmonary physical therapy.

Methods: The presented qualification program was developed on the basis of clinical experience of over 2000 patients participating in the pilot program of in-hospital rehabilitation launched in September 2020 and based on the Regulation of the Polish Minister of Health of 13 July 2020.

Results: The proposed model of patients’ qualification rests on well-known and validated tools for functional assessment: exercise tolerance assessment, dyspnea intensity assessment, functional fitness assessment, assessment of arterial blood saturation, lung ventilation function assessment, assessment of long-lasting COVID-19 symptoms, and patient’s basic mental health condition.

Conclusions: The proposed qualification model for the post-COVID rehabilitation program allows us to introduce adequate qualifications followed by much needed assessment of the health effects.

Relevance
The proposed model of patients’ qualification rests on well-tested and validated tools for functional assessment which allow the physiotherapist to adequately program physical exercises being the core of the therapy. The proposed battery of tests includes: exercise tolerance assessment (6-min Walk Test), dyspnea intensity assessment (Modified Borg Dyspnea Scale), functional fitness assessment (Fullerton Test), assessment of arterial blood saturation by pulse oximetry, lung ventilation function assessment via body plethysmography assessment of long-lasting COVID-19 symptoms (authors’ questionnaire) and patient’s mental health condition (Hospital Anxiety Depression Scale). Based on exercise tolerance and energy expenditure expressed in MET in the 6MWT, dyspnea assessment (10-pointMBS) and functional fitness assessment with the use of Fullerton test (‘30-s Chair Stand’ test) patients are qualified for adequate rehabilitation models A, B, C, D, or E.

The use of scales allows the assessment of the effects of the applied rehabilitation model and the improvement of limited exercise capacity associated with impaired ventilation and shortness of breath in people after coronavirus infection, but also the identification of persistent additional symptoms and the resulting rehabilitation needs related to neurological and psychiatric disorders and symptoms of the respiratory system musculoskeletal. It may be useful for physiotherapists.