Ava-Kathleen D. Rybicki, MA
Clinical Research Coordinator
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Monica Coran Kuns, CCC-SLP CBIS
Speech Language Pathologist
Good Shepard Penn Partners
Philadelphia, Pennsylvania, United States
.jpg "Benjamin Abramoff, MD, MS photo")
Benjamin Abramoff, MD, MS
Physician
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Liliana E. E. Pezzin, PhD, JD
Professor and Econometrician
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
Timothy R. Dillingham, MD, MS
Professor and Chair
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
The intervention was customized based on an algorithm highlighting participant-selected concerns and cognitive testing. Treatment of 38 participants with persistent cognitive symptoms following an initial covid-19 infection occurred in-person in an outpatient therapy setting over a period of 6 weeks. Treatment intervention spanned 3 visits during which meta-cognitive awareness and energy expenditure education were prioritized. This was achieved holistically through various techniques including the spoon theory, a cognitive rating scale, and discussion of stress, sleep hygiene, and nutrition. To avoid post-exertional malaise/post-exercise symptom exacerbation (PEM/PESE), predetermined criteria dictated appropriate advancement of cognitive complexity. Sample targets of intervention include attention re-training, memory compensation, information processing strategies, and word finding tools. To ensure reproducibility, protocols were standardized into custom algorithms and treatment programs.
Results:
Of 38 participants, mean age was 59.5 years (SD =12.5). 22 were female and 16 were male and over 12% were minorities. 100% of participants reported a positive impact on quality of life at their final evaluation or on their 90-day survey. 0% of participants reported PEM/PESE. Some examples of participant feedback 90 days after the completion of the program are as follows:
“The main positive was learning about rate of perceived exertion and managing my physical and mental energy based on this.”
“It was the right program for me. Brought out both physical and cognitive exercises I can incorporate to enhance my quality of life.”
“The program was very helpful in helping me understand how to best function post-virally.”
Conclusions: Speech therapy is a transformative part of PASC treatment. Current outcomes support positive findings with response to treatment. These findings were established across outcomes from 3 sites, supporting the feasibility of broader replicability for both positive treatment outcomes and SLP implementation.
