Background/Objectives: Neuromuscular fatigue (NMF) can impair manual dexterity and strength in healthcare professionals. Due to their high physical and cognitive workloads, physiotherapists (PTs) are particularly susceptible to NMF. This study investigated whether NMF, expressed as changes in manual dexterity and grip strength, occurs over a workday and across a workweek in PTs, and explored its relationship with stress and sleep quality. Methods: A total of 43 full-time PTs (25 female, mean age 37.72 ± 11.94 years) were recruited. Manual dexterity was assessed using the Functional Dexterity Test (FDT), while maximal grip strength (MGS) was measured by a hand dynamometer. Reliability was evaluated on a subgroup using Intraclass Correlation Coefficients (ICC3,1) and Standard Error of Measurement (SEM). Evaluations were conducted at the beginning and at the end of the work shift, on Monday and Friday. Subjective fatigue, perceived stress, and sleep quality were also recorded. Results: The FDT showed excellent intra-rater reliability (ICC > 0.93; SEM < 0.94 s). FDT performance was significantly slower on Friday evening compared to all other time points (p < 0.01), exceeding the minimal detectable change thresholds. No significant changes were observed in MGS across the week. Perceived stress was strongly correlated with fatigue levels on Monday (ρ = 0.731) and Friday (ρ = 0.612) evenings. Sleep quality and professional experience did not correlate with performance changes. Conclusions: PTs experience a significant decline in manual dexterity by the end of the workweek, suggesting an accumulation of NMF. While MGS remains stable, fine motor control is more sensitive to fatigue. Psychosocial stress appears to be a major driver of perceived fatigue in this population.

Background/Objectives: Wrist cock-up orthoses are standard for work-related musculoskeletal disorders, yet consensus is lacking on whether commercial orthoses (COs) or custom-made thermoplastic orthoses (THs) better preserve function. While COs offer availability, THs provide a superior anatomical fit. This study evaluated dexterity and satisfaction in healthy female employees to establish a functional baseline for preventive strategies. Methods: Healthy female office workers with no prior musculoskeletal or neurological conditions participated in this randomized cross-over study. Manual dexterity was assessed at baseline and after each of two consecutive workdays, during which participants wore, in a randomized order, either a CO or a TH made by an expert physiotherapist. Outcome measures included the Functional Dexterity Test (FDT), recording time and errors, and the Client Satisfaction with Device (CSD-It) scale. Results: Twenty right-handed women (mean age 45.6 ± 11 years) participated. A significant difference in FDT completion times across conditions (χ2 = 12.6, p = 0.002) was found. While both orthoses slowed performance compared to baseline (p < 0.01), the CO allowed for faster dexterity than the TH (p < 0.01). No differences were found in error rates. Regarding satisfaction, the CO achieved significantly better CSD-It scores than the TH (p = 0.0047), despite 60% of users reporting increased skin temperature with the CO. Final preferences were nearly evenly split (55% CO vs. 45% TH). Conclusions: Both orthoses impact manual dexterity without compromising precision. While the CO offered better execution speed and overall satisfaction, the TH version was preferred for prolonged skin tolerability. Selection should be individualized, balancing mechanical efficiency with the superior fit of custom-fabricated solutions in office environments.

PurposeThe aim of this study was to translate, cross-culturally adapt, and validate the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) into Italian.Materials and methodsThe MRPS questionnaire was first translated and cross-culturally adapted into Italian, and then anonymously administered, together with a global rating of change (GRC), to outpatients undergoing physiotherapy. Structural and convergent validity, internal consistency, and interpretability were assessed. Moreover, test-retest reliability was evaluated in a subgroup of participants who completed the MRPS twice.ResultsFactor analysis conducted on 200 questionnaires revealed a two-factor structure of the Italian MRPS, with eight items belonging to the internal factor and three to the external factor. The two factors and the total score showed a good-to-excellent internal consistency (Cronbach's alpha coefficients ranging from 0.74 to 0.93), with a moderate-to-excellent reliability (Intraclass Correlation Coefficients ranging from 0.67 to 0.90). The two global satisfaction measures were positively and significantly correlated with all items, while weak correlations emerged with the GRC. Finally, a ceiling effect was observed, with 36% of the subjects achieving the maximum total score.ConclusionsThe Italian version of the MRPS is a valid and reliable questionnaire for assessing outpatient satisfaction with physiotherapy care.

BACKGROUND:The Timed Up and Go (TUG) test, commonly used to predict falls, has been enhanced with an inertial sensor, creating the Instrumented TUG (iTUG). Its reliability has been evaluated in a few studies involving neurological and heterogeneous orthopaedic populations. AIM:The aim was to assess the intra-rater, inter-rater, and test-retest reliability of the iTUG in patients with femur fractures and define an interpretative model of the iTUG and a discriminative one to detect patients at risk of fall. METHODS:201 inpatients with femur fractures underwent the iTUG test before discharge and a telephone follow-up at 1-month post-discharge to record falls. In a subgroup of 48 patients, iTUG data were used for assessing test-retest, intra-rater, and inter-rater reliability through Intra-class Correlation Coefficients. In the total sample, iTUG reliable variables were used for exploratory factor analysis and creating logistic regression models to identify the best predictive model for falls. RESULTS:27/100 iTUG variables demonstrated "excellent" reliability; of those, 15 not-redundant variables were collected in a 3-factor model explaining 74 % of total variance. 92 % of patients completed the follow-up, and 5.5 % were classified as fallers. The fall risk model created with three iTUG variables showed an R2= 0.31, with an AUC= 0.91. CONCLUSION:The iTUG test is a reliable tool for assessing individuals with femur fractures, with 27 highly reliable variables. The 3-factor model offers a focused framework for gait evaluation, while the fall-risk model highlights the predictive value of iTUG variables, indicating that fall risk in the elderly depends on multiple gait characteristics. This article was awarded the SIAMOC Best Paper 2024.

OBJECTIVE:To assess the reliability of the Rehabilitation Complexity Scale-Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions. DESIGN:A retrospective observational study. Demographic and clinical variables were collected, including length of stay, modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay. SETTING:Study on inpatients admitted to sixteen neuromotor rehabilitation units. PARTICIPANTS:Of 5870 hospitalizations, 4091 cases (mean age, 71.8 ± 13y; 42.2% men) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age, 71.8 ± 12.8y; 41.6% men). INTERVENTIONS:Rehabilitation program for neurologic or orthopedic condition (median [1st-3rd quartile], duration: 27 days [20-41]). MAIN OUTCOMES AND MEASURES:RCS-E scores on admission were categorized as follows: <8 (low complexity), 8-10 (medium complexity), and >10 (high complexity). For each patient, we calculated the mBI-derived parameters: mBI gain, rehabilitation efficiency, and rehabilitation effectiveness. RESULTS:A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, P<.0001), length of stay (rho=0.41, P<.0001), and premorbid mRS (rho=0.23, P<.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both P<.0001, rho=0.48, and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge. CONCLUSIONS:This study demonstrates the reliability and utility of RCS-E in assessing neurologic and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.

This study aimed to investigate and compare the vertical Ground Reaction Forces (vGRFs) of patients with Parkinson’s Disease (PwPD) and healthy subjects (HS) when the confounding effect of walking speed was absent. Therefore, eighteen PwPD and eighteen age- and linear walking speed-matched HS were recruited. Using plantar pressure insoles, participants walked along linear and curvilinear paths at self-selected speeds. Interestingly, PwPD exhibited similar walking speed to HS during curvilinear trajectories (p = 0.48) and similar vGRF during both linear and curvilinear paths. In both groups, vGRF at initial contact and terminal stance was higher during linear walking, while vGRF at mid-stance was higher in curvilinear trajectories. Similarly, the time to peak vGRF at each phase showed no significant group differences. The vGRF timing variability was different between the two groups, particularly at terminal stance (p < 0.001). In conclusion, PwPD and HS showed similar modifications in vGRF and a similar reduction in gait speed during curvilinear paths when matched for linear walking speed. This emphasized the importance of considering walking speed when assessing gait dynamics in PwPD. This study also suggests the possibility of the variability of specific temporal measures in differentiating the gait patterns of PwPD versus those of HS, even in the early stages of the disease.

Objective: Scar adherence due to a pathological healing process can cause physical and psychological disturbance. Soft tissue mobilisation (STM) techniques are widely used to treat and prevent scar adherence, but little is known on their effects. We aimed to analyse the effect of STM in patients with subacute post-surgical scar adhesions affecting the extremities. Method: A single-group quasi-experimental study was conducted on consecutive patients undergoing post-surgery limb rehabilitation. Patients with a baseline Adhesion Severity (AS) index of <0.5 at the worst scar point, as measured by the Adheremeter, were eligible. All patients who completed a minimum of five manual treatment sessions were included. The primary outcome was the AS index and the secondary outcome was the Italian version of the Patient and Observer Scar Assessment Scales (POSAS-I). Results: A cohort of 19 patients underwent an average of eight STM sessions over a period of one month. The AS index value increased from a median of 0.12 at baseline (interquartile range (IQR): 0.05–0.25) to 0.41 post-treatment (IQR: 0.26–0.63; median change: 0.24; IQR: 0.16–0.40; p<0.001). A large effect size was observed for both AS and Observer Scar Assessment Scale (OSAS-I) (Cohen r=0.6), with a large probability of superiority (PS) (87% and 86%, respectively). A moderate effect was observed for the Patient Scar Assessment Scale (PSAS-I) (Cohen=0.4; PS=71%). Pre–post treatment changes exceeded the minimal detectable changes for the AS and OSAS-I in 68% of subjects, and for PSAS-I in 21% of subjects. Conclusion: STM manual techniques may produce a large effect on the mobility of adherent subacute post-surgical scars.

OBJECTIVE:To assess the construct validity, responsiveness and minimal important difference of the cumulated ambulation score in patients with hip fracture in sub-acute rehabilitation facility. DESIGN:Observational, prospective, monocenter, cohort study. SETTING:Rehabilitation Institute. PARTICIPANTS:456 older adults with hip fracture (≥65 years) admitted for inpatient rehabilitation. MAIN OUTCOME MEASURES:Cumulated ambulation score, functional independence measure and functional ambulation category were collected at admission and discharge. Construct validity and responsiveness were assessed through hypothesis testing and minimal important difference was determined using the anchor-based method; floor and ceiling effects were also assessed. RESULTS:The cumulated ambulation score showed strong correlations with the functional independence measure and functional ambulation category scores at both admission and discharge, satisfying all the hypotheses for construct validity. The effect size of cumulated ambulation score was 1.63. Changes in cumulated ambulation score had a moderate-to-strong correlation with changes of other instruments and were able to discriminate patients improved from those not-improved, and patients classified as independent ambulators from those dependent. A ceiling effect was found only at discharge. The estimated minimal important difference was 2 points. CONCLUSIONS:The cumulated ambulation score showed high levels of construct validity and responsiveness according to the hypothesis testing. A two points improvement at the end of rehabilitation was found to be clinically important in people with hip fracture in the sub-acute phase. The ceiling effect found at discharge suggested the limitation of the scale in assessing people with a partially recovered autonomy in performing postural changes and gait.

PurposeTo investigate the responsiveness and minimal clinically important difference (MCID) of the Functional Independence Measure (FIM) from a clinician's perspective in hip-fractured elderly undergoing inpatient rehabilitation.Materials and methodsData of 701 hip-fractured elderly admitted to our rehabilitation institute were retrospectively collected. Ten a priori hypotheses were formulated.ResultsThe effect size of the FIM scores after treatment were large (total = 1.38, motor = 1.78). Moderate correlations were found between the change total score of FIM and Barthel Index (BI, r(s) = 0.51), Functional Ambulation Categories (FAC, r(s) = 0.52) and a checklist regarding participants' independence in transfers (r(s) = 0.59). The area under the receiving operating characteristics were 0.82, 0.81, and 0.85 when BI, FAC and checklist were used as anchors, respectively. Based on these findings, the FIM showed high responsiveness (9/10 hypotheses met). Triangulation of findings showed that MCIDs of 22 and 21 points were the most appropriate for the FIM total and motor score, respectively.ConclusionsThe FIM scale is appropriate for assessing independence and functional recovery in hip-fractured elderly. Improvements of 22 and 21 points at the total and motor FIM were identified as indicators of minimal clinical change in those admitted to a rehabilitation facility with an FIM total score between 40 and 80.

Recent studies suggest that also the non-critical form of COVID-19 infection may be associated with executive function impairments. However, it is not clear if they result from cognitive impairments or by COVID-19 infection per se. We aimed to investigate if patients in the post-acute stage of severe COVID-19 (PwCOVID), without manifest cognitive deficits, reveal impairments in performing dual-task (DT) activities compared to healthy controls (HS). We assessed balance in 31 PwCOVID vs. 30 age-matched HS by stabilometry and the Timed Up and Go (TUG) test with/without a cognitive DT. The DT cost (DTC), TUG test time and sway oscillations were recorded; correct cognitive responses (CCR) were calculated to evaluate cognitive performance. Results show a significant difference in overall DT performance between PwCOVID and HS in both stabilometry (p < 0.01) and the TUG test (p < 0.0005), although with similar DTCs. The main difference in the DTs between groups emerged in the CCR (effect size > 0.8). Substantially, PwCOVID gave priority to the motor task, leaving out the cognitive one, while HS performed both tasks simultaneously. Our findings suggest that PwCOVID, even without a manifest cognitive impairment, may present a deficit in executive function during DTs. These results encourage the use of DTs and CCR in PwCOVID.

Gait disorders represent one of the most disabling features for people affected by neurological disease and recovery of walking function is one of the main goals of gait rehabilitation. However, to date, there is a lack of agreement on which is the most beneficial type of gait training in neurological subjects. International guidelines offer conflicting recommendations on instrumental gait rehabilitation: some recommend the use of instrumental methods [1,2], some advice against them [3,4], while others recommend instrumentation only for research purposes or for non-ambulatory persons [5,6]. Our aim was to compare the outcomes of instrumental-assisted vs overground gait training in patients with neurological disorders. The research was performed through several databases (PubMed, Scopus, Embase, Central). Eligibility criteria were studies of adults with neurologic disorders performing instrumental vs overground gait training. Outcomes were measures of gait, balance and independence in daily activities. We included randomized controlled trials in which intervention protocols included gait training performed with treadmill or Lokomat, while control group was trained by overground walking for the same experimental group's amount of time. Quality of the included trials was evaluated with the Cochrane Collaboration's tool for assessing risk of bias. Of the 1059 records identified, only 25 studies were included in this systematic review. Studies included 1075 patients in total, of whom 530 were trained by instrumental-assisted walking training and 545 by overground walking. 747 subjects (69.4%) had sequaele of stroke; 174 (16.2%) multiple sclerosis; 104 (9.7%) Parkinson's disease; 30 (2.8%) with spinal cord injury; 20 (1.9%) with traumatic brain injury. The overall weighted mean age was 60 (range, 31-74) yrs in the instrumental group and 61 (range, 32-73) yrs in the overground one. Results showed that instrumental and overground gait training similarly improved comfortable gait speed, walking distance, balance and independence in daily activities (Table 1). However, biases assessment showed high or unclear risk of bias in more than 50% of the studies. Due to the current quality of the literature, it was not possible to achieve firm conclusions about the most effective type of gait training. Indeed, the instrumental rehabilitation did not reveal more benefits compared to overground walking training in any of the analysed outcomes. Therefore, higher-quality RCTs with larger sample sizes in different populations are needed for stronger conclusions.

Background and aim Falls and fall-related injuries are a major public health issue which needs global attention due to its clinical and socioeconomic impact. Important risk factors for falls are polypharmacy and the assumption of so-called Fall Risk Increasing Drugs (FRIDs). Aims of our study were to investigate the associations between falls and the use of medications among inpatients by conducting a retrospective case-control study in a rehabilitation hospital in Northern Italy in 2018. Methods A Conditional Logistic Regression was performed to analyze the impact that 13 types of FRIDs individually and the number of administrated FRIDs had on the risk of falling. A second regression model was obtained adjusting the case-control matching for CIRS, Morse and Barthel scores. Results We identified 148 cases and 444 controls. 3 types of FRIDs were significantly correlated (p < 0,05) with an increased risk of falling: Antipsychotics, Antidepressants, Diuretics. Antidepressants were the only type of FRID significantly correlated (p=0,008) even in the model adjusted for CIRS, Morse and Barthel scores. The unadjusted model showed that the addition of one type of FRID to therapy was significantly associated with the fall event (p<0.05). Conclusion Assumption of drugs, in particular antidepressant and polypharmacy, can play a role in hospital falling. The fall risk assessment tools available, suffer from low specificity and sensitivity and do not assess these risk factors. A holistic approach with a multidimensional evaluation of the patient through screening tools, functional assessment tools and a full medical evaluation should be pursued to improve prediction.

Diagnostic accuracy to differentiate Parkinson's Disease (PD) from other neurological disorders by movement disorder specialists is >85% for longer duration (>5years) and medication-responsive people with PD [1]. However, this accuracy remains suboptimal (<55%) in the early stages of disease, i.e. when symptoms may be very subtle [1]. Therefore, it's of paramount importance to identify diagnostic markers which could help in timely and accurate diagnosis and in clinical management [2]. Gait may be a potential marker since its impairments appear in the very early disease, may precede the onset of overt motor signs and evolve more rapidly than other motor features [2,3]. The purpose of this work is to assess whether gait variables, known to correctly classify PD from healthy subjects [4], are capable to differentiate PD from other Parkinsonism in subjects with an onset of symptoms from less than 3 years. 17 drug-naïve individuals with PD (mean age 70.0±7.4 yrs), 9 with vascular parkinsonism (VP, mean age 76.6±5.5 yrs) and 9 with essential tremor plus (ET, mean age 65.9±8.1 yrs) were enrolled. Eight spatiotemporal variables of gait [4] were acquired using a GAITRite® electronic walkway under comfortable walking. To assess the diagnostic performance of each variable in discriminating PD from VP and ET, the area under the receiver operating characteristic curve (AUC) and its 95% Confidence Interval (95% CI) were assessed. Participants with PD were not different from VP and ET regarding sex (p=0.86 and p=0.13, respectively) and age (0.07 and 0.06, respectively). Of the gait variables considered, gait speed, step time and step time asymmetry showed a moderate ability in differentiating PD from the other movement disorders (Table 1). In addition, double support time and swing time CV were able to differentiate individuals with PD from those with ET. The gait model, obtained combining the 8 gait variables, showed the highest ability in discriminating PD from VP (AUC=0.90) and ET (AUC=0.86), with a diagnostic accuracy of 88.5% and 80.8%, respectively. This study found that spatiotemporal gait variables, assessed with a sensorized mat, can be used to differentiate PD from VAS and ET. In particular, the model of gait obtained combining several variables had a good diagnostic accuracy in the first ages of disease. This provides a foundation for future research to investigate the use of gait assessment as a clinical tool to aid diagnostic accuracy of PD subtypes, allowing the correct treatment and care to be applied [5].

BACKGROUND AND PURPOSE:The Mini-BESTest is a balance measure with robust psychometric properties widely used in people with Parkinson disease. The aim of this study was to examine-with advanced psychometric techniques-some key properties of the Mini-BESTest (including unidimensionality, functioning of rating categories, internal construct validity, reliability indexes) in a consecutive sample of individuals with Parkinson disease admitted for balance rehabilitation.METHODS:Confirmatory factor analysis and Rasch analysis (partial credit model) were performed on 193 individual raw scores of the Mini-BESTest items.RESULTS:Confirmatory factor analysis fit indices and principal component analysis of the residuals confirmed the scale's unidimensionality. At Rasch analysis, the 3-level rating scale demonstrated appropriate functioning. All items fitted the Rasch model. Item response dependence was negligible. No differential item functioning was found across gender and age groups.DISCUSSION AND CONCLUSIONS:We confirmed and extended the evidence (demonstrated in different populations) on the general psychometric soundness of the Mini-BESTest, even when tested with rigorous statistical methods. In addition, 2 forms were created: (i) to transform raw scores into linear estimates of dynamic balance; and (ii) to compare the individual's item responses with those expected by the Rasch model (thus providing an aid for tailored interventions) and manage missing responses. Further independent studies using advanced psychometric techniques are warranted, also in people with balance disturbances of different etiology. Our study further increases the confidence in using the Mini-BESTest to assess dynamic balance in people with Parkinson disease and provides some useful additional clinical aids for interpreting the results and calculating more precise change scores.See the Supplementary Video, available at: http://links.lww.com/JNPT/A384.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by loss of nigrostriatal dopaminergic neurons [1]. In addition to cardinal motor symptoms, individuals with PD suffer of gait impairment [2]. Although functional imaging is useful for the diagnosis and pathophysiological evaluation of PD, little is known about the relationship between neuroimaging findings and PD clinical features. A study found a correlation between dopamine denervation and impaired gait automaticity [3]; others reported no association between dopaminergic denervation and some gait parameters, such as stride length and velocity [4,5], assuming that deficits in nondopaminergic neurotransmitter systems played the main role in gait impairments [3]. We aimed to examine the relationship between striatal dopaminergic depletion with disease severity in motor symptoms and gait variables in drug-naïve individuals with PD, in order to find where nigrostriatal pathway mainly acts. A total of 18 drug-naïve individuals with PD (mean age 70.4 ± 7.4 yrs) were enrolled. Motor symptoms were evaluated using the modified Hoehn and Yahr (H&Y) stage. Seven spatiotemporal variables of gait were acquired using a GAITRite® electronic walkway under comfortable walking, of which the coefficient of variation and the asymmetry were then calculated. The extent of striatal dopaminergic depletion was evaluated by dopamine transporter imaging with single-photon emission computed tomography using 123I-FP-CIT. Correlations between H&Y stage and gait variables with the specific binding ratios (SBRs) of the striatum (separated into putamen and caudate nucleus) were assessed with the Spearman's correlation coefficients (r). The mean SBRs of both the putamen and the caudate nucleus were significantly associated with the modified H&Y stage, with correlation coefficient of at least 0.60. A moderate correlation was found also between the asymmetry in the SBR of the putamen and the H&Y stage. Moreover, among the spatiotemporal gait variables, a moderate correlation was found between the mean double support duration and its asymmetry with the mean SBRs of both the putamen and the caudate nucleus (Table 1). On the contrary, stride length and velocity showed a weak correlation (below 0.30). Our findings suggest that both disease severity and gait impairments in early PD are associated with decreased dopamine binding in the striatum. Since the double support time showed a moderate correlation with dopaminergic depletion in particular in caudate nucleus, we propose this variable as a marker of the effect of nigrostriatal denervation on gait in individuals with early PD. On the other hand, the poor correlations found between the reduction of stride length and velocity with the nigrostriatal depletion confirmed the hypothesis of a major involvement of other systems (such as the cholinergic) in the control of these variables. Our findings supported the notion that a large part of gait impairments in PD resulted from multisystem degeneration [6,7].

Many clinical practice recommendations indicate rehabilitation as essential for patients with sequelae of severe or critical COVID-19 and suggest the prompt initiation of a multicomponent rehabilitation program focused on aerobic and endurance training. However, randomized controlled trials (RCTs) regarding aerobic exercise are lacking. Therefore, we aimed to assess the feasibility and effectiveness of the addition of aerobic training to standard rehabilitation in subjects with subacute COVID-19. Participants were 32/214 patients with the sequelae of severe or critical COVID-19 in the acute phase who were eligible and agreed to participate in the study (eligibility = 15%, recruitment = 100%). After randomization and assessment with functional and strength tests, all the participants underwent an inpatient-tailored rehabilitation program (50 min/day, 5 days/week, 10 sessions); in addition, the experimental group performed a low- to moderate-intensity aerobic exercise (30 min/day, 10 sessions). No dropouts or severe adverse events were reported, with an attendance rate of 95.6%. Most of the secondary outcomes significantly improved in both groups, but the improvement in the Functional Independence Measure and Cumulated Ambulation Score—Italian version was significantly greater in the experimental group (at least, p < 0.05). This RCT showed that aerobic exercise is feasible and safe in subacute COVID-19. Moreover, it appears to be beneficial and useful in improving patients’ independence and mobility.