Impact of telerehabilitation after sports injuries on psychological outcomes during the Covid-19 pandemic

BACKGROUND: The Italian government imposed a national lockdown from March to May 2020 aimed at prevent-ing the spread of SARS-CoV-2 but causing psychological distress in patients who had already started a rehabilitation program after sports injuries. METHODS: Because of the impossibility of continuing the in-presence rehabilitation, patients attended a telerehabilitation program of mixed supervised and self-administered sessions. An on-line survey created to evaluate psychological characteristics was carried out after the start of the lockdown (T1) and after one month, when lockdown ended (T2).RESULTS: Fifty-three patients replied at T2 (50% of the initial sample). Self-efficacy showed a significant decrease (P=0.037). High levels of resilience (4.0/5 at T1; 3.9/5 at T2) and perception of support from physiotherapists (4.4/5 at T1; 4.3/5 at T2) were found. Perception of support from physiotherapists was significantly related to self-efficacy, optimism and adherence. Negative mood states were inversely associated with resilience, self-efficacy, optimism, and motivation. No significant difference was found between age and sport activity groups. Women had significantly higher levels of depressive (P=0.027) and post-traumatic stress symptoms (P=0.042) at T1 and more tension (P=0.021) at T2 than men. CONCLUSIONS: The telerehabilitation program carried out during the emergency, was effective in promoting clinical improvements, maintaining almost all psychological outcomes stable and preventing the worsening of psychological distress. This is due to the influence of high levels of perception of support from physiotherapists, resilience, and low levels of bad moods.