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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 4  |  Issue : 1  |  Page : 15-21

International society of physical and rehabilitation medicine webinar series - An effective global educational initiative during COVID-19 pandemic


1 Chief Coordinator, ISPRM World Youth Forum; Department of Physical Medicine and Rehabilitation, University of Miami/Jackson Health, System, FL, USA
2 Chair, ISPRM Education Committee, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Texas Children's Hospital, TX, USA
3 Chair, ISPRM Online Education Subcommittee, Burke Rehabilitation Hospital, Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, NY, USA
4 President Elect, ISPRM, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
5 Chair, ISPRM-WHO Liaison Committee, Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy
6 President, ISPRM, Neurological Rehabilitation Center, Virtus Medical Group, Hong Kong, China
7 Immediate Past President, ISPRM, Department of Physical Medicine and Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, PR, USA

Date of Submission16-Aug-2020
Date of Acceptance13-Oct-2020
Date of Web Publication22-Feb-2021

Correspondence Address:
Dr. Manoj K Poudel
Department of Physical Medicine and Rehabilitation, University of Miami/Jackson Health System, 1611 NW 12th Ave, Miami, FL 33136
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisprm.jisprm_31_20

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  Abstract 


The International Society of Physical and Rehabilitation Medicine (ISPRM) has recently started an educational initiative named “ISPRM Webinar Series,” broadcasting a series of live interactive online webinar sessions over 3 months. The objectives of the webinars were to connect rehabilitation professionals worldwide, share experiences/expertise, and create teaching-learning activities during the coronavirus disease 2019 (COVID-19) pandemic. The pandemic has been adversely affecting the lives of people including being a big challenge to the medical community. The specialty of physical and rehabilitation medicine is facing challenges and simultaneously having unique opportunities to contribute to the care of COVID-19 survivors. This article describes the purpose, educational structure, and overall experiences during the ISPRM Webinar Series. Distinguished speakers/panelists from around the world delivered their message, expertise, and experience in several topics with a special emphasis on the COVID-19 pandemic. A historical moment for ISPRM was when the Honorable Director General of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, sent a special message to ISPRM and its global audience. The audience for the various webinars has included colleagues from 101 countries and territories, with an average number of 365 participants per live session and a high prevalence of youth. In conclusion, based on the feedback of the participants, the ISPRM Webinar Series proved to be a timely and effective educational initiative with wide-spread global reach during the COVID-19 pandemic.

Keywords: Coronavirus disease 2019, ISPRM, pandemics, rehabilitation, webinar


How to cite this article:
Poudel MK, Dy R, Oh-Park M, Gimigliano F, Kiekens C, Li L, Frontera WR. International society of physical and rehabilitation medicine webinar series - An effective global educational initiative during COVID-19 pandemic. J Int Soc Phys Rehabil Med 2021;4:15-21

How to cite this URL:
Poudel MK, Dy R, Oh-Park M, Gimigliano F, Kiekens C, Li L, Frontera WR. International society of physical and rehabilitation medicine webinar series - An effective global educational initiative during COVID-19 pandemic. J Int Soc Phys Rehabil Med [serial online] 2021 [cited 2021 Apr 14];4:15-21. Available from: https://www.jisprm.org/text.asp?2021/4/1/15/309893




  ISPRM and Its Global Efforts Top


The merger of the International Rehabilitation Medicine Association and the International Federation of Physical Medicine and Rehabilitation was officially completed in the year 1999 to form the International Society of Physical and Rehabilitation Medicine (ISPRM).[1] Since the beginning, the organizational structure and policy agenda of ISPRM have targeted the well-being of people living with disability and the health professionals involved in the delivery of the rehabilitation care. The leaders at all levels of the hierarchy of ISPRM's organizational structure have been working hand-in-hand globally with leaders in many nations.[2] Currently, ISPRM represents 77 national physical and rehabilitation medicine (PRM) societies worldwide.


  Situation of Coronavirus Disease 2019 and Need for the ISPRM Top


The pneumonia of unknown cause reported in December 2019 in Wuhan, China, was later named as coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO).[3],[4] After overseeing the rapid speed and scale of transmission globally, the WHO declared the COVID-19 as a pandemic on March 11, 2020.[5] As of August 14, 2020, the disease has spread to 213 countries and territories infecting more than 21 million individuals with over 750,000 fatal events.[6]

Population living with disability, including older persons with comorbid conditions, are impacted by the pandemic more significantly. However, with appropriate actions and protective measures, the risk can be lowered.[7] COVID-19 can affect multiple organs causing significant impairment and disabilities in physical, psychological, and cognitive domains. PRM specialists have an increased role in the overall care and well-being of COVID-19 survivors.[8] ISPRM has been taking a leading role globally in providing expert knowledge, framework, and guidance for the rehabilitation of survivors of COVID-19.

One of these initiatives has been a webinar series approved by the ISPRM President's Cabinet based on a survey report of the Country Ambassadors of the ISPRM-World Youth Forum (ISPRM-WYF).


  About ISPRM Webinar Series Top


The ISPRM Webinar Series is the first webinar series organized by ISPRM for a global audience. The main goals of the series are to bring together rehabilitation professionals around the world, share experiences/expertise among each other, and create teaching-learning activities during the COVID-19 pandemic. The ISPRM Education Committee and WYF organized the series under the guidance of the President's Cabinet. From May 8 to July 22, 2020, a total of 10 webinars on COVID-19 and PRM were broadcasted live weekly/bimonthly [Table 1]. Each webinar was approximately 60 min in duration. The webinar sessions were promoted around the world with a flyer disseminated through the various media.
Table 1: International Society of Physical and Rehabilitation Medicine Webinar Series – sessions and the distinguished speakers/panelists

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PRM physicians, residents, fellows, medical students, physical therapists, occupational therapists, speech language pathologists, researchers, psychologists, and other health professionals from 101 countries and territories [Figure 1] participated with an average of 365 participants per webinar session.
Figure 1: The coverage map of International Society of Physical and Rehabilitation Medicine webinar series

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Distinguished speakers/panelists from around the world delivered their expertise/experiences in each session. Each lecture included a question and answer session, chatroom, and polls. The recorded sessions were made available at https://www.isprm.org/isprm-webinars along with related handouts, reference materials, and the answers to the questions of the participants. The recorded videos have been watched 3356 times as of August 14, 2020.


[Table 1]">  Webinar Sessions of ISPRM Webinar Series [Table 1] Top


Webinar 1 – Global situation I

The speakers (Marta Imamura form Brazil, Francesca Gimigliano from Italy and Mooyeon Oh-Park from USA) presented on the overall situation, and the status of PRM physicians/residents/fellows in their respective countries. New York was the epicenter at that time, hence Mooyeon Oh-Park, as Chief Medical Officer of Burke Rehabilitation Hospital shared the experiences of expansion of a rehabilitation hospital with surge beds and operation for staff management, personal protective equipment, and establishment and implementation of clinical practice guidelines for COVID-19. The speakers also discussed the key leadership skills during a response to pandemic and disaster. Rochelle Dy, Chair of the ISPRM Education Committee, concluded the session with an encouraging message for residents and fellows around the world as a closing remark.

Webinar 2 – Brain injury

Manoj Poudel started with a brief presentation on the possible etiopathogenesis, clinical symptoms, and imaging findings of COVID-19 patients with brain injury. David Cifu, an international expert on brain injury rehabilitation, stressed that while there is an increased need of PRM services during the pandemic, rehabilitation physicians should stay with the PRM basics for key PRM interventions and include telemedicine for outpatient follow-up. He discussed brain-injury specific issues, their management strategies, and the importance of prevention of complications. He also highlighted the importance of diet, exercise, sleep, stress management, pain care, productivity, social integration, family, and faith during this crisis.

Webinar 3 – Pulmonary rehabilitation

Richard Novitch, a pulmonologist from Burke Rehabilitation Hospital and the Department of Rehabilitation Medicine at Montefiore Health System in New York, USA, explained how all pulmonary disorders tend to cause similar clinical problems with regard to the patterns of impairment and disability-breathlessness, fatigue, weight loss, change in affect, muscular weakness, and necessity to recruit accessory muscles for ambulation and instrumental activities of daily life. The main problem is getting someone to begin to move when all the signals their body is giving them, suggest they should remain still. Oxygen therapy is the main stay of treatment, prone position helps in ventilation perfusion match, and it is good to avoid mechanical ventilators as much as possible. Federica Gamna, a PRM physician from San Luigi Gonzaga University Hospital in Torino, Italy, shared her experiences of managing COVID-19 patients in intensive care and sub-intensive care units. In the units, they encouraged respiratory muscle training and alveolar recruitment strategies. Both speakers highlighted the importance of progressive weaning of oxygen and gentle progressive exercises.

Webinar 4 – Global situation II

The target of this webinar was the global audience with special focus on developing countries. Chen Hong, a PRM physician from Tongji Hospital in Wuhan, China, shared the experiences working in a rehabilitation unit with 90 patients with COVID-19 and described the characteristics, assessment, and rehabilitation management of patients suffering from mild versus severe/critical symptoms. There was an elaborate discussion on physiological systems indicators (respiratory, cardiology, neurological, and others) to decide on when to start rehabilitation. Sanjay Wadhwa, the President of the Indian Association of PMR (IAPMR), reported on the status of COVID-19, the challenges faced, and the responses in India. He elaborated on the Strengths, Weaknesses, Opportunities, and Threats model of response and the involvement of PRM physicians and IAPMR to develop national and hospital guidelines on COVID-19.

Webinar 5 – Research

Farooq Rathore, from Pakistan and a representative of low- and middle-income country in Cochrane Rehabilitation provided an overview of PRM research that was published during the COVID-19 pandemic and elaborated on the value of publishing during pandemic. He provided approaches to identify different formats and journals for the publication of PRM-related research. Stefano Negrini, the Director of Cochrane Rehabilitation and Editor-in-Chief of the European Journal of PRM discussed the scientific evidence learnt from the experience with COVID-19. The audience had the opportunity to learn about the resources on COVID-19 from Cochrane Rehabilitation. The session encouraged the participants to get involved in scholarly activities and highlighted the need of careful consideration of overflow of published information during pandemic/disasters.

Webinar 6 – Ultrasound and interventional procedures

Christopher Visco, from Columbia University Medical Center in New York, USA, outlined the process of re-opening outpatient with specific consideration to both diagnostic and interventional ultrasound as it is “risk versus risk” rather than risk versus benefit. He shared his experiences on challenges around the prolonged contact time with ultrasound and precautions used. Andrew Sherman, from the University of Miami Miller School of Medicine in Florida, USA, stated that the issues of patients' pain have exacerbated due to prolonged sitting and reduced level of exercise during the lockdown. He made participants aware of an objective system to score the risk of patients who are interested in obtaining in-person pain treatments and precautions required during interventional spine procedures. The speakers were involved in point-counterpoint discussion on the use of steroid injection for musculoskeletal/spine/pain procedures.

Webinar 7 – Spinal cord injury

Carlotte Kiekens, the Director of Spinal Unit at Montecatone Rehabilitation Institute in Imola, Italy, shared her experience with nine patients with spinal cord injuries (SCI) infected with COVID-19, 8 males and 1 female with a mean age of 61 years, 4 tetraplegic and 5 paraplegics along with the clinical pictures and the outcomes (one death). Marinella Galea, the Chief of James J. Peters Veterans Affairs Medical Center SCI Unit in New York, USA, described the details on seven SCI patients with COVID-19 infection. Presenters discussed the features of COVID-19-infected SCI individuals and identify key issues. Both speakers highlighted the importance of telemedicine for follow-up care.

Webinar 8 – Cardiopulmonary rehabilitation

Yuan-Yang Cheng from Taiwan, elaborated on the rehabilitation protocols developed by Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation for five categories of COVID-19 patients (outpatient with mild disease with and without risk factors, hospitalized patients with moderate-severe disease, ventilation-supported patients with, and without normal cognitive functions). Matthew Bartels, Chair of the Department of Rehabilitation Medicine of Montefiore Health System in New York, USA, and an international expert on cardiac rehabilitation, shared the frontline experiences on common cardiac issues (acute coronary syndrome, cardiomyopathy, heart failure, hypercoagulability, arrhythmias, stroke, etc.,) of the COVID-19 patients and their challenges. He described the role of cardiopulmonary rehabilitation for patients with mild symptoms, those with pulmonary secretions or dyspnea and those dependent on a ventilator along home exercise prescription for COVID-19 survivors.

Webinar 9 – Global situation III

Abena Tannor started the lecture with brief update on the COVID-19 situation in Africa, important challenges and measures taken in a low-resource setting in Ghana. She highlighted the opportunities to develop the specialty of PRM in her country even during the pandemic. Carl Leochico from the Philippines described the impact of COVID-19 pandemic on PRM in the Philippine General Hospital in terms of service delivery, residency training (lack of clinical exposure, lack of face-to-face supervision, lack of training on contact procedures, postponed examinations, shift to virtual learning, and call to revisit the curriculum), research and telemedicine. Maher Benjadid, the President of Saudi Arabian Society for PRM highlighted that the leadership role of the national society was important when some of the rehabilitation hospitals/wards were converted to COVID-19 units/facilities and outpatient services were limited to telemedicine. He stated that residency training continued with some modifications (virtual lectures, modification in evaluation of residents, and mental health support).

Webinar 10 – ISPRM - World Health Organization Collaboration

Walter Frontera, Professor at the University of Puerto Rico School of Medicine and Immediate Past President of ISPRM, presented the historical timeline of the collaboration between the WHO and the ISPRM. He highlighted the activities of the ISPRM-WHO Liaison Committee which is currently chaired by Carlotte Kiekens. The audience learned about the strong participation of the ISPRM at the World Health Assembly in 2019, the meetings for Rehabilitation 2030–A Call for Action, and WHO regional events. He emphasized that the rehabilitation physicians, together with other rehabilitation professionals, should use the COVID-19 crisis as an opportunity because the rehabilitation medicine team has an important role in prehabilitation, acute rehabilitation including the intensive care unit, postacute phase, and outpatient follow-up of COVID-19 patients. He thanked WHO for its continuous support and collaboration. Alarcos Cieza, the Head of Specialist Unit of Sensory functions, Disability and Rehabilitation of WHO, highlighted the overall goals and functions of WHO and the resolutions related to rehabilitation, the commitment of WHO to the fulfillment of the goals of Rehabilitation 2030–A Call for Action and emphasized the role of ISPRM. The need for clear guidance to identify priority patients who should continue rehabilitation when the rehabilitation services are temporarily ceased, decreased or diverted with the help of tele-rehabilitation is a WHO recommendation. She added that WHO-ISPRM collaboration is essential for strengthening the health system to provide rehabilitation services, for the development of national strategic plan and monitoring framework and to formulate Rehabilitation Competency Framework. She concluded that the ISPRM-WHO collaboration is strong however there is more to do.


  Special Message by Director General of World Health Organization Top


July 22, 2020 became a historical day for ISPRM as the honorable Director General of WHO, Tedros Adhanom Ghebreyesus participated in an ISPRM event for the first time in its history [Figure 2]. This proved that WHO highly values the collaboration with ISPRM to work for the benefit of individuals who need rehabilitation services from PRM physicians and the multi-professional team they lead. The transcript of the special message that was broadcasted during the webinar #10 was as follows:
Figure 2: Tedros Ghebreyesus, the Director General of World Health Organization (left), Walter Frontera, Immediate Past President of International Society of Physical and Rehabilitation Medicine (bottom right), Leonard Li, President of International Society of Physical and Rehabilitation Medicine (middle right) and Manoj Poudel, Chief Coordinator of International Society of Physical and Rehabilitation Medicine-World Youth Forum (top right) during webinar session on International Society of Physical and Rehabilitation Medicine-World Health Organization collaboration

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“Dear colleagues and friends,

One in three people will need rehabilitation at some point in their life. But too often these needs are going unmet. The situation has been exacerbated by the COVID-19 pandemic, which has disrupted health systems and economies around the world. It is critical that rehabilitation is well integrated along the continuity of care, especially in acute care.

But in many countries, rehabilitation is under resourced. WHO and the ISPRM have a history of working together to address the unmet needs of rehabilitation. The international societies are key supporter of the WHO Rehabilitation 2030 initiative. Many of the tools and resources WHO are developing draw on the expertise and experience of the ISPRM and the broader rehabilitation community. This kind of partnership is vital for fulfilling our vision for Universal Health Coverage and the other health related sustainable development goals.

The COVID-19 pandemic has thrown many health systems into turmoil, but it also represents an opportunity to bond together, strengthen collaboration and demonstrate the value of rehabilitation to population health. Now, more than ever, the rehabilitation community needs to be united across disciplines, specializations and countries so that every person has access to rehabilitation services that they need.

I thank you.”


  Promotion of ISPRM and Its Activities during the Webinar Sessions Top


During each webinar session, 3–5 min of presentation was dedicated to educating the audience about ISPRM. The moderators briefly presented information on the ISPRM history, current activities, future plans, World Congresses, committees, task forces, awards, the Journal of ISPRM, and the newsletter. A video message from Jorge Lains, the President of the ISPRM World Congress 2021 in Lisbon, Portugal was shown during webinar #10. The audience was encouraged to visit the official website (isprm.org), and social media accounts of ISPRM, and join ISPRM by applying for membership. A session also included a thank you note to all the past presidents of the ISPRM for their contributions.


  Thank You Note From President of ISPRM, Leonard Li Top


During the closing remark for ISPRM Webinar Series, Leonard Li, from Hong Kong and the current President of ISPRM sincerely thanked Tedros Adhanom Ghebreyesus, distinguished speakers, organizers, moderators, hosts and audience for their invaluable contribution to successfully convene the webinar sessions. He encouraged the ISPRM members to work hand-in-hand during the COVID-19 crisis and ensured that ISPRM is there to help the national societies and ISPRM members during the crisis and beyond.


  Positive Messages of the ISPRM Webinar Series Top


During the COVID-19 pandemic, ISPRM continued its global leadership in PRM and in rehabilitation. The ISPRM Webinar Series was one of the successful projects for this purpose. The webinar sessions helped in connecting the distinguished speakers around the world with ISPRM and its members to deliver the expertise and experiences on COVID-19 topics related to PRM. At the time of global chaos, the series provided a sense of guardianship to the members of ISPRM members by creating a platform for interaction and information sharing. Further, the webinar sessions provided an invaluable opportunity to the members of ISPRM-WYF to gain experience in the international arena. Other health and rehabilitation professionals were able to participate and hear from the speakers with experiences of treating COVID-19 patients. Feedback received from the audience after each session helped in the continuous improvement of the webinars. The audience has been watching the recorded version.


  Challenges of Organizing Global Webinar Series during a Pandemic Top


The COVID-19 caused a global crisis and has affected every domain of human life. Because of this it was difficult for the webinar organizers from the different regions of the world to come together and plan the webinar sessions. This was overcome by long phone calls, video conferences, and threads of E-mail/text communications, even at odd hours. As all the PRM leaders and professionals were busy in their countries responding to the pandemic, the search for the appropriate speakers with experience of COVID-19 patients and pandemic was tedious. ISPRM President's Cabinet and various leaders of ISPRM helped to initiate the connection and to finalize the invitations to the speakers. The collaboration of speakers, moderators, and hosts from different countries around the world was specifically challenging. However, the extra efforts put by the individuals made the teamwork, in true rehabilitation fashion, easier. The webinars were organized at different times of the day to give the opportunity to audiences in different time zones.


  Future of ISPRM Live Webinars Top


After the huge success of ISPRM Webinar Series, the global audience has requested ISPRM to continue the webinars in the future. After webinar #10, 39% of audience expressed that ISPRM should organize educational webinars every week, whereas 33% wanted in on a monthly basis and 28% wanted it in bimonthly frequency. The audience requested topics related to strengthening knowledge and skills of physiatrists (35%), COVID-19-related topics (26%), PRM resident education topics (19%) and topics related to ISPRM and its committees/taskforces (18%). The future plan is to develop a robust curriculum and include the ISPRM committees/taskforce/special interest groups for the future webinars.


  Conclusions Top


The specialty of PRM has been facing unique challenges during the COVID-19 pandemic. Both WHO and ISPRM agreed that, more than ever, the rehabilitation community needs to be united to deliver the rehabilitation services to every person who needs it. One of the responses of ISPRM to COVID-19 crisis was the ISPRM Webinar Series. On the basis of the global needs/demands, timing, contents, and encouraging participation of WHO leadership, distinguished speakers and enthusiastic audience, the ISPRM Webinar Series proved to be an effective educational and information sharing platform with extensive global reach despite the challenges of the pandemic.

Acknowledgments

The authors would like to acknowledge Ms. Jessyca Idi, Executive Director of ISPRM Central Office for working as a principal host of all the webinar sessions and ISPRM President's Cabinet and leaders for guidance, support and feedback to conduct the webinar sessions successfully.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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ISPRM and Its Gl...
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Positive Message...
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