Authors (including presenting author) :
Fung HWK(1), Fong WK(2), Chan HL(3), Lui MH(4)
Affiliation :
(1) Physiotherapy Department, Pricne of Wales Hospital
Introduction :
Idiopathic scoliosis is a common orthopedic condition in adolescent with prevalence of 2-4% in Hong Kong population. Early physiotherapy interventions are essential in preventing deterioration especially during the growth spurt. For this reason, we modified our original scoliosis exercise program in 2019 with the concepts of LEAN management and triage stratified care. We aimed to decrease the waiting time for class and arranged precise care to patient according to their risk of progression.
Objectives :
To evaluate the effectiveness of new scoliosis program in reducing waiting time
Methodology :
Concepts of triage stratified care were applied in our new scoliosis class model. The original four session’s classes were trimmed down to one or two sessions according to the risk of progression of scoliosis. The risk of progression was calculated with a widely adopted formula from authoritative international articles, including factors of age, Cobb angle and Risser sign. Also, the concepts of LEAN approach were used to facilitate the workflow. Non-value added and lengthy assessment procedures were streamlined and valued added components including back care education, specified exercises and a 10 points knowledge quiz were retained and reinforced.
The efficiency was measured by differences in waiting time and the quality of service was measured by difference in score improvement of knowledge quiz. 122 and 145 subjects from original and new scoliosis classes were selected by convenience sampling.
Result & Outcome :
The mean difference in waiting time for two groups was evaluated by independent T-test. The mean waiting time for original and new scoliosis group were 142.9 days(SD 48.8) and 38.7 days(SD 30.1) respectively with a mean decrease of 104.1days (95% CI -113.1 to -93.1, p< 0.01). The mean difference of quiz score improvement for two groups was evaluated by independent T-test. The mean improvement of quiz score was 22.2% (SD 46.6%) in original group and 15.7% (SD 48.7%) in new group. The mean quiz score improvement was 6.5% (95% CI -23.8% to 10.8%, p=0.460) lower in new group but with no statistically significant difference. In conclusion, the reformed and streamlined scoliosis exercise class program significantly reduced the waiting time of the service with no deterioration of service quality. Patient with scoliosis could receive early and timely treatment to reduce the risk of deterioration and disease progression.
