Authors (including presenting author) :
Tam HL(1), Chan JSY(1), Chan OHL(1), Yeung AKC(1)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital
Introduction :
High Risk Infant (HRI) Program includes pre-term, extreme low birth weight (ELBW), hypoxic-ischemic encephalopathy (HIE) and infants with long stay in NICU. High risk infants are prone to developmental and behavioral disorders. Continuous monitoring of developmental progress with regular follow-ups has been suggested by paediatric guidelines to commence as early as possible to identify anomaly (Committee on Fetus and Newborn, 2008). Although the HRI program has launched in our physiotherapy department in recent years, the program is adversely affected by COVID-19 pandemic as parents have concerns on bringing HRIs to the hospital to attend the program.
Objectives :
1. To compare the developmental outcomes of the infants throughout the HRI program
2. To review the effectiveness and satisfaction of the HRI program with incorporation of tele-rehab during COVID-19
Methodology :
The initial assessment was made at 0 month, and followed up at corrected age of 4, 8 and 12 months using Infant Neurological International Battery (Infanib) for developmental assessment. For infants who did not prefer to or could not physically attend follow-up sessions due to COVID-19 pandemic, telephone follow-up was made to advise on developmental progress and prescribe home exercises. Infanib score improvement is compared using paired-T test. Percentage of infants reaching normal development in terms of Infanib score is compared using Chi-square test.
Result & Outcome :
There were totally 128 infants assessed and treated under HRI Program in Physiotherapy Department of Prince of Wales Hospital from February to December 2020. Around 40% of infants did not attend at least one of the follow-up sessions and an additional 20% of infants had reviews delayed due to COVID-19 pandemic. Parents who received telephone follow-up reported positive feedback in enhancing developmental progress during COVID-19 pandemic while reducing the risks of going to the hospital physically.
The average score in Infanib significantly increases from 54 ± 6 at 0 month to 63 ± 8 at 4 months (p=0.000) to 72 ± 19 at 8 months (p=0.009). The percentage of infants reaching normal development in terms of Infanib significantly improves form 4% at 0 month to 61% at 8 months (p=0.000, df=4, Chi-square statistics=46.63).
Conclusion
Our study suggested that developmental progress improves significantly with time and along HRI program monitoring and intervention. The periodical follow-ups are
beneficial to them in early detection and family empowerment. Tele-care follow-ups during COVID-19 pandemic period has shown positive effect for monitoring developmental progress. It could be implemented in conjunct with regular training to maximize the capacity to patients.
