Authors (including presenting author) :
Sham PK(1), Leung YY(1), Chui KW(1), O HH(1), Mok YT(1), Choi YY(1), Cheng YF(1), Wong YB(1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Physiotherapy (PT) is one of the multidisciplinary team of Geriatric Day hospital (GDH) of Princess Margaret hospital (PMH) providing extended rehabilitation for stroke patients discharged from acute settings or required further care. Apart from conventional mobility and gait training, various interventions including interactive balance training equipment focusing on specific sensory and motor component with visual biofeedback, transcranial direct current stimulation, neuromuscular electrical stimulation, transcutaneous electrical stimulation over acupoints. In addition, carer training, multidisciplinary team home visit or community physiotherapy and post-stroke educational talk are provided to both the patients and care-givers. This aims at empowering stroke patients with self-management and promoting early re-integration to the community.
Objectives :
To evaluate the functional mobility of stroke patients after attending stroke rehabilitation in GDH of PMH in the past 3 years.
Methodology :
Stroke patients who had completed a course of rehabilitation in GDH during April 2016 to March 2019 were reviewed. Outcome measures including Modified Functional Ambulatory Category (MFAC), Modified Rivermead Mobility Index (MRMI) and Timed Up and Go Test (TUGT) were evaluated.
Data were retrieved retrospectively in the Clinical Management System. Wilcoxon Signed Rank test was used to compare the within group non-parametric statistics pre- and post-GDH training. Significance was set at p-value less than 0.05.
Result & Outcome :
843 patients were reviewed, 58% were male with mean age of
69.8±12.2 years old. The mean duration of GDH training was 10.6±6.0 weeks with
an average of 16.7±9.5 sessions attended.
Upon discharge, mobility status of patients was improved. The mean MFAC significantly increased from 4(assisted walker) to 5(supervised walker) (p< 0.001). The percentage of independent walker (MFAC 6-7) increased from 23.3% to 36.8%. MRMI score significantly increased from 26.9±8.8 to 30.0±8.7 (p< 0.001) and TUGT significantly decreased from 38.9±28.1 to 31.4±22.2 seconds (p< 0.001).
PT stroke rehabilitation at GDH has been shown to effectively improve functional mobility of patients, facilitate early re-integration to the community and improve their quality of life. However, TUGT of stroke patients after GDH training was still beyond 30 seconds which indicated impaired mobility with risk of fall. Fall prevention program of GDH including educational talk and theraband Tai chi class, as well as home care program are the key to minimize fall risk.
