Authors (including presenting author) :
LAM WSV(1), MAK YTI(1), TO WKR(1), MAK MYM(1)
Affiliation :
Physiotherapy Department, Tuen Mun Hospital
Introduction :
People with diagnosis of Knee Osteoarthritis (OA knee) are commonly referred for physiotherapy. Normally, a 2-session knee care and exercise class is provided in Tuen Mun Hospital (TMH). In the UK, a structured program named ESCAPE (Enabling Self-management and Coping with Arthritic Pain using Exercise) was found to be effective in pain control and functional improvement for patients with OA knee. It helps patients understand their own condition and take them through a 6-week progressive exercise training program (twice per week for 12 sessions). The program was also shown to be effective in reducing health care utilization costs. Thus, a trail of ESCAPE approach program was enrolled in TMH for OA knee service enhancement with local adaptation which was modified to a 6-session program.
Objectives :
This study aims to evaluate the effectiveness of the ESCAPE approach program (EAP) in TMH.
Methodology :
Patients aged above 45 referred for physiotherapy with diagnosis of OA knee solely (unilateral or bilateral) were recruited to the scheduled EAP in TMH. The EAP was composed of educational talks and individual exercise training once per week, for consecutive 6 weeks, emphasizing the strategies in self-management and lifestyle modification. Outcome measures for the evaluation included the Numeric Pain Rating Scale (NPRS), Numeric Global Rate of Change Scale (NGRCS) and Knee injury and Osteoarthritis Outcome Score (KOOS) (HK Chinese version). For KOOS, 3 sub scales (pain, physical function and knee-related quality of life) were evaluated separately. Assessment was done in the initial and final session.
Result & Outcome :
38 patients (15 male, 23 female, mean age = 62.9) were recruited for the EAP training, with mean attendance of 4.5 sessions. Comparing the initial and final sessions, the NGRCS of the EAP improved from 0.21 to 3.26 (p< 0.001) and the pain level of EAP decreased from 6.45 to 4.39 (p< 0.001). There was trend of improvement in all of the KOOS subscales but only the physical function subscale (from 64.92 to 67.94, p=0.024) was found to be statistically significant. The EAP was shown to be effective in pain control and physical function improvement for patients with OA knee even though it was decreased from 12 sessions to 6 sessions. Further service modification and development may be preferable for enhancing the knee-related quality of life in patients.
