Authors (including presenting author) :
Mok YT(1), Chui KW(1),O HH(1), Cheng YF(1), Lau BSC(1), Leung YYC(1), Wong TWL(2)(3)
Affiliation :
(1) Physiotherapy Department, Princess Margaret Hospital (2) Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University (3) School of Public Health, LKS Faculty of Medicine, The University of Hong Kong
Introduction :
Community Physiotherapy (CPT) services in Lai King Building (LKB) of Princess Margaret Hospital (PMH) commenced in 2016. Home visits were provided to the following clients: (i) Active Geriatric Day Hospital (GDH)patients with history of falls or functional impairments compared with premorbid state (ii) Frail elderly who had difficulties to access Out-Patient Physiotherapy services (iii) Patients with co-morbidities referred by the Community Nursing Services (CNS). (iv) Patients discharged from LKB required post-discharge support. The scope of CPT included on-site indoor and outdoor mobility assessment, functional training and exercises program, fall risk identification with environmental assessment, and fall prevention advice, care givers education, chest physiotherapy and pain relief. The service aimed at promoting patient’s mobility and preventing fall injury, thus preventing the hospital readmission and promoting the concept of aging-in-place.
Objectives :
To review CPT services of LKB of PMH and evaluate the outcomes of GDH patients receiving CPT in 2018.
Methodology :
Data of patients received CPT services in 2018 were retrieved from the Clinical Management System (CMS).
Result & Outcome :
A total of 186 patients (mean age= 77.1 ± 12.1 years old)receiving CPT services of LKB in 2018 were reviewed with 46.8% of the patients had recent fall-related incidents. 87.1% were under home care while the remaining were institutionalized. All patients received mobility assessment with exercises programs educated. 31.7% were provided outdoor mobility assessment and training. Environmental assessment and advice as indicated were given to 58.1% of the clients. 76.9% of patients with care giver education provided. Pain relief treatments and chest physiotherapy were contributed to 14% and 5.9% of patients respectively. Among the patients reviewed, 74.7% of the clients received GDH rehabilitation, 37.6% of these GDH services recipients are neurological patients while 25.8% are musculoskeletal patients. Both Modified Functional Ambulation Categories (MFAC) and Timed up-and-go among all GDH patients were showed statistically significant improvement (p＜0.01) with analysis by Wilcoxon Signed Rank Tests. In addition, both the Modified Rivermead Mobility Index (MRMI) for neurological patients and Elderly Mobility Scale (EMS) for musculoskeletal patients were also significantly improved as illustrated by paired t-tests upon discharge from GDH (p＜0.01). In conclusion, CPT services play a role in enhancing the elderly’s mobility and facilitating the patient back and live in their own community. Significant improvement of mobility was shown in GDH patients received CPT services. Future studies on the effectiveness of the services for those home care and residential patients received CPT only are warranted.
