Authors (including presenting author) :
OR WKV1, HO OLL1, LEUNG PHM2, CHAN MFM1, MA FCB1, MAK MYM1
Affiliation :
1 Physiotherapy Department, 2 Department of Prosthetic and Orthotic, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong SAR
Introduction :
Passive-active exercise training using lower limb ergometer is pivotal treatment modality for functional motor training in different conditions such as stroke, spinal cord injury and neuropathy. For those fragile patients with sensation deficits, they were prone to have skin abrasion, pressure and frictional injuries after prolonged repetitive training. Previous protection methods by using towel and elastic stocking were found to be insufficient in skin protection and keeping proper limbs position. Some pressure and frictional injuries were reported after ergometer training in the past. Thus an innovative protective device was designed by Physiotherapy and Prosthetic and Orthotic Departments.
Objectives :
1.To enhance patient safety when using prolonged repetitive ergometer training in physiotherapy 2.To unify the protection setup process of potential frictional injury related to the exercise device 3.To arouse the alertness of staff in skin protection
Methodology :
Since July 2019, a working group was formed among physiotherapists, physiotherapy assistants and prosthesis and orthotic therapists in discussing the protection setup and ways of reduction of frictional movement during the ergometer training. After literature review, discussion, normal subjects’ and patients’ trials, two special designed protective device prototypes were made. Then a series of trial was done on normal subjects in August. A semi-final product was made based on this trial result and was distributed to different clinical areas for trials and feedback. After a half-year patient trial period, a final product was used in physiotherapy service in NTWC.
Result & Outcome :
RESULTS From Aug 2019 to Dec 2019, different protective device testers were used by twenty physiotherapists and thirty patients. Continuous assessment and skin monitoring of patients were done. Ongoing discussions and collaborations between teams were carried out in order to modify the protective device. Numerous trials were carried out in acute in-patient, rehabilitation in-patient and out-patient physiotherapy units of TMH. The involved physiotherapy colleagues reported that the new device was more convenient in application as compared with the previous method. They also reported that it was a more satisfactory way in keeping patients’ limbs position. The time in setting up the new skin protection device was similar to previous method. There were two reported pressure injuries within 1-year with the previous method whereas no similar incident was happened after the new method applied from Aug 2019. Besides, colleagues reported that they increased the alertness and awareness of skin protection. 80 percent of targeted patients were satisfied and felt more comfortable in using the new protective device. CONCLUSION Through the multidisciplinary collaboration work, implementation of the new protective device when using prolonged repetitive lower limb ergometer machine is suggested to enhance patient safety and minimize the risk of potential frictional and pressure injuries. Moreover, this project also significantly arouses the alertness of staff in pressure injury prevention.
