Authors (including presenting author) :
Chan SKM (1), Kwan IYF (1), Lee WWY (1), Lam PL (1)(2), Chan GNY(1)
Affiliation :
(1) Physiotherapy Department, David Trench Rehabilitation Centre, Queen Mary Hospital, Hong Kong
(2) Physiotherapy Department, Queen Mary Hospital, Hong Kong
Introduction :
Knee osteoarthritis (OA) affects more than 20% of the population in Hong Kong. More than 700 Joint replacement surgeries were performed in HKWC last year and 3000 more are still on the waitlist. Current treatments such as regular analgesics and joint care advice are usually fragmented, resulting in unsustainable effect. Therefore, establishing an integrated self-management program is crucial as this will help to delay disease progression and ultimately alleviate the burden for arthroplasty. Recognizing the challenges ahead, the Physiotherapy Department in David Trench Rehabilitation Centre of Queen Mary Hospital launched a pilot program, inspired by “ESCAPE Pain” from the United Kingdom, to empower patients to cope with the disease.
Objectives :
To evaluate the clinical effectiveness of a 6-week integrated self-management program for patients with knee OA.
Methodology :
Patients diagnosed with knee OA aged 55 years old or above were included in a weekly 2-hour session as a group. Physiotherapist-led discussion was held in each session to equip them with essential knowledge of the disease. It is then followed by a supervised exercise session. Throughout the program they will be continuously guided to progress the exercises and work towards their goals. An exercise diary was then provided upon completion of the program to encourage them to stay physically active in daily life.
Numeric Pain Rating Scale (NPRS), Knee Injury and Osteoarthritis Outcome Score – Physical function domain (KOOS-PS), Chinese version of Self-efficacy for exercise (SEE-C), 30-second chair stand test and patient satisfaction questionnaire were used for evaluation. Telephone follow-up was performed 1 month upon completion of the program.
Result & Outcome :
125 Patients were recruited into the program from June to December 2019 and 93 have completed. Baseline average NPRS and KOOS-PS score was 6.4 and 63.0 respectively; indicating the majority of our patients had moderate pain and functional impairment at the time they entered our program. Post-program evaluation showed improvement in NPRS, KOOS-PS, SEE-C and 30-second chair stand test, all of them were statistically significant (p< 0.05). The overall patient satisfaction score was 88.7%. Majority of them have reported capability in self-management and confidence to maintain regular exercise during telephone follow-up.
The integrated self-management program demonstrated improvement in pain and function in knee OA patients of moderate severity. Their self-efficacy to stay physically active was also enhanced. Further studies could examine the long-term benefits of such program and its sustainability in community settings.
