Authors (including presenting author) :
Wong FY(1), Chan MF(1), Wong CK(1), Yuen WM(1), Fung WK(1), Ku PC(1), Tung LH(1), Ma FC(1), Mak MY(1), Wong ST(2)
Affiliation :
(1) Physiotherapy Department, Tuen Mun Hospital,
(2) Department of Neurosurgery, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority
Introduction :
A neurosurgical rehabilitation ward was newly opened in Tuen Mun Hospital (TMH) in December 2017. Stable neurology patients could be transferred from acute neurosurgical ward to the rehabilitation ward for extended-care. They would receive physiotherapy sessions 5 days a week with a specialized team of physiotherapists. A spacious ward environment and a well-equipped gym with advanced technology equipment, e.g. robotic gait device could be provided for ambulatory training. Close collaboration and communication between physiotherapists and other disciplines was established including a bi-weekly multidisciplinary case conference. Through intensive physiotherapy, patients might be benefited from better functional outcomes upon discharge.
Objectives :
To evaluate the mobility and functional outcomes of patients transferred to the neurosurgical rehabilitation ward in TMH.
Methodology :
Patients transferred from acute neurosurgical ward to the rehabilitation ward in TMH from May 2019 to November 2019 were reviewed. Individualized physiotherapy program including ward-based training and gym training if indicated were provided. Demographic data was collected. Outcome measures including (1) Elderly Mobility Scale (EMS), (2) Modified Functional Ambulation Category (MFAC), and (3) Modified Rankin Scale (MRS) were collected on admission to the neurosurgical rehabilitation ward and upon discharge.
Result & Outcome :
A total of 47 neurosurgical patients (mean age 61.9 +/- 15.7 years, 20 male and 27 female) were recruited. They suffered from brain tumor (34.0%), subdural hemorrhage (23.4%), spinal tumor (10.6%), intracranial aneurysm (6.4%), subarachnoid hemorrhage (4.3%), arteriovenous malformation (4.3%), intracerebral hemorrhage (2.1%) and others (14.9%). The mean length of stay was 21.0 +/- 17.4 days.
The mean EMS score was 11.1 +/- 5.8 on admission to the neurosurgical rehabilitation ward, and was improved to 15.9 +/- 4.9 upon discharge. (p< 0.001) The median (inter-quartile ranges) of MFAC and MRS scores were 4 (4-5) and 2 (1-4) on admission and were improved to 6 (5-6) and 1 (1-2) respectively upon discharge. (p< 0.001) 51.1% of patients could walk independently upon discharge and the majority were discharged home (82.9%). Our results demonstrated that patients transferred to the neurosurgical rehabilitation ward in TMH had improved mobility and functional status after receiving intensive rehabilitation training.
