Authors (including presenting author) :
Ng T(1), Chan PK (2), Wan KY(1), Lok G(1), Wong CW(1), Lee FL(1), Chiu KY(2)
Affiliation :
(1)Occupational Therapy Department, MacLehose Medical Rehabilitation Center (2)Department of Orthopedics & Traumatology, Queen Mary Hospital
Introduction :
OT Interventions in KOA included knee ergonomics education and individualized pacing strategies application. The objectives of the intervention were to increase pain self-efficacy and control the fatigue level of activity participation. Assessment paradigm relied on self-administered questionnaires on pain self-efficacy, fatigue level, knee symptoms and activity pattern. However, patient usually encountered problems to recall the time distributed on physical activities. The outcomes may be influenced by the effect of social desirability bias. We therefore adopted the use of commercial activity tracker(AT) to obtain objective data since 2016. In 2018, we updated the equipment of wrist-worn AT with heart rate measurement. We would like to collect objective data of moderate and vigorous physical activity (MVPA) from the AT that correlated to patient’s activity pattern. With the help of the AT, the activity pacing strategies can be effectively implemented in community-living environment.
Objectives :
Successful application of the wrist-worn activity tracker to capture data of physical activity level of patients with KOA.
Methodology :
To prepare the environment: We had prepared a cell-phone with bluetooth streaming and a pocket WIFI to facilitate the data retrieval. To improve patient acceptance: Occupational Therapist would conduct group educational class for explanation before the program and individual interview weekly to explain the data and their performance. To reduce cyber phobia: We would assist patient to download and operate the apps individually if needed. Individual management would help reduce their anxiety of handling electronic and internet-based device. To ensure data security: Each account was set-up with an email address. No personal or identifiable information could be retrieved from the app. To conduct data processing: Supporting staff was trained to synchronize the data to the phone-based pacer app. The data collected from AT were active minutes and MVPA per day and 7 days in total. Those data was useful in goal setting with patient.
Result & Outcome :
The physical activity pattern of patients recruited from the Comprehensive Osteoarthritis Mangement Program (COME) were assessed with the wrist-worn AT. We aimed to collect data of MVPA of patients through the one-week assessment with AT. Patients from COME were recrited for OT activity pacing intervention. From March 2018 to October 2019, there were a total of 82 patients recruited from the program.73 patients completed the one-week assessment by using the AT. After the assessment, 36 patients were selected for the 5-week program (activity pacing) with second-time use of the AT (2 review sessions per week). Results showed significant improvement in the Functional Assessment of Chronic Illness Therapy – fatigue (FACIT) scores after the 5-week program. The participants with MVPA less than 90 minutes reduced by 19% while participants with MVPA over 210 minutes increased by 16%
