Authors (including presenting author) :
Leung HC(1), Lam SL(1), Li SK(1), Chan CC(1), Yip LF(1), Chiang KH(1)
Affiliation :
(1) Physiotherapy Department, Shatin Hospital
Introduction :
A pilot tele-rehabilitation program was implemented in Geriatric Day Hospital (GDH) at Shatin Hospital during the service suspension since March 2020 due to COVID-19 pandemic.
Objectives :
(1) To maintain continuity of care in view of physical barriers;
(2) To enhance efficiency of Physiotherapy service delivery and the quality of patient-centred care.
Methodology :
144 GDH patients were recruited into the program from the period of March to May 2020. They were then provided with comprehensive assessment, individualized home exercise program, advice and education, continuous monitoring through phone call, video call and messaging. All assessments and interventions were only conducted under safe and supervised conditions. Outcomes concerning functional mobility and balance, including Modified Functional Ambulation Classification (MFAC), Berg Balance Scale (BBS), Modified Rivermead Mobility Index (MRMI), Timed Up and Go Test (TUG) and 6 Minute Walk Test (6MWT) were analyzed. Reliability of the estimated MFAC (assessed by phone call or videotaping) was evaluated by comparing to the post-program MFAC (re-assessed upon face-to-face session). Survey on patients and carers satisfaction was also conducted.
Result & Outcome :
A total of 114 patients (mean age: 74.2 ± 12.8) completed the program and outcome evaluation within 14 weeks. Each patient received an average of 4.9 sessions, while average service time for initial assessment and subsequent follow-ups were 36.7 minutes and 18.2 minutes respectively. By comparing pre and post program outcomes, it was demonstrated that patients had significant improvement in ambulatory status (MFAC: 4.94 vs 5.15, p< 0.05), balance (BBS: 29.97 vs 32.37, p< 0.05), functional mobility (MRMI: 28.12 vs 29.30, p< 0.05) and walking endurance (6MWT: 135.09 vs 155.29, p< 0.05); clinical improvement in walking speed (TUG: 44.95 vs 40.31, p=0.14). There was no significant difference in estimated MFAC and post-program MFAC (5.27 vs 5.15, p=0.071), which showed that estimation of MFAC during tele-assessment could be a reliable tool in measuring patients’ ambulatory status in tele-rehabilitation. A high patient satisfaction rate (100%) was also reported.
Physiotherapy tele-rehabilitation program was a feasible mode of service delivery. It promoted service efficiency and quality by allowing delivery of Physiotherapy assessment and intervention disregarding physical boundaries; improving patient’s functional outcomes; and providing ample support to patients and carers. Further development of this new complementary service model should be enhanced with the traditional rehabilitation service.
