Authors (including presenting author) :
Wan KY (1,) Ng YL(1), Chan PK (2), Chiu KY (3), Li-Tsang WP (4)
Affiliation :
(1)Department of Occupational Therapy, MacLehose Medical Rehabilitation Centre, (2)Department of Orthopaedics and Traumatology, Queen Mary Hospital,(3)Department of Orthopaedics and Traumatology, The University of Hong Kong,(4) Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
Introduction :
Elderly patients with TKR may result in residual pain and their adaptation to functional activities might not be ready within a limited in-patient care from an acute hospital. A fast track rehabilitation program was set up at a rehabilitation hospital aiming at enhancing management of pain and functional training to these patients so that they would be better equipped upon returning home.
Objectives :
To study the effects of the fast track rehabilitation program for the patients with TKR on their functional performance and their participation in daily activities.
Methodology :
A longitudinal cohort study was conducted at 1-month post discharge from the in-patient fast-track rehabilitation program. The main outcomes included the measurement of functional performance by an OA-knee specific functional scale and their participation through the evaluation of the commercial-grade accelerometer.
Result & Outcome :
27 subjects were recruited for the study through convenience sampling during September 2018 to December 2019. Results showed that functional performance was significantly improved at discharge and post 1-month discharge as reflected by Knee Injury and Osteoarthritis Outcome Score (KOOS) ADL subscale score ( F (2, 50) = 118.17, p < 0.0,1 η2 partial = 0.83). Among the 25 patients who participated in the step count measure, the average steps for the total 7-day period was 28774.88 (SD= 17339.67). There were 2 patients (8%) with < 1000 daily steps collected and 8 patients (32%) with > 5000 daily steps collected. The step count of the other 15 patients ranged from 1000-2999 (7 patients, 28%) and 3000-4999 (8 patients, 32%) daily.
The program has achieved the purpose of enhancing functional performance as shown by the KOOS ADL score. However, fewer than 3000 daily step counts was still recorded among 36% of the group indicated that they might still have limitation in participation. Mechanisms to identify these patients’ needs should be explored for referral to the appropriate ambulatory rehabilitation to help boost the level of activity participation.
