Authors (including presenting author) :
Yeung KNC, Lai PH, Lam KY, Fung KYB
Affiliation :
Physiotherapy Department, Kwong Wah Hospital
Objectives :
The objective of this study is to evaluate the effectiveness of an early physiotherapy intervention program of stable back cases prior to the first Orthopaedics and Traumatology (O & T) consultation, on reducing patient’s waiting times to the first O & T consultation, improving patient ‘s perceived feeling of improvement and the clinical outcomes of pain and disability level.
Methodology :
The study used a non-experimental design. A retrospective review of the collected data was conducted between 1 Jan 2019 to 31 Aug 2020 to identify if an early physiotherapy intervention program of stable back cases prior to the surgeon consultation had positive clinical outcomes on four dependent variables: patient’s waiting times to the first O & T consultation, patient ‘s perceived feeling of improvement, pain and disability level in Kwong Wah Hospital, Hong Kong. Study outcomes of reported pain (Numeric Pain Rating Scale), functional disability (the Roland and Morris Disability Questionnaire- HK Chinese version), patient ‘s perceived feeling of improvement (Numeric pain global rating of change scale) was assessed at baseline and after physiotherapy’s intervention. Reduction of waiting time of patients to attend the first O & T consultation was calculated in weeks as the difference between the date of initial consultation appointment and the re-scheduled date of co-joint clinic.
Result & Outcome :
Among 277 referred, 221 subjects completed the program. There were statistically significant improvements in reduction of pain and disability among the subjects who completed the program (p=0.000 using Exact Test). Participants in the program had 2.6 out of 10 points less pain and 1.9 out of 24 points less disable on discharge. And the mean score of patients perceived feeling of improvement was 5.0 (SD±2.5). On average, patients attending co-joint clinic waited 81 weeks less than the initial O & T consultation appointment given. 57 patients (25.9%) were able to discharge directly from the co-joint clinic after the first consultation without any specialist follow-up. 24 patients (11%) referred again for back physiotherapy within 12 months. This new service delivery model of care may serve as viable options to improve patient’s waiting time and health outcomes in other stable musculoskeletal conditions.
