Authors (including presenting author) :
Li SK(1), Lam SL(1), Chan CC(1), Yip LF(1), Leung HC(1), Ng WL (2), Chiang KH(1)
Affiliation :
(1)Physiotherapy Department, Shatin Hospital (2)Medicine and Geriatrics Department, Shatin Hospital
Introduction :
With the background of service suspension during COVID-19 pandemic, a Get-To-Start stroke tele-rehabilitation program was implemented from August to October 2020 (the third wave of the pandemic) in Geriatric Day Hospital (GDH) at Shatin Hospital (SH), in order to handle with the new stroke cases referred from SH inpatient in advance, so that patients could start training through tele-rehabilitation immediately after discharged, without any delay of service.
Objectives :
(1) To support early and safe discharge of stroke patients from inpatient; (2) To ensure the continuity of early rehabilitation for stroke patients at home.
Methodology :
Multidisciplinary face-to-face initial physical and functional assessment was provided on the day of inpatient discharge to prepare for tele-rehabilitation by GDH. The patients were then followed up by tele-rehabilitation sessions with the first session implemented within 5 working days after the initial assessment. Case conference was also conducted for case discussion and caring plan.
Result & Outcome :
A total of 13 stroke patients (8 men,5 women) were recruited. 12 of them completed the part of physiotherapy program and re-evaluation. The mean age of patients was 62 (range: 44-84). During the program, patients and/or their carers were contacted by phone call (100%), video call (76.92%) and/or video taken and sent by patients or therapists (61.54%) on their progress, including home exercise compliance and performance (100%); mobility and gait re-education (100%); fall prevention and education (100%); limb function (38.46%) and pain assessment and control (23.08%). New home exercise was also prescribed via video clips (100%), HA Go prescription (61.54%) and electronic exercise pamphlet (7.69%). All patients showed good compliance to our exercise prescription, and no patients suffered from fall during the program.
During the first and second wave of the pandemic, GDH service was suspended from early of February to mid of May 2020 and no new cases were intake for more than 3 months. The Get-To-Start program for stroke patients could effectively bridge the service gap during GDH service suspension. The response time for new case referral was even shortened from the normal service patch of 2 weeks to 0 day. In addition, physiotherapy tele-rehabilitation provides a new normal platform for patient assessment, intervention and monitoring through two-way communication among therapists, patients and their carers and without physical barriers. It is highly recommended that tele-rehabilitation should serve as a complementary mode of service in future development.
