Authors (including presenting author) :
Tsui AYY (1), Ling SO (2), Ng PK (2), Yim CW (2), Kwan HY (2), Yau A (2), Tang WK (2), Fong SY (2), Chan RWY (1), Chan BSC (1), Kong ISY (1), Yeung JTK (1), Chau RMW (1)
Affiliation :
(1) Physiotherapy Department, Kowloon Hospital; (2) Department of Respiratory Medicine, Kowloon Hospital
Introduction :
Since 2020, the global pandemic has profound effect on the provision of pulmonary rehabilitation services. Conventional Pulmonary Rehabilitation Programs(PRP) in hospitals were suspended from time to time. Physical inactivity would have significant negative impact on the patients with chronic respiratory diseases.
Objectives :
To review the pre-COVID-19 benefits achieved on the health, daily life and perceived well-being in the patients with chronic respiratory diseases and the anticipated problems amid COVID-19 to work out the preparedness post-pandemic.
Methodology :
A retrospective review of chronic respiratory disease patients joining PRP in Kowloon Hospital from May 2014 to Aug 2019 was conducted. The symptoms, activities and impact components of St. George’s Respiratory Questionnaire(SGRQ) were analysed for service planning.
Result & Outcome :
122 patients with chronic respiratory diseases joining the PRP were reviewed, including 116 males and 6 females, age ranged from 57-88. Majority(85%) were COPD patients with moderate to severe symptoms. Patients demonstrated significant improvement in the symptoms component(54.57±18.70versus43.03±18.88;p=0.000), activities component including activities caused or limited by breathlessness(64.78±19.58versus52.51±20.90;p=0.000) and reduction in impact component including social functioning, psychological disturbances(39.58±20.46versus25.06±19.44;p=0.000) resulting from airways diseases. The overall mean change of score was 13.61(49.63±16.24versus36.02±16.02;p=0.000), showing very efficacious treatment in term of the 3 components for chronic respiratory disease patients.
Benefits of conventional PRP for chronic lung disease is well-documented. Literatures reported significant functional performance decline in COPD associated with decreased functional capacity and increases in body fat resulting from physical inactivity. With enforcement of social distancing measures & suspension of non-emergent public healthcare services, chronic lung disease patients are facing unavoidable devil of physical performance decline. Upon service resumption, the need for a new normal in infection control measures for delivery of pulmonary rehabilitation service and the preparedness in catering for deteriorated patients for continuation of PRP and rehabilitation of recovered COVID-19 patients is exigent, rendering proactive service planning inevitable. While amidst pandemic, with the popularity of smartphone & the powerful Health Information & Technology in HA, Tele-care for disease monitoring, rehabilitation exercise prescription & advice is enabled as adjunct interim therapy for suitable patient, such as smartphone legibility and record of good exercise compliance. The new service enhances service accessibility & practicality, patient-therapist interaction for enhanced personal experience. By bringing the service to patient while staying home, it helps to decrease exposure to infection risk & social stigmatization upon symptoms manifestation during travel to hospital in these patients.
