Authors: (including presenting author): :
Yeung MH(1), Cheung CT(1), Lau WK(1), Hung YW(2), Fan CH(2)
Affiliation: :
(1)Physiotherapy Department, (2)Department of Orthopedic and Traumatology, Alice Ho Miu Ling Nethersole Hospital
Introduction: :
Knee osteoarthritis (OA) is one of the most common degenerative diseases in older adults. It limits patients’ activities, function and quality of life. In AHNH, 387 total joint replacement (TJR) surgeries were performed in 2018 and yet 1000 more were still on the waiting list. Meanwhile, most patients only receive analgesics and general advice with suboptimal effect. Therefore, a non-surgical management program – KEEP (Knee Exercise and Self-management Physiotherapy) came out in August 2019 for these patients in order to delay their disease progression.
The program consisted of patient empowerment through knowledge transfer, functional coping skills, therapeutic exercise habit formulation, peer sharing and support. The model of care comprised of a 6-week hospital-based module and a subsequent 6-month collaborative care module by a community NGO partner.
Objectives: :
1. To enhance patients’ understanding on OA knee condition and self-management techniques.
2. To promote optimal fitness and function.
3. To assist patient in exercise habit development.
Methodology: :
This is a prospective study. In KEEP program, patients followed tailor-made training including patient empowerment, coping strategies, mobilization, strength and functional exercises. After finished the hospital-based module, patients would join the collaborative community-based module to complete the continuum of care.
Primary outcomes included Physical function Short form (PS), pain (P) and quality of life (QoL) domains of the Knee injury and Osteoarthritis Outcome Score (KOOS) – Hong Kong Chinese Version. Secondary outcomes included Numeric Pain Rating Scale (NPRS) and 30-Second Chair Stand Test.
Result & Outcome: :
After KEEP program, subjective physical capacity and QoL were significantly improved, revealed by KOOS–PS (from 59.0 to 66.2, p< 0.05) and KOOS-QoL (from 33.5 to 52.3, p< 0.05). Knee pain in terms of KOOS-P was improved from 53.5 to 60.8 without statistical significance (p=0.187). NPRS and 30-Second Chair Stand Test had no significant changes.
15 patients finished the hospital-based module and joined the collaborative care module by the community NGO partner.
6-month follow-up outcomes when patients completed hospital and community modules would be available in April 2020.
Conclusion
KEEP program was effective in enhancing function and QoL. We are confident that with both the hospital module and the continuous patient empowerment module in collaboration with a community NGO partner, patients’ physical fitness, self-management strategies and exercise habits formulation could be enhanced and maintained.
