Authors (including presenting author) :
Cheung OK(1), Fung HT(1), Lui NF(1)
Affiliation :
(1)Occupational Therapy Department, Queen Elizabeth Hospital
Introduction :
Conventionally, the outpatient cognitive training is only provided in face-to-face mode. During the pandemic, many patients hope to minimize the attendance to hospitals. To maintain the utmost service quality, the expansion of tele-rehabilitation service has been catalyzed. In our department, the tele-rehabilitation for outpatient cognitive training has been launched since October 2021.
Objectives :
To examine the effectiveness of tele-rehabilitation cognitive training to improve cognitive function and reinforce brain health behavior in patients with Mild Cognitive Impairment (MCI).
Methodology :
The SOPD patients referred to our department were screened from October 2021 to October 2022. Inclusion criteria included patients who: 1. were aged above 60; 2. scored Montreal Cognitive Assessment Hong Kong Version (HK-MoCA) between 2nd to 16th percentile, indicating MCI; and 3. had a device compatible with Zoom.
Participants attended 5 face-to-face and 3 Zoom sessions. Each session consisted of brain health exercise, training on multiple cognitive components and home program. Assessments were conducted before and after training. A feedback questionnaire was also collected.
Result & Outcome :
Six female patients (mean aged 73.17) were recruited. The HK-MoCA median score improved from 17.5 to 18 (p=0.141), whilst “executive function” showed the most obvious improvement among all domains with the median score raised from 1 to 3 (p=0.257). The median score of Digit Span Forward Test and Occupational Questionnaire increased from 7 to 8 (p=0.102) and 17.5 to 21 (p=0.157) respectively. The scores showed an increased tendency. However, statistically significance was not achieved, possibly due to small sample size.
The attendance rate was 83.75% which was satisfactory. 100% participants was willing to pay for the tele-rehabilitation service, and agreed that “the program provided effective treatment” and “close communication with the therapist was maintained”. Yet, a diverse result was shown in “whether telecare was better than face-to-face service” (both “disagree” and “neutral” comprised 33.3% whilst both “agree” and “highly agree” comprised 16.7%).
In conclusion, this program tends to be effective to improve cognitive function and reinforce brain health behavior in MCI patients. The tele-rehabilitation service gains positive feedback from our patients.
In future, tele-rehabilitation can supplement the conventional service to fill the current service gap. Macroscopically speaking, tele-care service promotes more equal access to our healthcare services for all patients, especially for those who have difficulty in accessing the hospital.
