Authors (including presenting author) :
Chan SW(1), Yeung SS(1), Fong YH(1), Lam LY(1), Wong CKC(1), Chan WKV(2), Chan PK(2), Chiu KY(2)
Affiliation :
(1)Physiotherapy Department, MacLehose Medical Rehabilitation Centre, (2)Department of Orthopaedics and Traumatology, Queen Mary Hospital
Introduction :
The Structured Non-surgical Treatment Program (SNTP) has been launched in MacLehose Medical Rehabilitation Centre (MMRC) since July 2022 for patients waiting for Total Joint Replacement (TJR). Due to the increasing waiting time for surgery, it is crucial to empower patients in developing an exercise habit and improving exercise compliance to maintain an active lifestyle in the community.
Objectives :
To develop an exercise class structure that improves patients’ exercise compliance and enhances self-management skills.
Methodology :
SNTP in MMRC was conducted with a maximum of 12 patients per group. There were 7 sessions with visual and audio aids: a PowerPoint with voice-over narration regarding their condition; an exercise pamphlet; an exercise flowchart on a whiteboard and training videos prescriptions via the HA Go mobile application. Patients chose their music preferences and shared experiences. Rewards were provided for patients with good exercise compliance. Outcomes were evaluated from July to November 2022: sessions attended per patient, default rate, the Self-Efficacy for Exercise Scale (SEE), the patient satisfaction questionnaire, knee pain by the Numeric Pain Rating Scale (NPRS), the Knee Injury and Osteoarthritis Outcomes Score in pain (KOOS-P), physical function (KOOS-PS) and quality of life (KOOS-QoL) and the 30-second Chair Stand Test.
Result & Outcome :
219 new patients attended SNTP which expanded from 17 to 59 new patients in July and November 2022 respectively. 84.5% of patients attended more than 4 sessions out of 7 with a low default rate (4%). 55 patients attended additional sessions to further optimize their physical condition. The SEE improved from 4.2 ± 2.4 to 4.9 ± 2.4 (p<0.0005). A patient satisfaction score of 9.4 ± 0.9 out of 10 was achieved. Pain at rest decreased by 0.6 ± 2.7 (p=0.004), KOOS-P improved by 3.9 ± 13.8 (p<0.0005), KOOS-PS improved by 1.4 ± 9.3 (p=0.035) and 30-second Chair Stand Test improved by 3.8 ± 3.8 (p<0.0005). In conclusion, SNTP in MMRC acts as a steppingstone for patients to reduce sedentary behaviors, which can be promulgated to the community and carried over in community health centres in the future.
