Authors (including presenting author) :
Tang WH(1), Ng KPT(1), Chan OKA(1), Chiu HNJ(1), Ho KYC(1), Kwok TK(1), Lui KST(1), Mak SHT(1), Tse CSS(1), Mak MYM(1)
Affiliation :
(1)Physiotherapy Department, Tuen Mun Hospital, New Territories West Cluster
Introduction :
During COVID pandemic, Geriatric Day Hospital (GDH) service was greatly reduced or even suspended. Telehealth service was one of substitution of the conventional GDH rehabilitation service under this pandemic. However, many elderly have accessibility problem to telecommunication equipment. A hybrid mode of home visit with telehealth under the assistance with PCA was piloted.
Physiotherapists (PT) selected suitable patient with an individualized rehabilitation program. The first home visit was conducted by both PT and PCA. The subsequent home-based training would be conducted by PCA under the real-time supervision by PT through tele-technology (i.e. Zoom). The PT would supervise 2-3 PCA home based visits simultaneously. The PCA would conduct simple assessment, prescribed treatment through the direct instruction and feedback from the PT. Moreover, the patients could communicate with PT via Zoom.
Objectives :
To evaluate the effectiveness of tele-rehabilitation with PCA support
Methodology :
Medically stable patients, who required intensive rehabilitation training were included. The PT would provide the initial and final home visit whereas eight sessions of tele-training were provided by PCA. Timed Up and Go Test (TUG), Elderly Mobility Scale (EMS) and patient satisfaction were assessed as outcome measures. Pre-training and post-training data were analyzed by paired t-test.
Result & Outcome :
17 cases were recruited during the period of May to September in 2021. Among the recruited cases, 8 of them (4 males and 4 females) completed the whole course of hybrid home visit and telehealth training. The mean age was 84.3 with the range from 72 to 92. No adverse incident during tele-rehabilitation was reported. In the Pre and Post comparison, both mean TUG and mean EMS showed improvement without statistical significant difference (TUG mean change= 5.8s, p= 0.089; EMS mean change= 2.25, p=0.072). All patients were satisfied with this service model in terms of training duration, clarity of communication with case PT through Zoom, and confidence building in performing exercises.
The elderly, who need intensive physical training, showed improvement in their physical performance with the hybrid mode of home visit and PCA assisted tele-health service. Although there was no statistically significant difference in physical outcome, it could be considered as an alternative measure under the COVID situation.
