Authors (including presenting author) :
Mo KC(1), Ng MW(1), Tsang HC(1), To YL(1), Choo KL(2), Sun TF(3)
Affiliation :
(1)Physiotherapy department, North District Hospital,(2)Department of Medicine, North District Hospital,(3)Hospital Chief Executive Office, North District Hospital
Introduction :
The pulmonary system is the system most severely affected by COVID-19 infection. Different patho-physiological events could occur at different levels of the pulmonary system, resulting in diffusion problems predominantly. Evidence has shown that patients with chronic obstructive pulmonary diseases(COPD) who became infected with COVID-19 would be associated with worse clinical outcomes, needing intensive care or mechanical ventilator support. In severe cases, patients with respiratory problems may deteriorate further with frequent exacerbations or hospital admissions even after they have recovered from COVID-19 infection. To support this high-risk group, a home-based rehabilitation program was initiated by NDH Respiratory Collaboration Care Team(RCCT) since the fifth wave of pandemic in Hong Kong. Post-hospital discharge patients were visited by physiotherapists with Respiratory specialists’ support. Chest physiotherapy, oxygen therapy titration, intensive reconditioning exercises training together with tele-care support were provided.
Objectives :
To evaluate the effectiveness of home-based physiotherapy program for post-hospital discharge COVID survivors.
Methodology :
The outcome measures collected from April 2022 to November 2022 in ERV program of NDH respiratory physiotherapy outreach services were reviewed. Data collected before and after program was compared. Outcome measures are used to measure mobility level by Modified Functional Ambulation Classification(MFAC) and exercise capacity by 6-minute walk test(6MWT).
Result & Outcome :
[Data in (means ± standard deviation)] Twelve participants were recruited into the ERV program and seven (58.3%) patients completed the program. Five (41.7%) patients dropped out from the program, three were re-admitted to hospital and two refused service due to financial difficulties. For those who completed the program, five (71.4%) patients had underlying COPD while two (28.6%) patients had pneumonia (one with bacterial pneumonia and one with COVID viral pneumonia) during hospitalization. Three patients with COPD were on long-term oxygen therapy while two (28.6%) patients were using nocturnal non-invasive ventilation therapy for type II respiratory failure. Six (85.7%) patients were able to walk independently in pre-morbid state. The mean program length is 8.43 sessions(range: 6-10 sessions). Regarding the functional outcomes, patients’ mobility level, by MFAC, improved from 4.57±2.30 to 4.86±2.04. Patients’ exercise capacity, by 6MWT, also improved from 72.33±102.88 meters to 99.67±92.38 meters. All seven patients were able to stay at home for more than 28 days without hospital re-admission. To conclude, COVID survivors with significant physical deterioration would potentially benefit from home-based Physiotherapy support in terms of physical performance.
