Authors (including presenting author) :
Mo KC(1), Ng MW(1), Lee KL(2), Ip YK(2),Wong WY(1), Tsang HC(1), To YL(1), Lam CW(2), Sun TF(3)
Affiliation :
(1)Physiotherapy department, North District Hospital,(2)Psychogeriatric outreach team, NTEC,(3)Hospital Chief Executive Office, North District Hospital
Introduction :
Physiotherapy (PT)-led Multi-modal Stimulation and Movement program was launched in 2011 for NTEC Psychogeriatric (PG) clients living in private old-aged homes (OAHs). Structured program with group intervention incorporated with multi-modal stimulation exercise was conducted.
Since 2020, the program was re-modeled into an intensive individual cognitive-Physiotherapy training, to adopt to anti-COVID pandemic policy in maintaining social distancing and avoiding group activities. The major changes were as follows:
1. Group activities re-designed into individual training
2. Program length shortened from 24 sessions to 10 sessions
3. Outcome measures for cognitive-physical domain added.
Objectives :
To evaluate the effectiveness of individual cognitive-physiotherapy program in NTEC PG outreach service.
Methodology :
The outcome measures collected from November 2020 to March 2022 in NTEC PG physiotherapy outreach services were reviewed. Data collected before and after program was compared by paired t-test.
Outcome measures used to measure dual-task performance by Timed Up and Go Test with a cognitive task(TUG-cognitive), cognitive performance by Montreal Cognitive Assessment(HK-MoCA and HK-MoCA alternate version 1), total muscle strength by total grip strength, functional mobility by Elderly Mobility Scale, balance Berg Balance Scale, mood by Cornell Scale for Depression in Dementia(CSDD) and severity of behavioral and psychological symptoms of dementia(BPSD) by Neuropsychiatric Inventory(NPI).
Result & Outcome :
[Data in (means ± standard deviation)]
There were 89 participants completed the individual cognitive-physiotherapy program, among which 33 (37.1%) participants were able to walk with supervision or independently. Within the mobile group, the mean age of participants was 80.2±8.4 (Range: 66-96) years old, they attended 10.1±1.9 (Range: 6-14) sessions in average. Sixty-four percent of participants were female. Fifty-five percent participants were diagnosed with Dementia and 33.3% participants were diagnosed with Schizophrenia.
Participants’ dual-task performance improved from 35.2±17.1 seconds to 30.9±15.8 seconds (p=0.021). Cognitive performance improved from 9.5±7.0 points to 10.3±7.2 points (p=0.039). Whereas total muscle strength increased from 19.0±12.3 kg to 21.9±12.4 kg (p=0.037)
Other domains, including functional mobility, balance, mood and severity of behavioral and psychological symptoms of dementia(BPSD) were largely maintained or mildly improved without statistically significant differences.
To conclude, PG patients were benefited from individual cognitive-physiotherapy program in terms of dual-task performance, cognitive function and physical strength.
