Authors (including presenting author) :
HU SF(1), Tang SF(1), Wong CK(1), Cheung WY(2), Wong YW(2), Ng YL(3), Lo Estella(4)
Affiliation :
(1)Department of Physiotherapy, MacLehose Medical Rehabilitation Centre (2)Department of Orthopaedics and Traumatology, Queen Mary Hospital (3)Department of Occupational Therapy, MacLehose Medical Rehabilitation Centre, (4)Department of Nursing, MacLehose Medical Rehabilitation Centre
Introduction :
Osteoporotic vertebral fractures (OVF) are common fragility fractures among the elderly. It will lead to severe pain, decreased mobility, lower functional independence and increased risk of relapse. In July 2022, a one-stop and multi-disciplinary orthopaedic day rehabilitation was launched in MacLehose Medical Rehabilitation Centre to restore the physical and functional mobility of OVF patients.
Objectives :
To evaluate the outcomes of OVF patients joining the rehabilitation program
Methodology :
This program is composed of 13 half-day sessions of physiotherapy and occupational therapy training, doctor medical consultation and nursing care advice. Tailored exercise training, postural advice, fall prevention strategies and education talk on back care knowledge are included in the treatment sessions.
The physiotherapy program consists of pain relief modality, core stabilization, limbs strengthening exercises, stretching exercises, balance exercises for functional and gait training. Group exercise and interactive games are designed to improve exercise enjoyment and compliance. Advanced training is also introduced to patients with higher physical ability. To promote long term effect and encourage self-management, home exercise is prescribed through pamphlets and HA Go Application. Exercise compliance is monitored with collaboration with caregivers.
Baseline assessment is performed upon the first visit and the outcome measures used include Numeric Pain Rating Scale (NPRS), Elderly Mobility Scale (EMS) and Roland-Morris Disability Questionnaire (RMDQ). The outcomes are reassessed to evaluate the training effects in the last session. Numeric global rating of change scale (NGRCS) is also measured for the overall change in patient status.
Result & Outcome :
From 4th July to 31th December 2022, 61 patients were recruited. Forty-one of them (35 females and 6 males) completed the program and their mean age was 76.5 years old.
Upon completion, there were perceived improvements in overall status of most patients and the mean NGRCS is +5.14. Significant reduction in NPRS (MD=-2.34, p=0.00) and improvement in EMS (MD=+1.56, p=0.00) were shown, indicating the beneficial effects of the program on pain relief and functional mobility restoration. The significant decrease in RMDQ (MD=-5.95, p=0.00) reflected the reduction of physical disability in the OVF patients.
To conclude, the multidisciplinary rehabilitation program is proved effective for improving of the outcomes of patients suffering from osteoporotic vertebral fracture in terms of pain intensity, physical disability, functional mobility and perceived overall health status.
