Authors (including presenting author) :
Choi TL(1), Chan WY(1), Tam KL(1), Chan YT(1), Hau CY(1), Cheung TKR(1), Tsang HC(1), To YL(1), Sun TF(2)
Affiliation :
(1)Physiotherapy Department, North District Hospital, (2)Hospital Chief Executive office, North District Hospital
Introduction :
New Territories East Cluster Breast Care Centre located at North District Hospital (NDH) commenced service in late September 2020. Conventional physiotherapy service for lymphoedema management in NDH was not well organized. A new structural physiotherapy service for patients with breast cancer-related lymphoedema and lower limb lymphoedema was therefore implemented since September 2020 to enhance patient service and clinical outcome.
Objectives :
To enhance the physiotherapy service for lymphoedema management
Methodology :
All patients referred for physiotherapy for lymphoedema were recruited to attend class therapy. Data of patients from September 2020 to December 2022 were retrieved and analyzed retrospectively. Subjective and objective assessments included Numeric Pain Rating Scale (NPRS), Numeric Global Rate of Change Scale (NGRCS), The Disabilities of the Arm, Shoulder and Hand (QuickDASH), range of motion of upper limb, hand grip power and hand-behind-back level. Treatments provided included lymphoedema prophylaxis and treatment, pain management, scar management, limb motion training, muscle strength training and home care education.
Result & Outcome :
Results: From September 2020 to December 2022, a total of 66 cases with mean age of 61.24 (range 33-83) were referred for physiotherapy, which included 57 upper limb lymphoedema cases and 9 lower limb lymphoedema cases. The mean waiting time for initial treatment was 2.94 weeks (SD 2.19). The mean attendance was 19.2 (SD 17.46). The mean NGRCS were 6.35 (SD 2.28). Significant improvements were found in upper limb lymphoedema cases in the range of shoulder flexion (from 154 to 164 degree, p<0.001), hand grip power (from 15.4 to 18.5 kg, p=0.004) and hand-behind-back level (from T10 to T8 level, p=0.013). There were also improvements in the range of shoulder abduction (from 155 to 163 degree, p=0.058) and upper limb function (QuickDASH Score) (from 26.7 to 22.2, p=0.064).
Conclusion: Enhanced physiotherapy service for lymphoedema management is effective in providing patient-centered care service. Early physiotherapy is encouraged to enhance clinical outcomes.
