Authors (including presenting author) :
Lam HW(1), Cheung WL(1), Lam CM(1)
Affiliation :
(1)Occupational Therapy Department, Tuen Mun Hospital
Introduction :
With raising burden on global health-care system, the concept of incorporating advanced technologies into new era of stroke rehabilitation has gained popularity, in addition to conventional and labor-intensive manually-assisted occupational therapy (OT) intervention with evidence-based benefits in motor recovery and functional improvement. Incorporation of advanced technologies, including VR systems, motion tracking sensors, exoskeletons, and hand robotics, were commenced to rehabilitation service model in Rehab Stroke Unit (RSU) of Tuen Mun Hospital (TMH) since year 2020/21. Structured technologies-aided rehabilitation programs and protocols on activities of daily living (ADL) and upper limb (UL) functions were developed.
Objectives :
The study impact of technologies-assisted OT intervention on functional recovery of stroke patients in TMH.
Methodology :
The clinical outcomes of stroke patients discharged from TMH from 4/2019 to 3/2022 were evaluated. ADL performance and UL function outcomes assessed by Modified Barthel Index (MBI) and Functional Test of Hemiplegic Upper Limb (FTHUE) were obtained at admission and discharge.
Result & Outcome :
1424 stroke patients were discharged from TMH from 4/2020 to 3/2021. For ADL performance, mean change in MBI score of stroke patients was 10.3, 28.8% higher than Hospital Authority (HA) benchmark. For patients with initial MBI score 0-40 and 41-85 in TMH, mean change of MBI score was 16.9 and 12.6 respectively, 42% and 40% higher than same patient groups in HA benchmark respectively. For UL function, mean change in FTHUE score was 1, which aligned with HA benchmark. For longitudinal comparison of functional outcomes, 1309 stroke patients discharged from TMH RSU from 4/2019 to 3/2021 were analyzed. For ADL performance, mean changes in MBI score of stroke patients with initial MBI 41-85 were 13.18, 14.98 and 17.64 for year 2019/20, 2020/21 and 2021/22 respectively. The mean changes in MBI score improved 13.7% in 2020/21 and 33.8% in 2021/22 when compared with 2019/20. For UL function, there was no distinct difference found in mean change of FTHUE from 2019 to 2022. The integrated technologies-aided OT interventions enhanced intensive and repetitive trainings on ADL performance, and was proven to be more effective in functional improvement of stroke patients than convention OT intervention alone. By continuous incorporation of emerging advanced technology to OT interventions in stroke rehabilitation, feasibly a greater reinforcement in functional recovery of patients could be resulted along their journeys of rehabilitation.
