Authors (including presenting author) :
Ng LY (1), Chan CC (1), Ng YL (1), Cheung WY (2), Wong YW (2), Wong CK(3), Lo Estella (4)
Affiliation :
(1) Department of Occupational Therapy, MacLehose Medical Rehabilitation Centre
(2) Department of Orthopaedics and Traumatology, Queen Mary Hospital
(3) Department of Physiotherapy, MacLehose Medical Rehabilitation Centre
(4) Department of Nursing, MacLehose Medical Rehabilitation Centre
Introduction :
Osteoporotic vertebral fractures (OVF) are associated with pain, reduced mobility, social participation and quality of life. Early and suitable intervention to patients can improve the outcomes, reduce the re-fracture rate and hospital re-admission. In July 2022, the multidisciplinary day rehabilitation program was established in MacLehose Medical Rehabilitation Centre to provide early and one-stop service to patients suffering from OVF. In order to enhance the fall prevention and decrease the fear of fall, OT adopted LiFE program which promote functional-based activity training in OVF management. LiFE program is an evidence-based program which can reduce the fall risk of elderly. The training activities prescribed in this program are referenced to the Occupational Therapy Reference Manual of Lifestyle Integrated Functional Exercise.
Objectives :
To evaluate the outcomes of OVF patients joining the rehabilitation program
Methodology :
Apart from doctor’s osteoporosis management and nursing assessment, occupational therapist(OT) and physiotherapist(PT) conducted average 10 training sessions (9-13 sessions) in the program, aimed to minimize disease impacts and enhance the functional recovery of patients with OVF. OT provided education in home safety, fall prevention and back care in ADL. For the LiFE program, patients were taught and practiced 2-3 home-based activities with strengthening and balance component, followed by discussion to integrate the activities to daily routine. Patients’ compliance was reinforced by individual review and planning in each session. Supplementary materials prescribed by means of video through HA GO and booklets to enhance the information access by the patients.
Pre and post training assessment conducted at the first session and last session. The outcome measures used were Modified Barthel Index (MBI), Instrumental Activity of daily Living (IADL), Short Physical Performance Battery (SPPB), Fall Efficacy Scale (FES) and Life Space Index (LSI).
Result & Outcome :
From Jul 2022 to Jan 2023, Forty-two cases (female 83%; male 17%) attended the program. The mean age was 76.3 years old. 50% of patients had history of fall in recent 4 months. Forty cases completed the program and final assessment. A Wilcoxon Signed-Ranks test indicated that the post-program scores were significant improved in the IADL (Md=+2.5 z=-4.05, p=0.000), FES (Md=+11, z=-3.804, p=0.000), SPPB (Md=+2. z=-3.878, p=0.000), LSI (Md=+2, z=-3.937, p=0.000), compared with the initial scores.
Conclusion
Occupational Therapist successfully applied LiFE intervention in the day rehabilitation program for patients with OVF. The improvement including the functional performance in IADL and confidence in activity participation.
