Authors (including presenting author) :
CHAN HTF (1), LAM WSV (1), TO WKR (1), MAK MYM (1)
Affiliation :
Physiotherapy Department, Tuen Mun Hospital
Introduction :
Infection control is essential to avoid healthcare associated infections and risk of outbreaks in out-patient care. In response to the COVID-19 pandemic, a new service provision of Knee Care and Exercise Program (KCEP) with ESCAPE (Enabling Self-management and Coping with Arthritic Pain using Exercise) approach was established for patients with Knee Osteoarthritis (OA knee) with the use of tele-materials and HA Go platform.
KCEP aims to equip patients to perform home exercise and self-care with the help of newly produced self-empowerment video and newly designed booklet. Educational video and electronic materials were provided in advance to the initial physiotherapy appointment to enhance massages delivery in patient education. With the implementation of KCEP, a social distancing could be maintained in the congested out-patient consultation area as the duration of stay and treatment sessions could be reduced but keeping similar clinical effectiveness.
Objectives :
This study aims to evaluate the effectiveness of KCEP in Tuen Mun Hospital(TMH).
Methodology :
Patients aged above 45 referred for physiotherapy with diagnosis of OA knee solely (unilateral or bilateral) were recruited to the KCEP in TMH. In the first session, video education followed by individual assessment, consultation and exercise training were given. For patients with high irritability, electro-physical modalities and acupuncture treatment would be provided for pain relief. For patients with low irritability, home exercise and self-management techniques were educated. More techniques and exercise were introduced through individualized sessions and tele-materials, together with the use of HA Go Application. Patients would be discharged when they were confident to continue home program.
Outcome measures for the evaluation included the number of attendance, Numeric Pain Rating Scale (NPRS), Numeric Global Rate of Change Scale (NGRCS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) (HK Chinese version). Assessment was done in the initial and final session.
Result & Outcome :
64 patients (20 male, 44 female, mean age = 65.19±7.7) were recruited for the KCEP with mean attendance of 4.22±2.6 sessions. Comparing the initial and final sessions, the NGRCS improved from 0.16±1.03 to 4.41±2.3 (p< 0.05) and the pain level decreased from 6.16±1.98 to 3.45±1.86 (p< 0.05). Significant improvement was shown in the all KOOS subscales: pain score improved from 52.80±19.80 to 61.84±21.19 (p< 0.05). Physical function score improved from 59.19± 23.37 to 65.05±23.53. Quality of life score improved from 43.08±22.16 to 51.50±21.89 (p< 0.05). KCEP was shown to be effective in helping the pain control, physical function, knee-related quality of life for people with OA knee. This may be a new service delivery model in the future.
