Authors (including presenting author) :
Cheuk HW(1), Chung PH(1), Lau FO(1)
Affiliation :
(1)Physiotherapy Department, Tai Po Hospital
Introduction :
Tai Po Hospital is one of the SCI Rehabilitation Centre in Hong Kong for more than 10 years. Our services were guided by the SCI physiotherapy rehabilitation guideline. This review focuses on the outcome evaluation from year 2011 to 2020.
Objectives :
To review our SCI physiotherapy service through outcome evaluation from year 2011 to 2020.
Methodology :
Subjects were all the patients discharged from TPH SCI rehabilitation program in 2011 to 2020. Descriptive statistics were used for analyzing demographic data. Pre and post physiotherapy treatment program outcome indicators were measured, recorded and analyzed by inferential statistics. Statistical significance was set at p-value < 0.05.
Result & Outcome :
There were 285 SCI cases discharged with mean age 61.98±15.185 in 2011 to 2020. 68.1% of them were male while 31.9% of them were female. The most comment injury mechanism in our patients were ossification of posterior longitudinal ligament (OPLL) and related complications (18.7%). The second one was fell on the same level (16.3%) and the third one was infection or spondylodiscitis (13%). Out of the 285 discharged patients, 20 of them did not have Neurological Level of Injury (NLI) or the ASIA Impairment Scale (AIS) assessed and therefore 265 patients were recruited in the outcome analysis. 108 (37.9%) of them were motor incomplete tetraplegia (AIS C+D) who continued dominance in our SCI clients. The youngest group of patient was motor complete tetraplegia (AIS A+B) with mean age 50.92±16.253. The admission and pre-discharge measurement of NLI and AIS were mostly stayed the same. 97.2% patients lived at home pre-morbidly. 66.5% of them returned home upon discharge. 3.9% of them were discharged to others’ home. 17.4% of them were discharged to old age home. 12.1% of them were discharged to New Page Inn temporarily and would be back home afterwards. Motor complete tetraplegia has the longest mean length of stay (241.2±340.999 days) as they were the most disabled client and needed more time for placement. There was statistical significant difference (p< 0.05) demonstrated in the pre and post Modified Functional Ambulation Category, Elderly Mobility Scale, Modified Barthel Index (MBI) transfer, MBI ambulation, MBI wheelchair and MBI stair in motor complete paraplegia, motor incomplete tetraplegia and motor incomplete paraplegia. These implied that the patients’ functional mobility including bed mobility, transfer function, walking ability, and wheelchair control were improved after our intervention. We should stay focus on enhancing the functional mobility of our clients. On the contrary, for the motor complete tetraplegia, there was no significant differences demonstrated in all chest function related outcomes which included peak cough flow rate, maximal inspiratory pressure, maximal expiratory pressure and vital capacity. We may not need to measure the listed chest function related outcomes in future as it was difficult to measure and remain static in this group of client.
