Authors (including presenting author) :
Lam YT(1), Chan SY(2), Tang SF(1), Ip L(1), Cheng P(1), Lam P(1), Chan NY(1)
Affiliation :
(1)Physiotherapy Department, Queen Mary Hospital
(2)Department of Surgery, Queen Mary Hospital
Introduction :
“I dare not look into the mirror.” – exclaimed by one of the participants before joining the weight management physiotherapy program. Bariatric surgeries had been introduced in Queen Mary Hospital (QMH) to treat severe obese patients since 2007. This service was enhanced with multi-disciplinary involvement in 2020, with surgeons, clinical psychologists, dietitians and physiotherapists worked together to meet this growing demand. Weight management physiotherapy program was launched in QMH Physiotherapy Department in Sep 2020. This service aimed to help patients to develop exercise habit and lifestyle changes before and after bariatric surgery to cope with their weight problem. Before bariatric operation, patients were arranged for prehabilitation to help better prepared themselves for surgery. Patients received aerobic conditioning and light resistance training. They were equipped with essential knowledge on exercise and weight management. The prehabilitation prepared the patient physically, emotionally and mentally for the surgery and optimized post-operative outcomes. Patients were seen immediately after the operation with chest physiotherapy and graded exercise provided. In order to elicit additional cardio-metabolic benefit, patients came back 8-weeks post-operation for a structured exercise program. The program focused on cardio-aerobic exercise, strength training, flexibility and functional exercises in order to keep the weight off and reclaim the health.
Objectives :
To evaluate the effectiveness of weight management physiotherapy program.
Methodology :
Outcome measures including body mass index (BMI), weight, skeletal muscle mass (SMM), body fat mass (BFM), 6-minute walk test (6MWT) and hand grip strength were performed pre-operatively and post-operatively to provide continuous monitoring and to provide timely feedback for patients. Repeated measures ANOVA, paired sample t-test, Friedman test and Wilcoxon signed-rank test were used for data analysis.
Result & Outcome :
Ninety-five patients were recruited from 17 Sep 2020 – 16 Sep 2022. Forty-five patients completed prehabilitation and operation. Twenty-seven patients (8 males: 19 females) completed both prehabilitation and post-operative rehabilitation programs (mean age: 41.9, mean number of sessions received: 11.3). Almost all patients agreed that weight management physiotherapy program service could help changing their lifestyle. 96% of patients had developed exercise habit to cope with their weight problem. In addition, all patients believed that their confidence on weight management had improved. Objectively, statistically significant improvement was found in BMI, weight, BFM and 6MWT in these patients (p < 0.05). Improving trend for activity level was also observed. Weight management physiotherapy program is a safe and effective program. It is important to be part of the essential elements in the journey of weight reduction.
