Authors (including presenting author) :
Choi YYJ(1), Chui KW(1), O HH(1), Mok YT(1), Leung YYC(1), Wong TWL(2)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital, (2)Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University
Introduction :
Under the COVID-19 pandemic, Geriatric Day Hospital (GDH) of Princess Margaret Hospital (PMH) has been modified from whole-day to half-day service since late October 2020 for better disease prevention while continuously providing active rehabilitation and supporting patients to reintegrate into community. Physiotherapy (PT) service of GDH has also been reformed accordingly. As stroke patients is one of the largest group of GDH user, the availability of timely and effective PT service is crucial while complying with infection control measures and social-distancing.
Objectives :
To investigate the effectiveness of half-day PT service of GDH on functional mobility for stroke patients when compared with whole-day service.
Methodology :
55 stroke patients (ICD 430-436.99) who had attended half-day GDH from October 2020 to July 2021 were identified from Clinical Management System and were compared to 197 stroke patients who had attended whole-day GDH from October 2018 to July 2019. Patients were assessed using Timed Up and Go test (TUG) and Modified Rivermead Mobility Index (MRMI) at first and last sessions. Statistical analysis using 2-way repeated-measures analysis of variance was performed by SPSS.
Result & Outcome :
The mean age of half-day group was 68.7±12.6 and 54.5% of them were male. A mean of 10.2 half-day sessions was attended in 10.4 weeks. The mean age of whole-day group was 71.7±11.5 and 58.4% of them were male. A mean of 15.5 whole-day sessions was attended in 9.8 weeks. Difference in subject number between groups was due to a reduction in quota to 20 cases per day since late October 2020 and it was increased to 30 cases per day afterwards. No significant difference was found between two groups in age (p=0.094), gender distribution (p=0.611) and total number of weeks attended (p=0.397). However, the number of attendance of half-day group was significantly lower (p<0.001). No significant time x treatment interaction effect was found for TUG (F=0.554, p=0.458) and MRMI (F=2.029 , p=0.156). Significant improvements in main effect of time in TUG (F=34.072, p<0.001), MRMI (F=44.361, p<0.001) were resulted but no significant difference was found between groups in all outcome measures (TUG: F=2.376, p=0.125; MRMI: F=1.614, p=0.206). Both groups were therefore equally effective. With fewer number of attendance, half-day service reduced the effect of fatigue and the availability of telecare, exercise videos prescription via HA Go and domiciliary physiotherapy led to overall greater effectiveness. Nevertheless, whole-day service remained beneficial for individuals with complex geriatric disorders or psychosocial problem. To conclude, the new half-day GDH service under the COVID-19 pandemic was more cost-effective than the whole-day service in improving stroke patients' functional mobility.
