Authors (including presenting author) :
Cheng L (1)(2), Tsiim KM(1)
Affiliation :
(1) Physiotherapy Department, Our Lady of Maryknoll Hospital, (2)East Kowloon General Out-patient Clinic, Department of Family Medicine and Primary Heath care Service, Kowloon Central Cluster
Introduction :
East Kowloon General Out-patient Clinic (EKGOPC) Physiotherapy (PT) service provided interventions for musculoskeletal (MSK) cases including minor Soft Tissue Sprain / Strain, repetitive Stress Injury (RSI), degenerative joint pain problems. Most clients had onsets of problems more than 3 months before they received physiotherapy interventions. Literature studies showed that self-management approach improved pain, functions, mood and quality of life for clients with chronic pain (onset more than 3 months). Physiotherapy interventions focusing self-management strategies were adopted in EKGOPC. Clients needed further management in Specialized Out-patient clinic (SOPD) after examination then would be referred to OLMH PT within appropriate time frame.
Objectives :
To review EK PT MSK cases discharged from 04/2020 to 09/2020 and evaluate the effectiveness of the self management of chronic pain model.
Methodology :
Retrospective analysis of data from discharged cases was performed.
Result & Outcome :
171 MSK cases were reviewed. Cases mix, reasons of discharge, scores of Numeric Pain Rating Scale (NPRS), treatment period and number of sessions before discharge were evaluated. Results showed that majority of MSK cases were low back pain (22%), shoulder pain (21%) and RSI e.g. trigger fingers, tennis elbow (19%). 59% of cases reported improvement; 21% reported static progress and 12% reported recovery as reasons for discharge. The NPRS average scoring pre-intervention was 6.4 and post-intervention was 3.9. The average number of PT sessions for completion of treatment was 3.8. Results showed that self management model improved pain and allowed fewer treatment sessions comparing with conventional PT management in chronic MSK cases. Positive feedback from patients included: satisfactory evidenced based advice; clear instructions of home based symptoms relieving methods and exercises. Behavioral modification counselling skills demonstrated by PT facilitated education and improved motivation for self-management. Use of mobile apps (HA GO) helped to deliver educational materials efficiently. Success of the model also relied on clinical support, e.g. reminder phone calls to guarantee good attendance of follow up sessions, especially for elderly clients. Direct referral pathway to SOPD in mother hospital (OLMH) safeguarded clients who had needs of modality-based interventions and intensive rehabilitation. Multidisciplinary allied service were available in EKGOPC. Physiotherapist can advise other professional input to allow holistic care for suitable clients.
