Authors (including presenting author) :
Lam CCS(1), Leung AKY(1), Leung NC(1), Lui JTC(1), Wong AHY(1), Louie FTM(1)
Affiliation :
(1) Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
Introduction :
Splinting, education and exercise are the common non-surgical interventions for patients with carpal tunnel syndrome (CTS) provided by occupational therapist. Patients used to attend 4-6 face-to-face individual or group sessions in occupational therapy department (OTD). Under the COVID-19 pandemic, in order to minimize public gathering, face-to-face group education class to CTS patients were suspended. With advancement in mobile and communication technology, home-based online CTS program was integrated in our usual practice.
Objectives :
To evaluate the effectiveness of the pilot tele-care program on CTS.
Methodology :
The program has been started in OTD of Alice Ho Miu Ling Nethersole Hospital since March 2021. CTS patients who were referred to OTD and able to use Zoom with smartphone were eligible for recruitment. The program composed of 4 sessions: 3 individual face-to-face consultations for assessment and splint fabrication and 1 online Zoom class composed of CTS pathology education, activity modification and home exercises. 50 patients have completed the program. Pre- and post-program outcomes were measured including verbal rating scale (VRS) on numbness, Phalen’s test in seconds, grip strength and Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) score. Patient satisfaction on the program was assessed with 5 questions on a 5 point-likert scale from 1 (strongly disagree) to 5 (strongly agree). It was collected at the last session. Paired t-test with significance level of p< 0.05 was performed.
Result & Outcome :
The mean age of our subjects was 52 with 6(12%) male and 44(88%) female. There were significant improvements in functional outcomes: VRS on numbness (6.12 vs 3.98, p<0.001), Phalen’s test in seconds (21.82 vs 38.20, p<0.001), grip strength (20.71 vs 22.58, p=0.003) and QuickDASH score (33.67 vs 27.24, p=0.001). For the patient satisfaction, 96.5% of subjects strongly agree or agree that the program was beneficial to their conditions and gained more understanding of on their disease. There were 93.1% of subjects strongly agree or agree that they had learnt some specific ways to reduce symptoms. 62.1% and 65.5% of the subjects strongly agree or agree that they had confidence in controlling their symptoms and felt their symptoms had improved respectively.
Conclusion:
The pilot hybrid program with tele-care for CTS patients can improve their symptoms and hand function.
