Authors (including presenting author) :
Hui WW(1), Chan MYR(1), Cheong KN(2), Choi F(2), Ho YB(1), Chan NC(1)
Affiliation :
(1)Allied Health Department (Physiotherapy), Hong Kong Children’s Hospital, (2)Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital
Introduction :
Discharge home planning and the pertinent mobility training has always been a core physiotherapy domain, and is the ultimate goal of the medical and rehabilitation team. Under the context of COVID-19 pandemic, much of the rehabilitation service mode is revamped with technology to minimize face-to-face contact. HKCH physiotherapists adopted the concept of Virtual Tour, invited caretaker to prepare first-person perspective video and floor plan, and then rebuilt the home scene within the physiotherapy department for home environment-targeted precision training. The advantages of this approach are multifold, including infection control under the current pandemic situation, increased efficiency, optimization of manpower, conferral of active role to caretaker, and most crucially, the provision of an opportunity for the family to rehearse the home return scenario. With the employment of technology, the quality of our home visit service is not hampered nor restricted by infection control measures.
Objectives :
The case report aims to introduce a new method of virtual home visit under the COVID-19 pandemic as an alternative to conventional home visit, so as to minimize infection risk while maintaining quality professional physiotherapy service.
Methodology :
A virtual home visit was carried out for a 13-year-old patient with mixed connective tissue disease who has been hospitalized for 3 months due to multi-organ dysfunction and post-ischaemic limbs injuries. At the time of the patient's home leave planning, his mobility level was an indoor walker for 10 metres with moderate assistance and minimal hand function. The caretaker was invited to prepare first-person perspective video and to provide a floor plan with measurements for us to rebuild the home scene within the HKCH physiotherapy department. Home environment-targeted precision training, carer education on handhold and safety measures were performed and discussed under the simulated home environment.
Result & Outcome :
Home scene reconstruction and simulation was performed at the HKCH physiotherapy department for 10 sessions. The patient's home was reconstructed with existing rooms in the physiotherapy department, with the width and height of corridors and furniture adjusted to real-life measurement. Functional training such as sitting to standing, walking over door threshold and wheelchair transfers was performed accordingly. Home modifications were carried out with instructions for caretaker to clear up household clutter and to place furniture at appropriate places for support. No other major modifications were required. The caretaker and the patient acquired proper handling skills and were then competent and confident to return home in a month’s time. Both the caretaker and the patient reported the home return to be smooth and safe, and the practice was deemed to be helpful. The caretaker and the patient were satisfied with the simulated home training. The overall satisfaction was reported to be 9 and 10 by the caretaker and the patient respectively on a numerical rating scale of 0 to 10.
