Authors (including presenting author) :
Tang CY(1), IP YC(1), Tam CL(1), Cheung WYW(2), Leung YF(2), Cheng CW(1), Fung YK(1), Au TK(1)
Affiliation :
(1)Physiotherapy Department(IRS), TKOH, (2)Department of Orthropaedics and Traumatology, TKOH
Introduction :
Elderly undergoing total knee replacement(TKR) usually experience difficulties understanding home exercise and transfer techniques, leading to suboptimal post-operative outcomes. Since education materials and exercise videos were separately presented without clear association in traditional pamphlets, compilation of a brand-new physiotherapy education pamphlet with utilization-monitoring QR-codes linking to different tailor-made exercise and practical demonstration videos was proposed.
Objectives :
-To improve exercise compliance and pre-operative physique of elderly undergoing TKR
-To facilitate post-operative functional recovery and early safe discharge
Methodology :
Eighteen audio-visual-supported demonstration videos including therapeutic exercises, transfer techniques and home-care advice were produced by Physiotherapy Department with full support from Department of Orthopaedics and Traumatology of TKOH. Link-management-enabled QR-codes were linked to these videos, by which education material utilization, exercise compliance and effectiveness could be monitored. This pamphlet was distributed to patients in one-day TKR-prehabilitation workshop from 10/2018 onwards. Patients and caregivers were encouraged to review and practice selected exercises and home-care advice anytime, anywhere pre-operatively, during in-patient stay and post-operatively through their handy smartphones.
Pain(NPRS), knee range-of-motion(knee-ROM) and function measured by timed-up-and-go test(TUG) at post-op Day 5-7 and length-of-stay(LOS) were compared between cohorts with(wP) and without(woP) this pamphlet. Satisfaction survey was conducted. Daily one-month total “click” rate of all videos(d1mtCR) was also captured.
Result & Outcome :
In 8-11/2018, 22 out of 42 patients(mean age 70.6±6.0) received the new QR-coded pamphlets. Despite no statistically significant difference between wP and woP, wP experienced less pain and better knee-ROM. wP had significantly better TUG performance(43.1sec vs 63.6sec; p<0.01) and achieved discharge criteria earlier as reflected in shorter LOS(5.7days vs 7.9days; p<0.001) and no unplanned readmission within 2 months. More than 90% of patients satisfied with this pamphlet for the reason of improved user experience in this pamphlet that could enhance their understanding of the importance of physiotherapy training to post-operative TKR recovery and motivate them to perform home exercise through those convenient QR-codes with their handy smartphones. The fact of patient satisfaction has also been supported by the steady d1mtCR of >195 since 11/2018.
Conclusion:
This brand-new QR-coded pamphlet was an effective mode of patient education to (1)enhance patients’ and caregivers’ understanding of TKR rehabilitation journey, (2)facilitate early safe discharge, (3)monitor exercise compliance and (4)review exercise effectiveness.
Co-location with:
