Authors (including presenting author) :
Cheng P (1), Ng CM (1), Lam PL (1), Poon GWK (2)
Affiliation :
(1) Physiotherapy Department, Queen Mary Hospital
(2) Department of Paediatrics & Adolescent Medicine
Introduction :
The rate of obesity of adolescents has been growing for the past decade in Hong Kong. It has become an increasing concern due to the rising prevalence of associated co-morbidities such as metabolic syndrome and diabetes, obstructive sleep apnoea syndrome and psychosocial impairments early in life.
Adolescents who are severely obese with serious co-morbidities may require bariatric surgery consequently. Prior to the decision of surgery, increasing physical activity and lifestyle modification are important aspects in sustainable weight loss. Physiotherapy Department of Queen Mary Hospital has developed a PTPWCP since July 2016 for obese adolescents who might require bariatric surgery.
Objectives :
To evaluate the impact of the PTPWCP on physical fitness and psychosocial aspect of this group of patients.
Methodology :
Patients were referred to the PTPWCP by paediatricians at the Joint Paediatric Bariatric Clinic. The program consisted of an interview, educational talk, individualized exercise prescription to patients and their parents in the first session. Evaluation, advice on exercise and life style modification were then provided in every subsequent session quarterly. Outcomes including Body Mass Index (BMI), 6 min walk test (6MWT) distance, VO2max by submaximal treadmill test, 1 minute sit up test score, sit-and-reach test score and hand grip strength were taken in every session. Patients were discharged when reached 18 years old or bariatric surgery was no longer considered. Patients or parents were asked to fill in a service evaluation questionnaire after completion of 2 or more sessions. Data from 20 Jul 2016 to 31 Aug 2018 were collected and analyzed.
Result & Outcome :
15 patients (7 males), with mean age 15.4 years and mean initial BMI 36.4 kg/m2, were referred to the program. 10 patients completed 2 to 5 sessions and outcomes were compared between the first and the last session. There was a significant increase of left hand grip strength from 31 to 36 (kg) (p=0.02). No significant change was found in all other outcomes. 6MWT distance improved from 461m to 504m but was not statistically significant (p=0.08). For service evaluation, patients and parents gave high ratings in overall satisfaction score. 80 % and 90% of them believed this program has changed their exercise habit and increased their confident in controlling body weight respectively.
This suggested that the PTPWCP enhanced life style modification and psychosocial support to severe obese adolescents. The program also trended towards improving functional capacity of them.
Co-location with:
