Authors (including presenting author) :
Kwok TKK, Leung WMP, Heung HMT, To WKR, Mak MYM
Affiliation :
Department of Physiotherapy, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong SAR
Introduction :
Medical social collaboration (MSC) programme is a new collaborative programme between Hospital Authority and Social Welfare Department from 2018. It is an out-reach home based programme composed of rehabilitation, home care and respite care. The ultimate aim of this programme is to prevent early institution of the elderly. Its target group is mainly elderly patients with stroke or facture with impaired activity of daily living and mobility. It adopts a case management model, and hence, apart from providing home based rehabilitation, physiotherapists also participate in multidisciplinary case conference to make individual care plan for patients.
Objectives :
To determine the effectiveness of home based physiotherapy programme under Tuen Mun Hospital (TMH) MSC programme in improving mobility and balance of patients with stroke or fracture hip.
Methodology :
This was a retrospective study. Patients with stroke or fracture hip who had completed TMH MSC programme and referred for physiotherapy were analyzed while patients who were re-admitted or referred to Geriatric Day Hospital were excluded. The home based physiotherapy rehabilitation included mobility training, pain management, fall prevention and care-givers empowerment. Outcome measures were (1) Modified Functional Ambulation Classification (MFAC) for categorizing functional ambulation ability (2) Elderly Mobility Scale (EMS) and (3) Time Up and Go Test (TUGT) for assessing mobility (4) Berg Balance Scale (BBS) for static and dynamic balance abilities.
Result & Outcome :
From March to September 2018, a total of 54 patients (27 male and 40 female) were analyzed. The mean age of patients was 76.8 and they attended an average of 6.8 sessions of home base physiotherapy training. 42.6% of patients were cases with fracture hip and 57.4% of patients were cases with stroke. All the outcome measures were significantly improved. The post training evaluation of MFAC (from mean value of 5.0 ± 1.6 to 5.7 ±1.6 with p<0.001), EMS (from mean value of 13.8 ± 6.0 to 16.0 ±5.7 with p<0.001), BBS (from mean value of 31.1 ± 17.3 to 37.9 ±18.5 with p<0.001) and TUGT (from 32.8 ± 19.5 to 22.0 ±17.0 with p<0.001) were found to be significantly improved. Our study showed that the mobility and balance of patients with stroke or fracture hip was improved under home base physiotherapy rehabilitation of TMH MSC programme
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