The Evaluation of Pre-Operation Physiotherapy Clinic service for Thoracic Surgery patients

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Authors (including presenting author) :
Tsang RSW, Wong KCY, Fong PWK, Yeung AKC, Wu ECM, Siu EHK
Affiliation :
Physiotherapy Department, Prince of Wales Hospital
Introduction :
A trial Pre-operation Physiotherapy Clinic was established in October 2018 and jointly works with the Pre-operation Thoracic Clinic to facilitate same-day admission and better rehabilitation outcomes. Patients were sent from the pre-op thoracic clinic 1-2 weeks before operations. The clinic consists of chest assessment, home-based prehabilitation programme and post-op management. For prehabiltation programme, it included exercise knowledge and a practical session of cardio-pulmonary exercise. For post-op management, it included inspiratory muscle training and sputum clearance technique.
Objectives :
To investigate 1) Patient’s satisfaction with the pre-op physiotherapy clinic service 2) Patients’ knowledge of their current conditions and prehabilitation programme 3) Patients’ exercise tolerance after the prehabilitation programme 4) Hospital length of stay (LOS) with pre-op physiotherapy clinic.
Methodology :
A questionnaire was used to evaluate the satisfaction of the prehabilitation program, post-operation management and overall service. A short quiz was given at the beginning and by the end of the clinic to assess patients understanding on information; the result was analyzed by paired t-test. Six-minute walk test (6MWT) was used to evaluate the exercise tolerance of patients before and after prehabilitation program. LOS was calculated as time differences of the discharge and the admission date.
Result & Outcome :
Sixteen men and twelve women were recruited with a mean age of 60. The questionnaire reflected that patients are satisfied with prehabilitation program, post-op management and overall service (average score 89%, 89% and 95% respectively). The result of the quiz showed that patients significantly improved their knowledge on exercise and programme information. (p<0.001) For exercise tolerance, there is a 13.3% increase in 6MWT distance. The hospital LOS without pre-op physiotherapy clinic and pre-op thoracic clinic was an average of 6.27 days, while LOS with both clinic is average 3.4 days (reduced average 45.8%). To conclude, pre-operation physiotherapy clinic is a new service as compared with the traditional pre-op inpatient physiotherapy service. Although prehabilitation program cannot be proven to improve exercise tolerance of patient in this study, many studies have shown a positive effect on it. Pre-op physiotherapy clinic helps to reduce hospital LOS and facilitate same day admission. This clinic is beneficial to thoracic surgery patients and maybe is a trend for other kinds of operation in the future.

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