Occupational Therapy Post Acute Rehabilitation Program for patients after Total Knee Replacement in PYNEH

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Authors (including presenting author) :
Leong MW(1), Ho MS(1), Yuen PL(1), Ng PL(1)
Affiliation :
(1) Occupational Therapy Department, Pamela Youde Nethersole Eastern Hospital
Introduction :
To shorten the length of stay for patients undergoing Total Knee Replacement (TKR), fast-track approaches were well established with multidisciplinary collaboration. Clinical pathways with Early Recovery After Surgery (ERAS) has been started at PYNEH since 2017. As recent study has suggested that multidisciplinary rehabilitation during post acute phase can further optimize lower limb muscle strength and function, Occupational therapist is involved during this ambulatory stage which aims to provide extensive ADL training and rehabilitation so as to facilitate the functional recovery and hence enhance QoL.
Objectives :
To evaluate the effectiveness of a comprehensive OT rehabilitation program for patients after TKR during post acute phase
Methodology :
Patients after TKR, who were referred to Out-Patient Clinic of Occupational Therapy Department, started training immediately within one week. Eight to ten sessions of training with content included scar management, ADL training, functional strengthening and home program were provided during therapeutic sessions. Assessments were conducted on 4th week and 8th week post operatively during follow up. Outcome measures are Modified Barthel Index (MBI), Fall Efficacy Scale (FES-I (CH)) and Knee Injury and Osteoarthritis Outcome Score (KOOS).
Result & Outcome :
From May 2017 to Nov 2018, total of 131 patients (95 Females & 36 Males) with mean age of 69.67 were recruited in this study. Significant improvement was shown in ADL by MBI (p< 0.001) and patient-reported functioning by KOOS- ADL(p< 0.000) as well as QOL by KOOS – QOL (p< 0.005) after the rehabilitation program. Significant reduction in FES-I(CH) (p< 0.002) was also found between pre-op, post-op 4/52 and post-op 8/52. Occupational Therapy rehabilitation program for patients after TKR in ambulatory phase can enhance ADL functions and fall efficacy as well as to improve QoL.

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