Authors (including presenting author) :
Leung TC(1), Mok SYC(1), Fan WN(1), Poon LY(1), Wong SW(1)
Affiliation :
(1) Physiotherapy Department, United Christian Hospital
Introduction :
Recent local studies indicate a nearly threefold increase in the prevalence of overweight and obesity among school-aged children in Hong Kong [1]. Obstructive sleep apnea (OSA), a common comorbidity of obesity, now affects about 5% of this population which is alarming when comparing with the 1.5% projection two decades ago [2][3]. Exercise achieves weight loss and indirectly manage OSA, and the effectiveness would be further enhanced by incorporating Oro-motor Myofunctional Therapy (OMT) into the treatment [4][5]. A dedicated multidisciplinary team was formed and conducted a year-long pilot with hybrid mode of physiotherapy (Face-to-Face and Telecare) to address the long-term health and social impacts of obesity paediatric patients with OSA in United Christian Hospital (UCH).
Objectives :
This abstract reports the design, implementation and result of this pilot program in which effectiveness of the hybrid mode of physiotherapy as one of the core components was evaluated.
Result & Outcome :
The multidisciplinary team includes Paediatricians, Physiotherapists, Dieticians, and Childlife Specialists. Inclusion criteria covered children aged six or above, BMI 26-30 and with OSA requiring non-invasive ventilation (NIV). Nine kids were recruited.
The service was a one-year program with ten sessions of Physiotherapy, which started with four weekly sessions emphasizing on education and exercise for weight management and OMT training. Follow-ups were conducted via tele-consultation monthly to bimonthly to ensure compliance amidst busy schedule. Exercise prescription and education material dissemination via HA Go was utilized for family empowerment. Assessments were conducted at first visit as baseline, at 6th visit, and at the last follow-up. Outcomes including BMI, body-fat percentage, physical functions, tongue performances, apnea-hypopnea Index and sleep-related questionnaires were measured.
Results revealed varying degrees of success at the one-year mark. Qualitative interviews indicated that compliance with the program and home exercises significantly influenced outcomes. Participants demonstrating high compliance showed marked improvements in BMI, body fat composition and tongue performances. One case successfully discontinued NIV. Families with fair compliance reported time constraints due to academic pressure and motivational challenges as barriers. Comparing with past results, the hybrid model demonstrated a higher attendance rate than conventional face-to-face mode, which strongly indicated the beauty of telecare in term of convenience for home-based training.
This pilot program highlighted the efficacy of evidence-based physiotherapy interventions to families with obesity and OSA and shed light on the paramount components for effecting change in families. Future interventions could include flexible scheduling, enhanced family engagement strategies, and ongoing motivational support through regular check-ins and interactive educational resources.
