Authors (including presenting author) :
Cheung CY(1), Cheng KHW(2), Chin PH(2), Chan YLD(1), Lau WLC(1), Kan HY(1), Lau KF(1), CHOW TC(1)
Affiliation :
(1)Occupational Therapy Department, Kowloon Hospital, (2)Orthopedics & Traumatology Department, Queen Elizabeth Hospital
Introduction :
Occupational therapy emphasizes using meaningful activities to achieve desired outcomes. Our department has introduced an alternative rehabilitation model, the group task-oriented circuit training (GTCT) model for geriatric hip fracture in-patients, with the integration of the Rehabilitation Activities Management System (RAMS). Unlike the conventional OT hip fracture rehabilitation which consists of component-based preparatory training and individual-based activities of daily living (ADL) training, this model combines ADL task-oriented circuit trainings, which focus on practicing daily life tasks, followed by an ADL group.
Objectives :
Explore the effectiveness of the new GTCT model in promoting (1) functional independence, and (2) self-efficacy in geriatric hip fracture in-patients.
Methodology :
Patients aged 60 or above, community-dwelling, sustained a hip fracture with operational management done, with cognitive level enabling them to follow intervention, and being admitted to Kowloon Hospital were recruited in the study. The conventional group (18 subjects) was taken as the historical control, with the data retrieved from October to December 2023, while the experimental group (16 subjects) implementing GTCT model was taken as the prospective cohort from January to March 2024. The pre- and post- Modified Barthel Index (MBI) and Fall Efficacy Scale (FES) were assessed and compared among both groups. Patients’ feedback from the experimental group was collected for qualitative evaluation.
Result & Outcome :
With no baseline difference in demographics or outcome measures, both groups showed statistically significant improvement in MBI (p < 0.001). The difference in change of MBI among both groups was significantly different (p = 0.046), with a greater percentage improvement demonstrated in the experimental group (28.6%) than the conventional group (23.9%). The FES scores of both groups were also significantly improved (p = 0.001), with the experimental group exhibited a greater FES percentage improvement (64.8%) than the conventional group (41.0%), even with insignificant differences (p = 0.097). Additional improvement was observed in cognitive function of the experimental group. Its Abbreviated Mental Test (AMT) scores significantly improved (p = 0.041) while the conventional group did not (p = 0.163). The group task-oriented circuit training model could be a better and more effective alternative to conventional OT hip fracture rehabilitation. The study further guides and facilitates enhancement in our rehabilitation service delivery.
