Authors (including presenting author) :
Choi WM(1), Lau CKD(1), Tsui SY(1), Cho CF(2), Fung YK(1), Cheung YW(1)
Affiliation :
1 Physiotherapy Department, Tseung Kwan O Hospital
2 Department of Medicines, Tseung Kwan O Hospital
Introduction :
COPD has a significant impact on patients’ life and health care resources. It ranked the second respiratory cause for hospitalization (14.6%) and inpatient bed-days (20.5%). To align with HA strategic plan direction for supporting safe early discharge, TKOH COPD Post Exacerbation Empowerment Program (PEEP) was developed in 2023 to improve patients’ outcomes with multidisciplinary empowerment. Physiotherapists prescribe exercises via HA-Go Mobile App and patients could engage in rehabilitation on their own time and location. In view of space and resources constraint in specialized outpatient centre, 1 min sit-to-stand (STS) test was adopted as one of exercise capacity tests.
Objectives :
1.To improve patient’s strength, exercise capacity and self-management efficacy
2.To explore alternative exercise capacity test suitable for centres with time, space or resources limitation
Methodology :
-Inpatient COPD patients are screened by respiratory nurse for joining PEEP
-Designated physiotherapist provides empowerment and Home Ex prescription via HA go in Ambulatory Medical Centre at post discharged week 1, 2 , 4 and 8
Session 1: Baseline physical outcomes assessment and bronchial hygiene empowerment
Session 2: HA Go prescription for breathing and mobilization Ex
Session 3: HA Go prescription for strengthening Ex
Session 4: Physical assessment outcomes reassessment and Home Ex reinforcement
-Discuss with Respiratory Physician about patients’ rehabilitation potential and progress
Result & Outcome :
Results:
Between August 2023 and Feb 2024, 52 COPD patients (M: 47, F: 5) with mean age 73.4 were recruited for PEEP. Thirty-eight patients completed PEEP. Their mean 6 minutes walk (6MW) test distance improved from 288m to 316m with the Rate of Perceived Dyspnoea (RPD) decreased from 3.1 to 2.9. The number of 1 min STS repetitions increased from 19.6 to 22.0. Their self-efficacy (0-10) on exercises and dyspnoea management increased from 5.8 to 7.1 and from 6.2 to 7.4 respectively. Wilcoxon Signed Ranks Test and Spearman's rank correlation coefficient were conducted with IBM SPSS version 14. All outcomes except RPD have shown statistically significant improvements (p<0.001). One min STS repetitions and 6MWD were correlated (r = .716; P < .001). The hospital unplanned readmission rate in 28 days of patient joining PEEP was 11.5%.
Conclusion:
Home based Exercise program via HA-Go Mobile App improves patient’s clinical outcomes and self-efficacy. The 1 min sit-to-stand test is a valuable alternative to 6MWT to estimate functional exercise performance in COPD patients especially for centres with time, space or resources limitation.
