Authors (including presenting author) :
Leung DCH(1), Leung HKH(1), Tang TLM(1), Tsui AYC(1), Siu EHK(1)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital
Introduction :
Corrective surgical intervention for Adolescent idiopathic scoliosis (AIS) in the Prince of Wales Hospital (PWH) has been carried out under a standardized multidisciplinary pathway stipulated in 2018. Out-of-bed mobilization has been conducted at postoperative day 4, leading to the length of stay at an average of 11.1 days. An accelerated mobilization program endorsed by the Pediatric Orthopedic Division in PWH has been piloted in 2024.
Objectives :
(1) To reduce potential risks associated with prolonged immobilization; (2) To facilitate pain reduction and functional ability; (3) To shorten length of stay for better resource utilization.
Methodology :
A retrospective study was performed. Subjects were (1) patients with a principal diagnosis of AIS admitted under Pediatric Orthopedic Division; (2) included from the standard AIS-PSF operation list without known systemic comorbidities. Patients with postoperative complications causing permanent deficits requiring out-of-standard care will be excluded. Physiotherapy intervention was carried out daily, from the day of pre-operative admission to discharge. Additional service was arranged on Saturday, public and statuary holidays. Outcome measures were categorized as the average day of commencing: (1) Sit-out Training; (2) Independent Walking; (3) Stairs Training; and (4) total length of Stay.
Result & Outcome :
From January 2024 to December 2024, 18 patients were included with a mean Cobb's angle of 63.1 degrees. No adverse event occurred.
The day of (1) first sit-out is advanced from postoperative day 4 to a mean day of 2.33 (P<0.001); (2) achieving independent walking is advanced from postoperative day 6 to a mean day of 4.72 (P<0.001); (3) stairs walking is advanced from postoperative day 8 to a mean day of 6.22 (P<0.001). All mobility milestones were advanced under accelerated mobilization. Overall length of stay shortened from 11.1 days to 8.44 days (P<0.001).
Conclusion: The early mobilization in AIS-PSF advanced the time of achieving independent mobility, shortened the length of stay, and, in turn enhance clinical effectiveness.
