Authors (including presenting author) :
Li HT(1), Leung CF(1), Tsang NC(1), Wan SY(1), Yeung SF(1), Mak YK(2), Wong MK(2), Yam SK(2), Lam KM(3), Lee YY(3)
Affiliation :
(1)Physiotherapy Department, PYNEH, (2)Department of O&T, PYNEH, (3)Department of SOP, PYNEH
Introduction :
The SAFE (Screening Assessment Fast-track Education) program is a doctor-led collaborative program established in 2009. The triage program was enhanced in October 2024 with face-to-face consultation for improved triage screening and timely physiotherapy interventions. Previous SAFE program research identified gender-specific associations between body composition and osteoarthritis knee pain, suggesting a higher skeletal muscle mass (SMM) correlates with lower pain and better function in males, while a larger waist-to-hip ratio (WHR) is linked to increased pain and reduced physical ability in females. This pilot study evaluates the effectiveness of gender-specific training for knee osteoarthritis patients in the SAFE program, emphasizing muscle strengthening for males and weight management for females.
Objectives :
(1) Evaluate the effectiveness of gender-specific training for knee osteoarthritis patients.
(2) Assess patient satisfaction in the enhanced SAFE program.
Methodology :
Physiotherapy interventions included strengthening exercises, stretching, pain modalities and education. Based on the mentioned study, Neuromuscular and Muscular Electrical Stimulation for increasing muscle mass is added for males, while dietary and lifestyle advice are provided and emphasized to females for managing weight and lowering WHR. Outcome measures include pain score, Knee Injury and Osteoarthritis Outcome Score (KOOS), walking tolerance, SMM, percentage body fat (PBF), WHR, and patient satisfaction from 0 to 10.
Result & Outcome :
From October 2024 to January 2025, 11 patients (mean age 71.0 ± 5.66 years, 45.5% female) were assessed before and after 3 to 5 physiotherapy sessions. Significant improvement were found in pain score (from 4.91 to 2.64, p<0.001), KOOS-KP (from 60.82 to 69.55, p<0.001), KOOS-KPS (from 66.18 to 74.00, p<0.001), and KOOS-KQ (from 46.73 to 62.73, p<0.001). Walking tolerance improved significantly (from 28.18 minutes to 44.55 minutes, p<0.001). There was no significant improvement in SMM (p=0.071), PBF (p=0.077) and WHR (p=0.054). Patient satisfaction averaged 8.36 out of 10.
The enhanced SAFE program effectively controls pain and improves function for knee osteoarthritis patients awaiting O&T consultation with high patient satisfaction. It serves as a safety net for physiotherapists to identify those needing earlier O&T attention while providing timely interventions to prevent deterioration during the waiting period. Aging population with knee osteoarthritis is common. Therefore, SAFE could also help patients to maintain their comorbidity health conditions in the patient journey. Further research with longer duration, larger sample size and comparison group is recommended.
