Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Tang SF (1), Wong CK (1),HU SF (1), Cheung WY (2), Ng YL (3), Lo Estella (4)
Affiliation :
(1) Department of Physiotherapy, MacLehose Medical Rehabilitation Centre (2) Department of Orthopaedics and Traumatology, Queen Mary Hospital (3) Department of Occupational Therapy, MacLehose Medical Rehabilitation Centre, (4) Department of Nursing, MacLehose Medical Rehabilitation Centre
Introduction :
Tai Chi is an ancient exercise originating from China which includes sequential slow and relaxed physical movements combined with deep breathing. The movement helps strengthen the muscles in the abdomen and pelvic areas. Meta-analysis of Tai Chi in treatment lumbar spondylosis concluded that it might reduce pain and functional disorders. However, there were limited research on seated Tai Chi(STC). OVF is the most common type of osteoporotic fracture among the elderly. It can lead to severe pain, spinal deformities, decreased mobilities, lower functional independence and increased risk of relapse. In July 2022, a multi-disciplinary orthopaedic day rehabilitation program was launched in MMRC. Many OVF patients have impaired mobilities or wheelchair-users. STC incorporates elements of core stabilization, balance, postural alignment and concentration. It is also appealing because no special equipment is needed and is suitable for patient to do it at home or even in old aged home.
Objectives :
To evaluate the outcomes of OVF patients joining the rehabilitation program
To evaluate the additional values of seated Tai Chi for OVF patients
Methodology :
This program was composed of 13 half-day sessions of physiotherapy and occupational therapy training, doctor medical consultation and nursing care advice. The physiotherapy program consisted of pain relief modalities, core stabilization, limbs strengthening exercises, stretching exercises, balance exercises for functional and gait training. Ten movements of seated Tai Chi were also incorporated into the program since April 2023. To promote self-management, home exercise was prescribed through pamphlets and HA Go Application with involvement of caregivers. Baseline assessments were performed upon the first visit and the outcome measures used include Numeric Pain Rating Scale (NPRS), Elderly Mobility Scale (EMS) and Roland-Morris Disability Questionnaire (RMDQ). The outcomes were reassessed in the last session. Numeric global rating of change scale (NGRCS) was also measured for the overall change in patient status. The compliance was measured by the attendance rate.
Result & Outcome :
From 4th July 2022 to 30th November 2023, 176 patients were recruited. 141 of them (117 females and 24 males) completed the program, with mean age 76.6.Upon completion, there was perceived improvement in overall status of most patients with mean NGRCS +6.24. Significant reduction in NPRS (MD=-2.45, p=0.00) and improvement in EMS (MD=+1.89, p=0.00) were shown, indicating the beneficial effects of the program on pain relief and functional mobility restoration. The significant decrease in RMDQ (MD=-6.15, p=0.00) reflected the reduction of physical disability. The number of patients in non-STC and STC group were 79 and 62 respectively. Although there was no statistically significant difference among all outcomes. The compliance rate was greatly improved from 67% to 92% with the introduction of STC. To conclude, STC has significantly enhanced compliance rate and is safe for OVF patients. The promotion of STC application in Geriatric Day Hospital and telehealth could be further explored.
