Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Leung CF(1), Wan S(1), Tsang NC(1), Yeung SF(1), Kwong S(2), Lui WM(2), Mok WY(3), Yam SK(3)
Affiliation :
(1) Physiotherapy Department, PYNEH, (2) Physiotherapy Department, RTSKH, (3) O&T Department, HKEC
Introduction :
Decompression lumbar surgery is a common procedure in treating lumbar spinal disorders, yet elderly patients often doubt its effectiveness and safety. Allied Health Triage Clinic (AHTC) plays an important role in triaging cases with spinal disorders to ensure timely medical care. For cases proceeding to operation, AHTC provides spinal assessment and intervention to evaluate functional outcomes. As aging population becomes severe, this study aims to explore outcomes of surgical intervention in patients of age 60 or above.
Objectives :
1. To collaborate with O&T Department and provide fast-track, timely and effective care
2. To provide physiotherapy assessment, intervention, and functional outcome evaluation before and after surgery
Methodology :
From August 2017 to October 2023, 117 patients aged 60 or above (mean age 68.3 years, 50.4% female) were assessed preoperatively, postoperatively 6-month, postoperatively 2-year. Outcome measures included Oswestry Disability Index (ODI), 6MWT, 30-Minute Standing Tolerance (30MST), and Redefine Standing Tolerance. Physiotherapy intervention included stretching and core strengthening, neural mobilization, lifestyle modification.
Result & Outcome :
Significant improvement was found in ODI 6 months after (from 45.3% to 27.4%, p<0.001) and 2 years after lumbar surgery (from 45.3% to 28.8%, p<0.001).
Significant improvement was found in 30MST 6 months after (from 22.7 to 26.8 minutes, p<0.001) and 2 years after lumbar surgery (from 22.7 to 27.0 minutes, p<0.001).
Significant improvement was found in redefine standing tolerance 6 months after (from 4.91 to 5.97, p<0.001) and 2 years after lumbar surgery (from 4.91 to 6.09, p<0.001).
There was significant correlation between redefine standing tolerance and ODI before (-0.381, p<0.001), 6 months after (-0.600, p<0.001) and 2 years after lumbar surgery (-0.603, p<0.001). There was a strong, negative correlation between them. Those with higher redefine standing tolerance tend to have lower ODI.
Results showed that patients aged 60 or above obtained improvement after surgery. Decrease in LBP improves standing tolerance and ADL. Functional disability level and QOL were enhanced in terms of pain control and standing tolerance.
Evidence supported that collaboration between O&T Department and Physiotherapy Department in Spine Triage Program had an important role in patient journey before and after lumbar surgery.
