Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Chan WK, Ho CM, Lau ST, Au BKM
Affiliation :
Department of Occupational Therapy, Tai Po Hospital
Introduction :
In Hong Kong, stroke is a major cause of morbidity and mortality. Stroke is one of the significant factors of fall because of impairment in balance, gait, visuospatial/hemi-neglect, cognitive function and functional performance. Lifestyle-integrated functional exercise (LiFE) (2010) is widely adopted to reduce falls and improve functioning by embedding balance and strength activities into participants’ daily tasks and routines for community dwelling elderly. Research stated that a habituation of LiFE program is essential to improve balance and prevent falls. There is a service gap in LiFE program from the transition period between in-patient and GDH, therefore, a seamless rehabilitation service is required.
Objectives :
To evaluate the effectiveness of Daily LiFE program to stroke patients by exploring functional ADLs, fall efficacy and their satisfaction to the program.
Methodology :
Participants were recruited from Medical and Geriatric in Tai Po Hospital from July 2022 to Aug 2023. The inclusion criteria were: 1) diagnosed with stroke, 2) cut-off > 7th percentile in Montreal of Cognitive Assessment (MoCA), 3) MBI>60 with at least minimal assistance in ADL and 4) potential discharge home. Pre-discharge home visit with patient and carer training will be conducted. A pilot study of 34 stroke patients were recruited to attend 20-minutes LiFE training daily for 1 week. Outcome measures were: 1) Modified Barthel Index (MBI), 2) Fall Efficacy Scale (FES), 3) Short Physical Performance Battery (SPPB), and 4) Patient’s satisfaction survey.
Result & Outcome :
Twenty-five man and nine woman were recruited. Mean age of the participants was 67.2 (SD 1.54). Paired Sample T Test was conducted to analyze the data by comparing mean of the pre-and post-outcome measures. The results showed that there was a statistically significant change in MBI (t=-5.750, p =0.000), SPPB (t=-4.700, p=0.000) and FES (Z=-3.036, p=0.005). In patient’s satisfaction survey, all participants agreed that LiFE could enhance their knowledge on fall prevention, meet their daily needs and apply in daily life at home. LiFE has showed to be effective in improving patient’s ADL and fear of falling. Further enhancement of LiFE is to implement telecare (HA Go) and home program. Ongoing pilot by promoting community reintegration with pre-discharge home visit for patients will be promoted.
