Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Yeung EMP (1), Tsang KY (2), Li KT (2), Tai ML (1) Chan Dora (2), Yu TKK (1)
Affiliation :
(1) Department of Rehabilitation (2) Occupational therapy Department, Kowloon Hospital
Introduction :
With the support from Hong-Kong-Jockey-Club, JCIRDC in Kowloon Hospital started to provide the one-stop comprehensive NRD program for patients with acquired brain injury (ABI) since January 2022. Our occupational therapists provided individualized neuro-rehabilitation in focusing on patients’ cognitive remediation, upper limb and hand function training. These training components can be generalized and integrated into patients’ activities-of-daily-living (ADL), work and leisure activities, which facilitate their community reintegration and return to work.
Objectives :
To evaluate the cognitive, upper limb/ hand function and functional outcomes after NRD provided by occupational therapist via different smart rehabilitation technology in JCIRDC
Methodology :
A retrospective analysis was conducted for ABI patients who received occupational therapy from 1 April 2022 to 31 March 2023 at JCIRDC. Abbreviated-Mental-Test (AMT), Montreal-Cognitive-Assessment (HK-MOCA), Functional-Test-for-the-Hemiparetic-Upper-Extremity (FTHUE), 9-Hole-Peg-Test(9HPT), Modified-Bathel’s-Index (MBI), Functional-Independence-Measure (FIM) and Lawton-Instrucmental-Activities-of-Daily-Living (IADL) were assessed on admission and discharge from JCIRDC.
Result & Outcome :
Data from 122 discharged NRD-patients were included. 87%(n=106) of patients had stroke, 8%(n=10) had traumatic-brain-injuries, and 5%(n=6) had other-neurological-conditions. The average age of patients was 63±1 and 43%(n=52) were female.
Total-number-of-occupational-therapy-sessions delivered to patient was 21.22±6.36. In Cognitive performance, significant improvements were shown in AMT (admission AMT 6.67±3.21, discharge AMT 6.95±2.93, p=0.013) and HK-MOCA (admission MOCA 19.64±6.57, discharge MOCA 20.81±6.74, p=0.00). In upper limb and hand function outcomes, significant improvement was shown in FTHUE (p=0.00), and 9HPT was conducted for those who attained FTHUE level 5 or above (admission left 9HP 40.92±26.43sec, discharge left 9HP 33.62±23.39sec, p=0.01; admission right 9HP 33.30±16.34sec, discharge right 9HP 28.17±9.87sec, p=0.03). For basic ADL and IADL, MBI (admission MBI 76.47±20.77, discharge MBI 84.06±19.25, p=0.00), FIM (admission FIM 92.42±21.00, discharge FIM 99.73±20.31, p=0.00) and Lawton-IADL score (admission score 10.59±6.65, discharge score 12.11±7.26, p=0.00) were significantly improved after discharge from JCIRDC.
In subgroup analysis, the younger age group (<65 year-old) showed significantly better improvement in FIM gain (9.03±7.90 vs 5.59±5.95, p=0.001), Lawton-IADL gain (2.19±2.69 vs 0.86±1.78, p=0.001) and FTHUE gain (0.34±0.63 vs 0.11±0.37, p=0.011) than the group ≥65-year-old.
Conclusion:
The NRD program provided by occupational therapist significantly improved the cognition, upper limb/ hand function, ADL and IADL of patients with ABI, which enhance their independence in the community after discharge from JCIRDC.
