Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second 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) :
Tsang TW Ray(1), Chan WY Jenny(1), Cheung CH(1), Cheung KW Kristy(1), Chow LY Dorothy(1), Fong ON Hannah(1), Lee TK Harry(1), Ho OL Lydie(1), Kwan WS Aggie(1), Ly YF Connie(1), Tse CW Eric(1), Mak MY Mandy(1)
Affiliation :
(1)Physiotherapy Department, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority
Introduction :
Handgrip strength measurement is an easy and quick assessment in inpatient setting. Foreign studies have proved handgrip strength is able to predict the rehabilitation potential of patients with geriatric hip fracture, but it is questionable whether the prediction is applicable to Hong Kong elderly in the setting of Hospital Authority as an aid to plan the rehabilitation framework and there is no standard on defining what is the meaning of different ranges of handgrip strength in terms of rehabilitation potential.
Objectives :
Through this study, we hope to 1.)investigate the correlation of handgrip strength and rehabilitation outcomes of geriatric hip fracture patients for Hong Kong elderly 2.)define the meaning of different ranges of handgrip strength 3.)use handgrip strength to predict the rehabilitation potential of patients 4.)formulate different training pathways and special training programs for patients with different ranges of handgrip strength in the future
Methodology :
The data of geriatric hip fracture patients with surgery was retrieved from the Clinical Management System(CMS) of Tuen Mun Hospital in Hospital Authority from April 2020 to March 2023. The Initial Handgrip Strength and Final Elderly Mobility Scale(Final EMS) were investigated for their correlation. There were total 1552 patients(Female 1013 and Male 539). All the patients aged 60 or above. The mean age was 81.31(Female 82.56, Male 78.95). Simple linear regression was done to determine the correlation of Initial Handgrip Strength and Final EMS. Initial Handgrip Strength: The handgrip strength of the dominant hand was measured at the first attendance of physiotherapy assessment in supine lying using the Jamar Hand Dynamometer. Final EMS: The Elderly Mobility Scale(EMS) of the patient was assessed after completion of a course of rehabilitation before discharge from the hospital.
Result & Outcome :
Through simple linear regression, there was a significant relationship between Initial Handgrip Strength and Final EMS(p=0.000). Initial Handgrip Strength was a significant predicator of Final EMS(p=0.000). The regression equation was generated for the relationship between Initial Handgrip Strength(X) and Final EMS(Y). All elderly: Y=0.347X+2.741. Female: Y=0.540X+1.572. Male: Y=0.335X+1.446. After a course of rehabilitation training, patients with EMS scores 10-13(are borderline in terms of safe mobility and independence in ADL) were having a satisfactory rehabilitation outcome. While the patients with EMS scores over 14(are able to perform mobility maneuvers alone and safely and are independent in basic ADL) were having a good rehabilitation outcome. Through the equations generated, patients with the following Initial Handgrip Strength should have a specific Final EMS. Initial Handgrip Strength(All elderly 20.9kg; Female 15.6kg; Male 25.5kg or higher), Final EMS should be 10 or higher. Initial Handgrip Strength(All elderly 32.4kg; Female 23.0kg; Male 37.5kg or higher), Final EMS should be 14 or higher. Therefore, patients with Initial Handgrip Strength(Female 15.6kg and Male 25.5kg or higher) should be considered as having satisfactory rehabilitation potential. And patients with Initial Handgrip Strength(Female 23.0kg and Male 37.5kg or higher) should be considered as having good rehabilitation potential. In the future, we can formulate different training pathways and special training programs for patients with different range of handgrip strength in order to provide the most suitable and efficient rehabilitation training to them.
