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) :
Lam J(1), Leung KKY(2), Chan MY(1), Hui WW(1), Wong PL(1), Tung WL(1), Chan WW(1)
Affiliation :
(1) Allied Health Department (Physiotherapy), Hong Kong Children’s Hospital
(2) Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital
Introduction :
Children who survive critical illness in the Pediatric Intensive Care Unit (PICU) may have major physical, cognitive, and psycho-behavioral morbidities, which lead to functional impairments, limited movement and a lower quality of life. Symptoms such as fatigue, pain and anxiety might further reduce a patient's motivation and capacity to participate in PICU rehabilitation. Nintendo RingFit-based exercise training have recently been evaluated their potential capability to enhance physical activity and balance. However, there are no studies to investigate the potential benefits of it for paediatric patients who managed in PICU.
Objectives :
The study aim to evaluate the potential benefit of implementing ringfit- based training on the muscle strength and balance and at-the-moment perception in children hospitalized in the Pediatrics Intensive care Unit.
Methodology :
Participants were recruited from the PICU of the Hong Kong Children’s Hospital, they were randomized (1:1 block) into either into a conventional group (C) or intervention group (I). In the conventional group, participants received conventional physiotherapy training including chest physiotherapy, mobilization and strengthening exercises. While in the intervention group, participants received conventional physiotherapy plus an additional 20-min Nintendo RingFit-based exercise training in a seated position on Chair. Outcome measures includes manual muscle testing, Paediatric Balance Scale (PBS), Peds QLTM Present Functioning Scales (PedsQL™ VAS: measures anxiety, sadness, anger, worry, fatigue, and pain), as well as satisfaction survey. They were taken before treatment, immediately after treatment, and upon PICU discharge.
Result & Outcome :
The study was completed by 28 participants aged 4 to 17 years (mean 12±3.59 years). There was significant improvement in all outcome measures in both groups upon PICU discharge (p< 0.05). Specifically, the intervention group showed significantly better muscle strength (upper limbs: I:4.62±0.42 vs C:4.02±0.69; p = .04; lower limbs: I: 4.82±0.32 vs C:4.01±0.34; p = .04 ), PBS score (I:39.3±5.96 vs C:30.2±4.86; p = .04), total symptom score (I:2.43±3.12 vs C:.4.15±3.86; p =.04) and emotional distress summary score (I:1.23±2.96 vs C:3.2±1.86; p = .04) at average 7.3 sessions as compared to the control group. In addition, there was significant reduction in PedsQLTM VAS - anxiety (from 6.15±1.2 to 4.75±0.9, p =.04 ) and worry scores (from 6.16±0.9 to 3.64±1.1, p =.03) immediately following one session of Nintendo RingFit-based exercise training. For the satisfaction survey, around 92.8% of the participants agreed that the Nintendo RingFit-based exercise training is “interesting”, “can motive them to sit out of bed earlier” and “can encourage to exercise more in hospital environment”.
The Nintendo RingFit-based exercise training provides additional beneficial effects on muscle strength, balance, and self-perceived present functioning (e.g. anxiety, sadness, anger, worry, fatigue, and pain) for patients managed in PICU. Specifically, it provides immediate reduction in anxiety and worries after the intervention. Patients appreciated the implementation of RingFit-based exercise training, which may motivate them to sit out and exercise more in PICU setting.
