ABSTRACT
Purpose: A tele-rehabilitation service was implemented in a geriatric day hospital during the COVID-19 pandemic. We aim to assess the effect of physiotherapy tele-rehabilitation on enhancing service delivery and quality of patient care. Methods: 144 patients were recruited from a geriatric day hospital. They were provided with comprehensive assessment, individualised home exercise programme, advice and education, and continuous monitoring through telephone call, video call, and messaging. Assessments and interventions were conducted under safe condition and environment, with assistance from carers. Functional mobility and balance were measured using the Modified Functional Ambulation Classification (MFAC), Berg Balance Scale (BBS), Modified Rivermead Mobility Index, Timed Up and Go Test, and 6-Minute Walk Test. Reliability of the estimated MFAC (assessed by phone call or videotaping) was evaluated by comparing with the post-program MFAC (assessed by face-to-face session). Patient satisfaction and carer satisfaction were also assessed. Results: 114 patients completed the physiotherapy tele-rehabilitation programme and were evaluated within 14 weeks. Each patient received a mean of 4.9 sessions. The mean times for initial assessment and follow-up assessment were 36.7 minutes and 18.2 minutes, respectively. After the programme, patients had significant improvement in ambulatory status (MFAC: 4.94 vs 5.15, p<0.05), balance (Berg Balance Scale: 29.97 vs 32.37, p<0.05), functional mobility (Modified Rivermead Mobility Index: 28.12 vs 29.30, p<0.05), and walking endurance (6-Minute Walk Test: 135.09 m vs 155.29 m, p<0.05), and walking speed (Timed Up and Go Test: 44.95 minutes vs 40.31 minutes, p=0.14). The estimated MFAC and post-programme MFAC were comparable (5.27 vs 5.15, p=0.071). Therefore, estimation of MFAC using telephone call or videotaping during tele-rehabilitation was reliable in assessing ambulatory status. The patient satisfaction rate was 100%. Conclusion: The physiotherapy tele-rehabilitation programme is a feasible mode of service delivery. It is a convenient complementary service model to conventional physical training for enhancing quality of care.