Page 110 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP1.7 Patient Empowerment 10:45 Room 221

Monday, 18 May HAPPY Programme – Pilot Physiotherapy Exercise Training Programme for Haemodialysis Patients in Tseung
Kwan O Hospital
Yick CY 1, Choi WM 1, Ho TL 2, Yeung S 2, Au TK1, Cheung YW 1
1Physiotherapy Department (Intergrated Rehabilitation Services), Tseung Kwan O Hospital, 2Department of Medicine,

Tseung Kwan O Hospital, Hong Kong

Introduction

Patients with chronic kidney disease have limited exercise capacity. Their functional capacity is only 60% to 70% of healthy
age-matched individuals. Reduced physical functioning is associated with increased mortality, poorer quality of life and
higher risk of fall. Previous studies showed that exercise training can improve physical functioning and performance.
HAemodialysis Patient PhYsical Exercise programme (HAPPY programme) is set up in Tseung Kwan O Hospital (TKOH) in
collaboration with haemodialysis centre (HDC) since 2014, which provides physiotherapy exercise training for patients during
haemodialysis.

Objectives

To evaluate the effectiveness of HAPPY programme on physical capacity, self efficacy and quality of life of renal patients
receiving haemodialysis.

Methodology

Patients receiving haemodialysis were recruited by nephrologists and referred to physiotherapists. Baseline physiotherapy
physical assessment was conducted before participating in the HAPPY programme. Evaluations were performed after three
months and six months of training. Components of HAPPY programme included physical assessment, weekly intradialytic
exercise, cycling exercise based on patients’ rate of perceived exertion, home exercise programme prescription, identification
of patients with fall risk and referral for intervention. Outcome measures included a six-minute walk test, time up and go test,
Short-Form Health Survey (SF-36) on quality of life, self-efficacy and patients’ satisfaction.

Results

From January 2014 to January 2015, 12 patients (mean age: 59, sex: 5 male and 7 female) were referred to the HAPPY
programme at different periods. Eight of them completed the reassessment at three months, while four of them completed
the reassessment at six months. Some of them were pending for reassessment. The mean pre- and post-programme
outcomes were compared after six months of training. Six-minute walk test improved from 275.0 metres to 307.3 metres.
Time up and go test improved from 19.3 seconds to 12.6 seconds. Total SF-36 score increased from 49.0 to 59.5. Physical
health domain under SF-36 increased from 44.5 to 58.5 while mental health domain increased from 47.5 to 55.8. Self-efficacy
enhanced from 4.8 to 6.5. As reflected by the questionnaire results, all patients were satisfied with the HAPPY programme
arrangement. The pilot HAPPY programme is shown to improve exercise capacity, functional mobility and quality of life for
patients with haemodialysis treatment. Further review on continuation of one-year physiotherapy exercise programme is
warranted.

HOSPITAL AUTHORITY CONVENTION 2015

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